Category: Trauma

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/

 

Fibromyalgia and Mental Health

What is Fibromyalgia?

Fibromyalgia is a term used and suffered by many but understood by the few. It is a chronic disease that many professionals do not really understand or even believe is an illness.

According to the National Institute of Arthritis and Musculosckeletal and Skin Diseases (NIAMS, 2021), fibromyalgia is a chronic long lasting disorder that creates widespread pain and tenderness. It also causes fatigue, sleep disturbances, and sensitivity to pain. Scientists do not really know why people get fibromyalgia and unfortunately there is not a cure (NIAMS, 2021).

Fibromyalgia is most commonly seen amongst middle aged women, however, further studies have identified fibromyalgia amongst men and people from all ages (NIAMS, 2021).

Other studies have also identified it through genetic dispositions and those with no familial history of fibromyalgia. Fibromyalgia is an enigma within the medical sciences and its young discovery has not given researchers opportunity for full studies and exploration on the subject. According to Dellwo (2022) and NIAMS (2021) common symptoms of fibromyalgia include,

  • Sleep difficulties
  • Exhaustion/fatigue
  • Depression/anxiety
  • Brain fog
  • Memory issues
  • Concentration issues
  • Headaches
  • Ringling or numbness in hands and feet
  • Pain in face or jaw (at times TMJ is diagnosed)
  • Abdominal pain (like menstrual cramps)
  • Bloating
  • Constipation
  • Chronic widespread pain throughout the body or pain in multiple places at once in the body
    • Often felt in the arms legs, head, chest abdomen, back and buttocks
    • Described usually as aching, burning, throbbing or needle sensations
  • Heightened sensitivity to light, noise, odors, and temperatures
  • Muscle and joint stiffness
  • Allodynia (skin sensitivity or pain usually with clothes or touch)

The symptoms can be overwhelming alongside with the journey of getting the proper diagnosis. Hence why mental health for people with fibromyalgia, depletes. Fibromyalgia is only a little more than 30 years old from its discovery and identification.

Because it has not been that long since its finding, many doctors and medical personnel do not believe it exists or place importance on the detriment it has on the people who suffer from it.

Fibromyalgia and mental health

When getting diagnosed with fibromyalgia, it can be a tedious, frustrating journey. Not only are you having to go from doctor to doctor explaining how you feel, the symptoms you are having, but having to undergo every physical, blood, and neurological test doctors can think of only to say, “All tests came back negative, you are fine.”

This creates feelings of disappointment and frustration with not only the symptoms that you are feeling, but with the medical sciences that are supposed to help, not dismiss. You begin to think it is all in your head and doctors start override your case and become unempathetic as well as blaming you for not being better at your own health. Comments such as, “It’s your weight,” “you’re not exercising enough,” “you’re not eating right,” etc… create deterioration in your mental health.

According to Dellwo (2022) 27% through 58% of people with fibromyalgia report having feelings of hopelessness, depression, and thoughts of suicide. This is due to factors of being dismissed, difficulty managing symptoms, and there not being a cure.

Fibromyalgia however, has also been linked to many other forms of mental health disorders including anxiety, depression, and trauma (Johnson et al., 2006).

Trauma is a change in our psychophysiological chemistry. Trauma affects how the chemical and anatomy of our brain function (Johnson et al., 2006). Trauma and prolonged stress in adulthood influences brain modulatory circuit of both pain and emotions (Romeo et al., 2022).

It is important to also understand that when high forms of trauma—or prolonged trauma such as childhood ongoing trauma—dissociation (separation from consciousness) can occur. Some dissociative disorders include psychoform (psychological separation from consciousness) and somatoform (body dysfunctions).

Researchers have found high levels of both these forms of dissociative disorder symptoms with people who have rheumatic disorders and medical unexplained disorders (Romeo et al., 2022). In a study conducted by Romeo and colleagues (2022), they found high levels of psychoform and somatoform dissociation with fibromyalgia and a relational connection between childhood and prolonged trauma.

