What is Dissociation?

I often describe dissociation as the brain's natural response to protect itself in abnormal situations. Often times the word dissociation is immediately associated with Dissociative Identity Disorder (DID- previously known as Multiple Personality Disorder). It is important to understand that there is a wide continuum of levels of dissociation, and there are different types of dissociation.

Levels of dissociation.

Have you ever drove somewhere, made it to your destination, and then wondered, "How did I even get here this morning?" or "Where did the time go?" Everyone in the general population dissociates at low level. Higher levels of dissociation are usually born out of a trauma history when one's ability to cope was frequently overwhelmed. Some individuals find that when their attempts to cope are unsuccessful dissociation will kick in. Other individuals have the ability to dissociate like turning on a light switch. The harder part, however, is shifting out of a dissociative state to a grounded and present state. At very high levels of dissociation, as in those with DID, individuals do not have the awareness that they are in or have been in a dissociative state, and often have difficulty remembering durations of time.

What leads someone to dissociate?

As stated previously dissociation is typically born out of trauma. It is the brain's last option to protect itself. There is a chain of command or steps that precede dissociation, but if that individual is repeatedly exposed to the stressor (or similar stressors) that led them to dissociate- dissociation may evolve into an automatic response.

• Step one: is the fight/flight response. This is a mobilizing reaction. Individuals who have the ability to fight or flee a source of danger are at less of a risk of experiencing dissociation because their volition, faculty, and power was active.

• Step two: is the attach cry response. When fighting and fleeing are not available, attach cry is the response that calls for help. It says "I need someone to intervene. I can't handle this on my own. Help me, save me". If attach cry is responded to effectively and within a reasonable time frame by a trusted and safe adult, then dissociation is unlikely to occur.

• Step three: is where dissociation begins and can be associated with the freeze/fawn response. This is an immobilizing reaction. If fighting/fleeing is not possible, and if the cry for help was not responded to (or was not responded to well), then the brain finds a way of escape through dissociating.

Types of dissociation

Dissociative Amnesia:

Dissociative amnesia is when an individual forgets all or part of a significant event. Trauma is not encoded in the brain chronologically, but those who experience dissociative amnesia tend to have very fuzzy or fragmented memories. This type of dissociation has also been labeled "repressed memories". In essence the brain says (either due to where one is developmentally, or due to one's coping mechanisms being overwhelmed) "This is too overwhelming to process right now. I will tuck this away until I am capable of holding this information". Often, details of these memories resurface when the individual is in a safer season of life. Though incredibly uncomfortable and distressing, memories coming back into one's awareness can signify a marker of healing. It may the brain's way of saying, "This information is important and deserves attention. I am more equipped and capable of processing this now."

Dissociative Depersonalization/Derealization:

Dissociative depersonalization is when an individual has outer-body experiences. Those who experience this type of dissociation describe it as: feeling like a floating head, feeling like their head is detached from their body, they report having difficulty feeling in their body or connected to their body, they report feeling a fuzzy-tingly-numbness all over, and more. Some say they see themselves outside of their bodies. Overall, dissociative depersonalization is when one does not feel grounded within their own body. This is sort of the brain's way of saying "It is no longer safe to be in the body, so I must detach from it and leave it".

Dissociative derealization is when an individual has difficulty determining reality and is disconnected from their surroundings. Those who experience this say they have difficulty remembering if something happened or if they just dreamed it, or cannot recall if they accomplished a task or just imagined they did. This may be the brain's way of saying "This will be easier to tolerate if I pretend it isn't real, or if I can train myself to ignore pain". Traumatic experiences frequently have the ability to distort reality, so survivors struggling with the challenge of perceiving reality is a common trauma response.

Dissociative Absorption:

In my experience with clients today, dissociative absorption is the most common type of dissociation. Dissociative absorption is when an individual gets absorbed entirely in something unrelated to the painful event. This can include zoning out, day dreaming, getting lost and losing time by scrolling on social media/binging television/reading and more. This type of dissociation is escapism. This is like the brain's way of saying "I will flood myself with something else so I am not flooded with the pain of the event".

How is dissociation treated?

If you can relate to any of the experiences described above, it is possible for you to reclaim your ability to be and feel present! I hope the steps below provide some direction for you.

1. Seek a counselor who is trauma informed. I think it is important to have a "both-and" approach. In other words, treating both the root of the presenting issue, and having practical tools to apply now. In the case of dissociation, it is valuable to understand and process the events that led you to dissociate to survive pain and danger-and learn and develop tools for how to respond in real time when you feel dissociated today.

2. Get more in tune with your WOT (window of tolerance-see previous post). Consider what triggers you to go outside of your window, as well as, the patterns and cues that you are about to cross outside of it. If one is in a dissociative state, they are way outside of their window.

3. Actively apply interventions that intervene in the specific type of dissociation you lean towards. For example: For dissociative absorption, mindfulness can help to ground you to the present moment. For dissociative depersonalization, yoga, stretching, progressive muscle relaxation, or a consistent mind/body connection focused workout routine can help you to reconnect with your body.

4. Get in the practice of asking yourself, how present do I feel right now/ how connected am I to the here and now? (20%, 50%, 70%, etc) and catch yourself after you have had a dissociative experience. Even if it is hours or a full day later, being able to look back and identify a dissociative experience helps you to become more aware and enables new neural pathways to emerge so dissociating becomes less and less of an automatic response.

5. Lean on and receive help from your trusted support system (begin building one if needed). As stated above, those who reach out for help and receive an appropriate, attuned response are less likely to experience dissociation. Healthy relationships are a major conduit of healing.

   
   

One final note

For most who experience dissociation, it is not a permanent symptom you are projected to face for a life time. With quality help and tools, you can influence it and experience change!