Dissociation and psychosis: understanding their interplay in a psychotherapy case example

The interface of psychosis and dissociative disorders presents us with both theoretical and practical clinical problems. The two distinct psychopathological discourses share historical roots, but have evolved largely in there... [ view full abstract ]

The interface of psychosis and dissociative disorders presents us with both theoretical and practical clinical problems. The two distinct psychopathological discourses share historical roots, but have evolved largely in there own realms, as distinct ways psychopathological seeing. Recent advances in the field of dissociative disorders have promoted questioning on the borderline area between these clinical concepts and urge us to recognise novel ways of understanding psychotic phenomena. In this paper I elucidate this borderline area with the help of a clinical case report on the psychotherapeutic treatment of a patient, who has gotten multiple diagnoses relevant to this area (Major Depressive Disorder, Bipolar Disorder, Schizo-affetive disorder, psychotic level Obessive-Compulsive Disorder). The clinical diagnosis with best clinical face value in this patient is psychotic OCD and the psychotherapeutic treatment of this client takes simultaneously place on the distinct levels of 1. Work on early emotional life and interpersonal traumatization that mostly takes place in EMDR-therapy associated meeting place exercises, where dissociated emotional parts are led to communicate between themselves for greater internal integration and, 2. behaviourally oriented treatment of OCD-symptoms.