In other words, prolonged, cumulative, and childhood trauma affects the brain chemistry in which changes the ability for the brain to process pain, possibly creating fibromyalgia. However, it’s important to realize this does not mean “it’s all in your head”. It is a true and valid illness that was created by chemical changes in our brain by trauma in which we were exposed to. The pain is real, the symptoms are real, the suffering is real.

Ways to cope.  

Coping with fibromyalgia is hard.

It is not only a physiological coping strategy, it’s also a psychological, spiritual, and social support form of coping.

It takes motivation, determination, and self-care to be able to feel functional, FUNCTIONAL, when managing fibromyalgia. Sometimes to world around us does not understand and it is hard for them to empathize.

However, it starts with our own self-empathy. When we learn to empathize with our symptoms and how our body is managing stressors, and past traumas, we learn to appreciate the strength we generate throughout our every day lives that we wake up. Other important forms of coping techniques include,

  • Exercise
  • Stretching
  • Massages
  • Acupuncture
  • Physical therapy
  • Chiropractic exercises
  • Hobbies
  • Meditation
  • Yoga
  • Healthy eating
  • Educating self on symptoms
  • Swimming/water aerobic exercise (my personal favorite)
  • Anything that makes you feel whole, alive, strong.

As someone who has had to cope living with fibromyalgia, I realized it is a journey. It is a journey with the pain, learning the struggle, empathizing with myself, determination to continue, hope that I will feel better, strength that I have gained, and resilience.

The more I learned about my pain, the more I was able to comprehend and empathize with myself and fall in love with my strength to manage the everyday pain and adjustments of fibromyalgia.

If you would like to learn more about our practice and different mental health counselors please contact (915) 209-1234 for more information.

 

 

References

Dellwo, A. (2022, October 19). The 7 types of fibromyalgia pain. Verywell Health.  https://www.verywellhealth.com/seven-types-of-fibromyalgia-pain-716138#toc-hyperalgesia

Johnson, L., Zautra, A. J., & Davis, M. C. (2006). The role of illness uncertainty on coping with fibromyalgia symptoms. Healthy Psychology, 25(6), 696-703. Doi: 10.1037/0278-6133.25.6.696.

NIAMS. (2021, June). Fibromyalgia. National Institutes of Health.https://www.niams.nih.gov/health-topics/fibromyalgia#:~:text=Fibromyalgia%20is%20a%20chronic%20(long,a%20heightened%20sensitivity%20to%20pain.

Romeo, A., Tesio. V., Ghiggia, A., Di Tella, M., Geminiani, G. C., Farina, B., & Castelli, L.             (2022). Traumatic experiences and somatoform dissociative in women with fibromyalgia. Psychological trauma: Theory, Research, Practice and Policy, 14(1), 116-123.             https://doi.org/10.1037/tra0000907

 

 

 

 

 

 

Why Emotional Needs Matter

Dear Reader,

 

“A deep sense of love and belonging is an irreducible need of all people. We are biologically, cognitively, physically, and spiritually wired to love, to be loved, and to belong. When those needs are not met, we don’t function as we were meant to. We break. We fall apart. We numb. We ache. We hurt others. We get sick.”

-Brene Brown

As a former teacher, I have seen how important, in our culture, is to think our way through things with a heavy emphasis on thoughts and changing mindset.  There is no doubt that our mind is incredible and capable of amazing things.

Meta-cognition (thinking about our thinking) was very important in helping students develop critical thinking skills.  In essence, it helps us formulate decisions, problem solving, planning, and organizing.

Now, as a mental health counselor, I understand how important and essential emotional needs are.  So, let’s begin with one important question:

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Counseling After Experiencing Childhood Abuse

Trigger Warning: this blog contains mentions and examples of abuse, neglect, and other sensitive/potentially triggering material.

“At least 1 in 7 children have experienced child abuse and/or neglect in the past year, and this is likely an underestimate.” -Center for Disease Control, April 2020.

This is a startling statistic.

Count the seven closest people around you. One of them has likely endured childhood abuse and/or neglect. The fact that this statistic is likely an underestimate can lead one to believe that more than one of those 7 people has suffered through child abuse or neglect and shows many cases go unreported.

Let’s talk about what abuse is.

There are a few different types, and I will give short illustrations of each one.

Forms of abuse and neglect:

Read more

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