Dissociation - En kvalitativ studie om begreppets användning och användbarhet inom allmän vuxenpsykiatri

Sammanfattning: Dissociation is a term used ambiguously to describe one or several phenomena. Psychologists working in general adult psychiatry in Skåne were interviewed about their understanding and use of the term dissociation in relation to their work with patients. An aim of the study was to describe the use of the term in a clinical context that does not offer specialized trauma treatments. Another aim of the study was pragmatic; to make any tacit knowledge explicit to contribute to discussion between psychologists about dissociation in a clinical context. The material was analyzed thematically. The results show that dissociation is primarily conceptualized as a defense against intolerable stress, taking the form of interpersonal difficulties, lack of integration and alterations in states of consciousness. Dissociation was described as symptoms rather than in terms of the dissociative syndromes. A prominent theme was that dissociation is hard to conceptualize, assess and treat, and that there is a perceived lack of knowledge and a concern about continuous loss of knowledge. A counterbalance to these difficulties is a strong interest in dissociation, and commitment to patients who dissociate. The psychologists described psychodynamic and cognitive behavioural therapy differently regarding treatment possibilities.