What is dissociation?
In the simplest terms, dissociation is a disconnect in memory and experience. It can take many forms. There are some forms of dissociation that we all experience when our brain goes on “autopilot” Have you ever driven to work or school and been so absorbed in your thoughts that you don’t remember the actual drive? That is dissociation. On the more extreme side of dissociation, a person may experience a severe disconnection from their identity, their body, their actions, or their surroundings. Dissociative experiences happen on a spectrum, from ones that everyone experiences sometimes, to full on Dissociative Identity Disorder (previously called Multiple Personality Disorder). In the middle of the spectrum, dissociation can easily be mistaken for anxiety, ADHD, Bipolar Disorder, a Personality Disorder, and it is commonly occurring with Post-Traumatic Stress Disorder.
What causes dissociation?
Dissociation happens when a traumatic memory is triggered either through sensations (sights, sounds, smells, physical feelings, bodily sensations, etc.), thoughts and feelings (e.g. I feel trapped, I feel like I can’t breathe), or environments (e.g. In a small enclosed space) that are related to the memory networks of the trauma.
Traumatic memories are stored in the brain differently than other memories. In order to protect the person from being overwhelmed by the experience, the brain often separates out the experience (especially when the person goes into fight, flight, or freeze) and stores each aspect of the memory separately. The episodic memory (watching the scene like a movie) is stored in one place, the emotions/feelings about what was happening are stored elsewhere, the thoughts running through the person’s mind at the time are stored somewhere else, and the physical sensations the person was experiencing are stored in another place. This can be referred to as a fractured memory. When a person tries to recall it, it may feel blurry, foggy, jumbled, or hard to reach. It can be difficult to remember specific details of what did or didn’t happen or about the environment. Some people will not be able to remember it at all. However, when something happens that triggers an aspect of this memory, even if it cannot be recalled, a person may dissociate.
What do the different forms of dissociation look like?
Dissociation makes the person feel like they are reliving the memory in some way. They may experience similar feelings (intense anger or fear) that feels like it comes out of nowhere. They may experience bodily sensations (feelings of being held down or pain in certain areas). Or they may feel detached from their bodies and or/surroundings. This can make the world seem dream-like and not real. Survivors have described this as feeling like a ghost or feeling like part of them is stuck in the memory, reliving it over and over, while part of them is stuck in the present and the two are overlapping.
“Having PTSD is like having a really unfortunate time traveling ability. It hits you unexpectedly and takes you repeatedly to the most painful moments of your life.
It feels like being a ghost, living in two realms at once, but not being fully alive in either.”
-Survivor of complex trauma
When someone is dissociated, they may seem zoned out, have trouble concentrating, have issues with memory, feel numb and detached, have intense emotional responses come out of seemingly nowhere, or feel as though they can’t move. Some people may even regress to earlier ages while dissociated or have personality features that come out differently than normal. Their voice and speech may sound different. They may have difficulty finding their words, stutter, or speak with a much softer or much harsher tone than they usually do. Some people become disoriented to their surroundings while dissociated. In a more severe form of dissociation, people may even temporarily forget important aspects of their identity. Often, survivors do not realize when they dissociate, and this can be confusing to loved ones and themselves.
People who have experienced chronic trauma may also dissociate when their stress or anxiety levels get too high because their brain may have conditioned them to use dissociation as a coping tool to escape from the trauma or prolonged stress. This can become a problem when it keeps happening automatically and disrupts functioning. Dissociation can become such an automatic response and survivors can get really good at playing it off. Much like people suffering from memory problems, they may minimize how much it is actually impacting their lives either because it is so scary, or because it is so normal to them at this point, they don’t know any different.
For people who experience chronic dissociation, they may naturally learn ways to cope to avoid the dissociation, although these ways are not always healthy. These coping mechanisms can look like chronic busyness, avoiding being alone, talking to one’s self frequently when alone, using substances, needing the TV on or some other noise or stimulation going when alone, needing to remain frequently active, or, on the other hand, avoiding other people so that others do not notice their dissociative tendencies. For chronic dissociation, the dissociation episodes are more likely to occur when one is alone and unstimulated because this is when one’s thoughts and feelings catch up and can be overwhelming. Sexual stimulation can also be a trigger for dissociation episodes for some people. This can look like becoming fearful and regressing to the feelings of an earlier trauma, becoming hypersexual, or experiencing some amnesia.
How to help someone come out of a dissociated state or avoid going into one:
Since dissociation is related to past experiences, it is very important to help someone stay in the present moment and feel safe. This can look like asking them to use their 5 senses in the present moment using comforting objects.
Ask them to pick a color and name 5 things around them that are that color.
Have them feel the texture of a comfy blanket.
Invite them to smell a candle and describe the scent.
Have them listen to comforting music, nature sounds, or go outside and describe what they hear.
Offer them a mint, gum, or a candy to suck on and have them pay attention to the flavor and texture.
The more senses one can engage in the present moment, the more one can stay in the present moment and avoid dissociating. Asking what would help them to feel safe can also be a good idea, although a person who is dissociated may not always be able to answer.
When dissociation is a chronic issue, it is important to work with a qualified therapist to work through the deeper issues that cause the dissociation to occur. Not all therapist have the proper training to work with dissociation, so it is important to ask and get a referral to one who does.
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