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10 Reality Distortions: Paranoia and Dissociation
All that we see or seem Is but a dream within a dream. — E D G A R A L L A N P O E , “A Dream within a Dream”
Billy Pilgrim has come unstuck in time. — K U R T V O N N E G U T , Slaughterhouse 5
nlike psychotic symptoms observed in other severe illnesses, such as schizophrenia and bipolar disorder, borderline dissociation usually emerges and resolves suddenly—much like borderline rage and mood shifts—and often is precipitated by stress. Such was the case with Todd, who typically functioned at a high level, until the Christmas holidays unearthed memories that sparked his break with reality. This chapter describes the different manifestations of borderline dissociation, such as illusions, hallucinations, confused thinking, paranoia, and feelings of unreality. A special section offers guidance for family members confronting this frightening symptom.
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TODD This was a hell of a way to spend Christmas! Brad sat in the uncomfortable vinyl chair in the North Shore Hospital emergency room. He rubbed
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