This document summarizes a case study of a 37-year-old woman with dissociative identity disorder due to long-term sexual abuse. She began experiencing flashbacks and identity fragmentation at age 30, taking on differentiated and opposed personality components. The persistence of her dissociative symptoms over many years and their negative impact on her functioning provide evidence of a correlation between chronic trauma and long-term dissociative disorders. Her dissociative personalities included an aggressive entity, central organizer, representations of her abusive father and silent mother, her childhood self, and identities focused on bodily harm and pain.

1. BIBLIOGRAPHY:
1. Knefel, M., Tran, U. S., & Lueger-Schuster, B. (2016). The association of posttraumatic stress disorder, complex posttraumatic
stress disorder, and borderline personality disorder from a network analytical perspective. Journal of Anxiety Disorders, 43, 70-78.
2. Belli, H., Akbudak, M., Ural, C., Solmaz, M., Dogan, Z., & Konkan, R. (2016). Is there a complex relation between social
anxiety disorder, childhood traumatic experiences and dissociation?. Nordic journal of psychiatry, 1-6.
AUTHORS: Laura García Ayala (1), Marcos Gómez Revuelta (1), Oriol Porta Olivares (2), María
Juncal Ruiz (2), Daniel Abejas Díez (2), Nuria Isabel Nuñez Morales (1), Carmen Martín Requena
(1), Estíbaliz Sáez de Adana (1), Purificación López Peña (1), Ana González-Pinto Arrillaga (1)
(1): Hospital Universitario de Álava- Sede Santiago, Vitoria-Gasteiz, Spain.
(2): Hospital Universitario Marqués de Valdecilla, Santander, Spain
“Pieces of me”: a story of trauma and dissociation
INTRODUCTION: Traumatic event related disorders (ASD,
PTSD and dissociative disorders) could share a common
dissociative psychobiological origin. Patients diagnosed with
Dissociative identity disorder present a high sexual abuse
rate (85-90%), way above the rest of the traumatic spectrum
disorders.
OBJECTIVES: The goal of this study is to analyze the existing
relation between different types of trauma, especially sexual
abuse, and the onset and continuity of dissociative disorders.
MATERIALS AND METHODS: We report the case of a 37
years old woman with a long sexual abuse history. The symptoms
appear by age of 30, in the form of flashbacks, ushering a
persistent identity fragmentation in individual
differentiated opposed components, shaping a dissociative
personality disorder which was present for years, taking a
fluctuating and invalidating nature.
DISCUSSION: When a traumatic event occurs, acute
dissociative reactions frequently appear, usually briefly,
disappearing spontaneously afterwards. In this case we can
discern the persistence of the dissociative symptoms and the
repercussion they had in the patient’s functionality.
KEY WORDS: Dissociation, Trauma, Abuse, PTSD.
CONCLUSSION: The existence of a correlation between
the duration of a chronic traumatic event and the
persistence of dissociative symptoms in the evolution of a
dissociative personality disorder is possible.
PERSONALITY ROLE
“THE
ENTY”:
The agressive character, who likes
being hurt
“THE
DELEGATES”:
They are different kind of
personalities, ruled by “The Enty”
-Central:
The one who organizes the rest of
“The Delegates”
-Parents
They represent our patient’s father
and mother; father who committed
physical aggression, mother who
kept quiet
-”The Shy Little
Children
It represents herself during
childhood. She remembers herself
as a little girl who hid from her
father
-Body:
It represents her need of being
hurt, shown by her self-harm
-Pain:
It is he only way of communication,
with herself and with other people.