Dissociation and mental health

This thesis consists of three papers: a literature review, an empirical paper and a reflective paper. The systematic literature review examines the role of dissociation within eating disorders. Thirty-four articles meeting the inclusion criteria were identified through database searches and manual searches. The findings of these articles were reviewed and critically appraised. The evidence reviewed indicates that dissociation in people with an eating disorder diagnosis may have a number of roles. Individuals with an eating disorder diagnosis may use dissociation as a means of managing certain affective states and dissociation may also act as a means of separating oneself from eating disorder symptomatology. In addition, dissociation may play a role in the development of eating disorders in individuals who have also experienced trauma. Methodological limitations, clinical implications and future research recommendations are considered. There is a need for staff in eating disorder services to be aware of dissociation and to use or develop interventions which take this into consideration. Further research, using a wider variety of methodologies, is needed, in particular to further elucidate the relationship of dissociation to eating disorder symptomatology. The empirical paper is a qualitative exploration of the lived experience of dissociation in individuals with a diagnosis of psychotic disorders. Five participants were interviewed using semi-structured interviews. The transcripts of interviews were analysed using Interpretative Phenomenological Analysis. One super-ordinate theme emerged from the analysis. ‘Emotional impact of unsafe uncertainty’ describes the emotions evoked by dissociative experiences and the uncertainty that surrounds exploration of these experiences for participants. Themes are discussed and considered in relation to clinical implications. Further research is needed to more carefully consider the role of dissociation within psychotic disorders. Finally, the reflective paper discusses the author’s experience of the process of research and exploring experiences of dissociation in individuals with a diagnosis of psychotic disorders. This paper utilises an Acceptance and Commitment Therapy approach to support personal reflection and reflexivity