A Case Study Illustrating the Interplay Between Psychological and Somatic Dissociation

The concept of Dissociation was originally conceived as having a psychological and a somatic component. Nevertheless, recent versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) have isolated both elements. In the DSM the psychological manifestation of dissociation is diagnosed as a Dissociative Disorder and the somatic domain is diagnosed as a Somatoform Disorder. However, recent empirical and clinical evidence have been highlighting and corroborating a high degree of comorbidity between such disorders and a constant interplay between somatic and psychological dissociation. In the following case study, the clinical constellation of the patient nicely illustrates that her dissociative defenses began as a Conversion Disorder and how, after a mishandling of the case by a clinician, her dissociation symptoms were instantly transformed in a typical Dissociative Amnesia Disorder. Cases like this convincingly illustrate how the dissociative defenses not only subsume the mental but also extend to the bodily domain.