By Wasim Kakroo
Dissociative disorders are a group of psychological conditions characterized by disruptions in a person’s memory, identity, awareness, perception, and/or sense of self. These disorders can significantly impact an individual’s daily life, affecting their relationships, work, and overall well-being. In today’s article, we will try to provide an overview of the different types of dissociative disorders, their potential causes, and available treatment options. Furthermore, we will aslo delve into the cultural aspect specific to Kashmir, where dissociative disorders are often misunderstood and mistaken for possession by a jinn, leading individuals to seek help from faith healers, resulting in potential harm and abuse.
I. Types of Dissociative Disorders
1. Dissociative Amnesia: In this condition, a person experiences significant memory loss due to traumatic or stressful events, leading to an inability to recall important personal information and experiences.
2. Depersonalization-Derealization Disorder: Individuals with this disorder feel disconnected from themselves and the world around them, experiencing a sense of detachment or unreality.
3. Dissociative Identity Disorder (DID): Formerly known as multiple personality disorder, DID involves the presence of two or more distinct identities or personality states, each with its own memories and behaviors.
II. Causes of Dissociative Disorders
1. Trauma and Abuse: Severe trauma experienced during childhood, such as physical, sexual, or emotional abuse, can trigger dissociative disorders as a coping mechanism to protect the individual from overwhelming pain of reality.
2. Genetics and Neurobiology: There may be a genetic predisposition to developing dissociative disorders. Neurobiological factors, such as alterations in brain structure and function, may also contribute to the development of these disorders.
3. Coping Mechanism: Dissociation can be seen as a defense mechanism to cope with intolerable stress or overwhelming situations.
III. Treatment of Dissociative Disorders
1. Psychotherapy: The primary treatment for dissociative disorders is psychotherapy, specifically, specialized approaches such as Acceptance and Commitment Therapy (ACT), cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) that focus on trauma processing and integration of dissociated experiences. Psychodynamic psychotherapy can also be a very good option to understand the links with past abuse.
2. Medication: While there is no specific medication to treat dissociative disorders, antidepressants, anti-anxiety, and antipsychotic medications might be prescribed to manage accompanying symptoms like depression, anxiety, and hallucinations.
3. Self-Help Strategies: Patients can learn grounding techniques and coping strategies to manage dissociation when it occurs.
IV. Dissociative Disorders and Kashmiri Culture
The culturally rich region of Kashmir is a place where deep-rooted beliefs and practices play a significant role in shaping the perception and treatment of mental health issues, including dissociative disorders. As one delves into the unique cultural context, it becomes apparent that traditional beliefs in jinns, supernatural spirits, and black magic exert considerable influence on mental health attitudes and practices within the community. This interplay between cultural beliefs and mental health presents both challenges and opportunities for the well-being of the people living in this region.
One of the primary challenges arises from the confusion between mental health issues and jinn possession. The lack of awareness and education about mental health conditions can lead to individuals experiencing dissociative symptoms being misunderstood and wrongly attributed to being possessed by jinns. This misconception may result in delays in seeking appropriate mental health care, as people may turn to religious or spiritual interventions instead of seeking professional help. Addressing this challenge requires efforts to promote mental health literacy and awareness, encouraging open discussions about mental health within the community.
Within the cultural context of Kashmir, faith healers, commonly known as “pirs” or “fakirs,” hold significant influence and are often sought after for help with psychological problems. While some faith healers may have good intentions, the lack of proper psychological training can lead to misdiagnoses and the employment of harmful practices. Individuals with mental health issues may be subjected to rituals and treatments that do not address the root causes of their conditions, potentially exacerbating their suffering. Combating stigma associated with mental health and fostering collaborations between mental health professionals and faith healers could bridge the gap between traditional beliefs and modern mental health care.
However, the prevalence of unregulated faith healers in the region also presents a darker side to this issue. Some self-proclaimed faith healers exploit the vulnerability of individuals seeking help, subjecting them to emotional, physical, or even sexual abuse under the guise of healing rituals. The lack of proper regulation and oversight in this domain contributes to the perpetuation of such abuses. Therefore, establishing mechanisms to ensure accountability and protect the well-being of those seeking help from faith healers is crucial.
Addressing mental health challenges in Kashmir calls for a comprehensive approach that respects the cultural heritage while also embracing evidence-based mental health practices. Engaging local leaders, community influencers, and religious figures in mental health advocacy could facilitate positive change. It is essential to create safe spaces for open discussions about mental health, where traditional beliefs and modern science can coexist harmoniously.
- The author is a licensed clinical psychologist (alumni of Govt. Medical College Srinagar) and works as a Child, Adolescent and Family therapist at Centre for Mental Health Services (CMHS) at Rambagh Srinagar. He can be reached at 8825067196
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