Establishing a therapeutic relationship with a patient with a dissociative disorder may be more difficult for the nurse than establishing a relationship with a psychotic patient because the patient with a dissociative disorder:
a. is more reluctant to engage with others.
b. has symptoms that may seem contrived.
c. seems so needy that it overwhelms the nurse.
d. is seeking large amounts of secondary gains.
B
In that the symptoms of dissociative disorders can seem so unlikely or improbable to one who has never experienced such disorders, it is common for nursing and other staff to question the genuineness of the behaviors of a patient with dissociative disorder. They may seem sensational, exaggerated, and not authentic. However, they are "real" to the patient; dissociative disorders are not factitious and do not involve malingering. The patient with a dissociative disorder often appears withdrawn, vague, or interpersonally uncomfortable. Dissociative disorder patients are not necessarily more dependent than persons with other serious mental illnesses, nor more prone to seek secondary gains.
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