||The enemy in the mirror: self-perception-induced
stress results in dissociation of psychological
and physiological responses in patients with
, , and |
||European Journal of Psychotraumatology
||Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
||Autonomic nervous system; avoidance; dissociative
disorder; face in the mirror; impedance cardiography;
mirror-confrontation; parasympathetic; posttraumatic
stress disorder; self-perception; sympathetic
||Background: Patients suffering from dissociative disorders (DD) are characterized by an
avoidance of aversive stimuli. Clinical experience has shown that DD patients typically avoid
the confrontation with their own faces in a mirror (CFM).
Objective: To investigate potential CFM-associated self-reported and psychophysiological
stress reactions of DD patients, which most likely inform on the still unknown pathophysiology
of dysfunctional self-perception in DD.
Method: Eighteen DD patients and 18 healthy controls (HCs) underwent CFM. They were
assessed for CFM-induced subjective self-reported stress, acute dissociative symptoms and
sympathetic and parasympathetic drive using impedance cardiography.
Results: DD patients experienced more subjective stress and acute dissociation than HCs
upon CFM. Their psychological stress response did not activate the sympathetic and parasympathetic
Conclusions: In DD patients, CFM constitutes serious self-reported stress and is associated
with a blunted autonomic reactivity. Therapeutic approaches promoting self-perception and
self-compassion, in particular by using CFM, might serve as goal-oriented diagnostic and
therapeutic tools in DD.