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What dissociation really is and why it’s not as bad as you think?

Dissociation (often misspelled/confused as disassociation, which is incorrect) means disconnecting from own thoughts, feelings and emotions. Formal definition describes it as: separation of some aspects of mental functioning from conscious awareness, leading to a degree of mental dysfunction or to mental conditions including dissociative identity disorder.

 

Whenever I talk to my clients about dissociation, I start with the first part, while many people have the latter part in mind. Dissociation sounds scary and serious, mysterious and odd, something from a psychological thriller. In reality, almost everyone experiences mild forms of dissociation, not necessarily involving stress or danger. For example:

 

  • “Zoning out” while working out, physical labor, or other repetitive activity that frees up your mind.
  • “Running on auto-pilot” while you’re driving a well-known route and not remembering how you got there, or bored sitting in traffic your mind drifts to your shopping list or the busy day ahead of you, you are engaged in a type of dissociation.
  • “Losing time” because you’re captivated by a book, a movie or an activity or a hobby

 

The ability for literature or film to transport us mentally, and imaginatively, is a mild, adaptive form of dissociation.

 

  • Purposefully ignoring your body’s signals to use the restroom or stopping to eat — even delaying sleep — when you’re on a tight deadline or want to make it to your vacation destination.

 

In these ways, dissociation serves us and doesn’t present a problem unless we miss that the light has changed and get honked at to move along.

 

Dissociation and Trauma

 

However, in many situations, the mind’s ability to dissociate is an adaptive response to trauma. Some people with trauma histories, employ dissociative strategies to escape the pain of horrible memories.

 

May it be a life-threatening accident, sexual assault,  combat trauma, chronic stress, chronic physical abuse in childhood or emotional abuse in a relationship in adulthood. By dissociating, the client is allowing the mind to leave, even when the body is trapped.

 

Clients often report feeling disconnected from the environment as well as their body sensations and find it hard to assess the passage of time. Clinically, this is also called dissociation, and it’s best understood as a well-honed coping strategy; mastering the ability to mentally escape when it’s impossible to physically escape a potentially threatening situation. In some sense, dissociation is the opposite of integration – some aspects of ourselves, emotions, memories, and traits become unbearable and they can no longer be integrated into our sense of self. Research has identified several different types of dissociation that clients can experience.

5 types of dissociation:

  • Depersonalization – a disconnection from body and emotion, sometimes described as an “out-of-body” experience, for example, looking in the mirror and finding own face unfamiliar.
  • Derealization – a sense that the world isn’t real, for example, sensation as if seeing things through a fog, colors appearing too bright, like in a badly edited movie, or being in a video game.
  • Identity Disturbance – a sense of being a different person, or confusion about the self, for example, a client who is morally opposed to drinking alcohol ends up doing so at a party and enjoying it.
  • Identity Alteration – a more extreme version of identity disturbance in which someone cannot control variation in personality or actions, for example, a client reverts to a child state without any conscious awareness of their adult self.
  • Dissociative Amnesia is an extensive inability to recall important personal information or memories, sometimes called losing time”, for example, a client was involved in a car accident but cannot remember why they were driving in the first place.

Clients may experience just one of these forms of dissociation, or any combination of them at various times. And some of them may still be serving an adaptive function.

 

However, experiencing dissociation does not automatically indicate the diagnosis of Dissociative Identity Disorder (DID), or even a milder type, Dissociative Disorder Not Otherwise Specified (DDNOS). While it is important to be mindful of our emotional well-being, we should always consult our concerns with a mental health professional – we are not alone.

How can therapy help?

  • Grounding – It’s hard to do therapeutic work in a state of defense. By using grounding strategies such as breathing exercises, butterfly hug, 54321 technique, we can help clients return to their window of tolerance.
  • Backtracking – It’s important to find where the freeze response originated, both to avoid triggering it again and to begin to heal that hurt part. So notice, what was happening when you began to freeze? Was it a response to fear or shame? It can be helpful to ask, “What were you aware of? What did that experience remind you of?”
  • Mindfulness- learning how to be present in the here and now. By exercising focusing on sensory and emotional experiences you practice mental anchoring to the present through objects, sounds or smells.
  • Psychoeducation – we can use psychoeducation to help you identify dissociative symptoms and to explain how your responses were created, and why they were adaptive to have. This can help to reduce the shame around the response, and to initiate further work.

Do I have to worry?

 

If you see yourself in any of the dissociation forms or symptoms, don’t hesitate to reach out to a mental health professional.

 

Symptomology may sound confusing and contradicting to a lay person but a trained therapist will be able to shed light on your concerns.

Here are some other symptoms that may be part of dissociation:

  • You may have self-worth and shame issues. You may, too often, experience intense emotions or memories. You sometimes get triggered when someone expresses compassion to you. You have unexplained physical pain. You may feel shame. Anxiety can shoot up rapidly from an otherwise peaceful state.  You have nightmares. You can quickly change from a place of high confidence to self-hatred. You may even hear voices, which, by the way, does not mean these voices are a psychotic response.
  • More commonly, they are your echo originating from childhood trauma.

 

Last but not least, even receiving a dissociation diagnosis is not bad news – research says that with the right treatment even more severe cases of DID can be treated and the separate parts of the identity can be integrated into one self again.

 

If you would like to learn more about my services, please feel free to call our office for more information.

 

References:

 

https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/diagnosis-treatment/drc-20355221

 

https://www.azafap.org/thoughts-for-families/dissociation-101-when-relationships-dont-reward-the-brain/?gclid=CjwKCAjwt52mBhB5EiwA05YKo8FF3EuiQ0XUhOKzkhrwStffjB6SU9YvjDJJmenW41boWPveycE0HxoClmIQAvD_BwE

 

https://www.nicabm.com/topic/dissociation/

 

https://www.psychologytoday.com/us/blog/healing-trauma-s-wounds/201803/what-you-need-know-when-clients-dissociate-part-1

 

https://www.psychotherapynetworker.org/article/treating-dissociative-child

 

https://www.traumafocusedtherapy.com/dissociation-in-trauma-and-how-to-work-with-it-in-therapy/

 

https://depthcounseling.org/blog/levison-demystifying-dissociation

 

https://www.nicabm.com/working-with-structural-dissociation/

 

Zuzanna Gromulska, MS, LPC, LMHC

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