THEORY, PRACTICE AND EVIDENCE IN OCCUPATIONAL THERAPY A DYNAMIC Essay

THEORY, PRACTICE AND EVIDENCE IN OCCUPATIONAL THERAPY A DYNAMIC TRILOGY - Essay Example Dissociative disorders may be thought of in terms of adaptation. The dissociative response to stress has served an adaptive role in the patient's life in the past in that it has protected the person against the full-blown impact of intense emotional pain and trauma. By the time someone with dissociative problems is in treatment or is seen by an occupational therapist, the dissociate is no longer adaptive. It interferes with the person's ability to face and cope with reality, and thus with the ability to function. The purpose of occupational therapy treatment for patients with dissociative disorders is twofold. Patients need first to recognize their fear of experiencing emotions and begin to allow and accept their feelings. They need to recognize formerly traumatic events that hold many conflicting, painful feelings for them. Occupational therapy and expressive and cognitive media can aid in individual's exploration toward self-awareness. Second, occupational therapy can help people learn new functional ways of coping when their fears interfere with functioning and daily life. The acknowledgement and acceptance of painful emotions can be very frightening for patients with dissociative disorders who understandably may have a difficult time choosing to face their difficult realities over choosing a more familiar and comfortable escape. It takes time and the development of a trustworthy therapeutic relationship for patients to be willing to risk this change. Part of "accepting" feelings involves learning more effective ways to cope with the accompanying pain rather than escaping into the altered reality or different personality. This involves, first, learning to recognize personal patterns of dissociation - in other words, when, where, how and under what circumstances dissociation tends to occur - in order to avoid using these old patterns when stress increases. Second, it involves relearning and learning specific new strategies for coping with stresses that may have induced the person to dissociate in the first place. The integrating of personalities means that some personalities will no longer exist as separate and distinct. Alters typically perform specific, compartmentalized functions. Talents and skills that may have resided with one alter may thus be lost, resulting in a loss of familiar ways of coping. Therefore, the newly integrated individual may have much to relearn. An individual will typically have learned to dissociate to the exclusion of learning other, adaptive ways of coping. In this case, unfamiliar new ways of coping must be learned and new roles may have to be taken over and learned by the remaining personality or personalities. Occupational therapists, in conjunction with other members of the treatment team, can assist patients with dissociative disorders in all the ways described in the succeeding sections of the paper. The Therapeutic Approach Occupational Therapists can aid the therapy team by gathering historical information. This may often be expressed through a nonverbal medium (art, drawing, sculpting, and crafts) and thus is more likely to be facilitated in the occupational therapy process than in other therapies. Through the same process, occupational therapists can learn general information about specific alter personalities such as their names, ages, reasons why they were created and functions they serve for the