This is a brief summary of how the most important human mental functions function. They are all integrated, i.e. they function together at one point in time. In dissociative disorders, one of these functions is temporarily (dissociative stupor) or permanently (dissociative amnesia) switched off.

The cause of this disintegration of mental life is psychological trauma (traumatic events, 'unresolvable' and 'no-go' situations, severe social dysfunction) or unresolved intra-psychic conflict, resulting in a constant feeling of anxiety. A person is able to adapt to, practically, any situation - such a traumatic one too. This does not mean, of course, that such adaptation means that the problem is solved, but it allows one to function. Dissociative disorders are also a kind of adaptation, because they disable from consciousness certain mental functions that lead to anxiety. The onset of such disorders allows a relative mental balance to be maintained for a while.

The most common dissociative disorders include:

• Dissociative amnesia - the repression of traumatic, unresolved events from memory. Forgetting is in no way a resolution of the conflict, but only a 'cure'.
• Dissociativefugue - under this term is a period covered by oblivion in which the patient undertakes relatively conscious actions, usually aimless marching. Often following highly stressful events. Running away, covered by oblivion, also does not resolve the cause of the problem.
• Dissociative stupor - this is when we see increased motor inhibition, mutism (i.e. speech inhibition), lack of contact with the environment, refusal to take meals and even carelessness to attend to physiological needs properly.

Some individuals are more predisposed to developing dissociative disorders

This is related to the different resilience of specific individuals to psychological stress, to the possession of personality traits that either facilitate or hinder the resolution of conflicts, problems. (too much repetition, already been removed) Certainly an important factor contributing to the development of dissociation in a particular patient is certain personality disorders, i.e. deeply ingrained, persistent, non-adaptive patterns of relating to, thinking about and perceiving the environment. These patterns are so strongly instilled in the thinking of the individual that they cause difficulties in social and behavioural functioning.

Different traits can be disturbed, so that the predisposition of a particular disorder to dissociation varies. Dissociative disorders are not observed in the dissocial personality (formerly called psychopathic), which is characterised above all by a complete lack of empathy and even contempt for and violation of other people's rights. And what personality disorders will correlate with the occurrence of dissociative disorders?

Certainly all those disorders in which there is a strong anxiety component. Personality is a permanent, ingrained state; it is not possible to change it within days or months. This permanence, coupled with an anxious attitude is a very strong predisposition for dissociation to occur. If the patient's mental state is permanently burdened by anxiety, he or she wants, by whatever means, to free themselves from this anxiety. Such a possibility is created, for example, by dissociative amnesia - forgetting, which, however, does not in any way resolve the situation that led to this anxiety. Personalities with a strong anxiety component can include:

• Borderline (borderline) personality - a pattern of behaviour dominated by instability in interpersonal relationships, self-evaluation and affect, and marked explosiveness.
• Avoidant(avoidant, fearful) personality - a pattern of behaviour dominated by manifestations of social inhibitions, feelings of inadequacy and hypersensitivity to negative evaluation.

Dissociative disorders, photo: shutterstock

Other personality disorders can also, especially with additional environmental factors, lead to dissociative disorders. For example, if a person with an anankastic personality (characterised by a morbid preoccupation with order, perfectionism, and excessive mental control in interpersonal interactions at the expense of flexibility, openness and efficiency) takes a job where he or she encounters a toxic boss who, for example, will negate the quality of the work the person does, while publicly humiliating, ridiculing or criticising the person's appearance, a persistent anxious attitude may develop in that person. When something extremely stressful happens, dissociation can occur - e.g. a dissociative stupor. Let us emphasise that such a 'solution' in the form of a stupor is obviously not a solution to the problem, but only a temporary attempt to maintain mental balance.

Dissociative dis orders are in the ICD-10 (International Classification of Diseases) a subgroup of anxiety disorders, i.e. anxiety is the main cause. Therefore, in the search for causes or comorbidities in a person, those with an anxiety component should mainly be considered. Undoubtedly, certain personality disorders predispose to dissociative disorders - most often borderline, avoidant or anankastic personalities. If we have such people in our surroundings, let's try to talk, relieve the burden, suggest a visit to a psychiatric specialist. Anxiety can be treated! A combination of pharmacotherapy and psychotherapy produces clear results. It is not worth waiting until personality problems are joined by other problems of a psychological nature.