Samenvatting

DREAMLIKE PHENOMENA AND THE WAKING CONSCIOUSNESS – POOR SLEEP IS RELATED TO DISSOCIATION D. VAN HEUGTEN-VAN DER KLOET
In psychopathology, dissociation happens when emotion, memory, and consciousness do not collaborate well, leading to feelings of depersonalization/derealization and memory problems. Many clinicians regard childhood traumatic experiences as the culprit causing dissociation but recent studies have pointed in the direction of another explanation: a labile sleep-wake cycle may cause dreamlike phenomena to intrude into the waking consciousness, thereby fostering dissociative symptoms. In previous studies, researchers have found that dissociative symptoms can be induced in healthy participants using sleep deprivation. Conversely, sleep improvement seems to lead to a decrease in dissociative symptoms. This paves the way for the development of new treatment methods for dissociative disorders based on sleep normalization. Interestingly, mindfulness based treatment (known to improve sleep), could not alleviate dissociative symptoms in our study.


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Denkt u eens terug aan de laatste keer dat u dagdroomde. Misschien was het toen u in de auto reed. Een deel van uw aandacht was aanwezig bij het autorijden. Maar het grootste gedeelte van uw bewuste geest was ondergedompeld in fantasie. Stel dat u geen controle meer heeft over uw dagdromen en die dromen zich onaangekondigd aan uw wakende bewustzijn opdringen? U zou hierdoor uw gevoel van realiteit kunnen verliezen, betoogt Dalena van Heugten-Van der Kloet.

Hoe zou het zijn als u ’s ochtends wakker wordt, in de spiegel kijkt en u uw eigen gezicht niet herkent? Dit zal voor veel mensen als een zeer onwerkelijke ervaring klinken. Echter, voor mensen met een dissociatieve stoornis kan het de realiteit betekenen. Dissociatie treedt op wanneer het geheugen, emotie en bewustzijn niet met elkaar in de pas lopen. Dat zorgt dan voor allerlei nare klachten zoals geheugenproblemen, overmatig dagdromen, of hevige verstrooidheid. In de ernstigste gevallen kan het zelfs leiden tot twijfels over de eigen identiteit.

Hoewel een algemeen geaccepteerde definitie van dissociatie ontbreekt, heeft Steinberg (2001)32 vijf symptoomclusters gedefinieerd die de belangrijkste kenmerken van dissociatie omvatten: depersonalisatie, de-realisatie, dissociatieve amnesie, identiteitsverwarring, en identiteitsverandering. Depersonalisatie verwijst naar het gevoel vervreemd te zijn van jezelf. Een voorbeeld hiervan is dat je je voelt alsof je een toeschouwer bent die vanaf een afstandje naar zijn eigen lichaam kijkt, op dezelfde manier waarop je naar iemand anders kijkt. Mensen met

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