The husband of a patient who has been diagnosed with severe dissociative disorder asks the nurse if he is in any way at fault for his wife's illness. He states their relationship is mutually supportive, and no trauma has recently occurred
Which response would be most therapeutic and best illustrates our current understanding of the etiology of such disorders? a. "We think the disorder is caused by trauma or abuse early in life. You seem very concerned about your wife; we could talk about your concerns if you like.".
b. "I doubt there is anything you could have done that made it worse or could do to make it better, because we think it is primarily a genetic disorder you are born with.".
c. "These disorders arise from within the person; they are just something the rest of us have to be supportive about until they get better on their own.".
d. "These conditions are understandably frustrating; it's hard to imagine why a person would put their loved ones through what they do.".
A
Describing the role of early-life abuse in most such disorders, accompanied by providing an opportunity for the patient to discuss his questions and responses about such illnesses, is the most accurate and therapeutic response. The role of genetics in these disorders is very limited, and suggesting that there is little that others can do to help increases the spouse's helplessness and distress. The suggestion that his wife is somehow purposely acting as she does reflects a complete misunderstanding of the symptoms of these disorders and would likely create more distress within the relationship.
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