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Dissociation: What It Is, Symptoms & When to Get Help
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Have you ever driven a car and reached your destination only to realize that you have no recollection of the entire drive? Or has it ever seemed to you that you were actually watching yourself as if you had an outside body?
These events are manifestations of dissociation - and they occur quite frequently, but people are unaware of it. This article defines dissociation, describes its symptoms, discusses its causes, and offers advice on how to cope with the daily impact of the condition.
What Is Dissociation?
Dissociation is a psychological mechanism through which an individual may experience a disconnection from their thoughts, emotions, environment, or self-identity. It operates on a broad continuum. At the minor end of the spectrum, dissociation is simply a part of the human condition. For example, when you "zone out" during a rather dull talk. At the end, it may mean the person loses track of time, experiences derealization, or has multiple identity states.
According to the American Psychiatric Association (APA), dissociation is defined as a breakdown of the normally unified functions of consciousness, memory, identity, emotional expression, perception, and behavior. It should not be viewed as a deficiency in character or a lack of strength. Indeed, it is most commonly a protective mechanism - your brain's way of distancing itself from an intolerable situation.
Dissociation Symptoms: What Does It Actually Feel Like?
Symptoms of dissociation can be very different from one person to another, depending on the type and severity. Usually, they are grouped into two main categories.
Depersonalization means that you may feel so detached from your body, thoughts, or emotions that it seems like you are just a spectator of your own life. As if you are a character in a movie rather than a living person.
Your body may not feel like yours, for example, your hands might seem unfamiliar. Your voice might also seem to come from a distance.
Derealization means that the world around you seems unreal, dreamlike, or distorted. For example, colors may look dull. People and objects may seem like flat pictures or fake. Even places that you know well may suddenly seem strange or unfamiliar. Depersonalization and derealization may sometimes happen at the same time or separately.
Besides these two, dissociation symptoms may also include:
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Memory blanks or "missing time" that cannot be explained
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Feeling emotionally numb or disconnected from one's feelings
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Disoriented about one's identity
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Hearing voices inside the head that seem different from one's own thoughts
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During stress or conflict, feeling like one's body is separate or alien
How Common Is Dissociation?
People tend to underestimate how common dissociation is really. As per a review published in Psychiatric Clinics of North America, about two out of every hundred people in the overall population suffer from a dissociative disorder that can be diagnosed.
According to the National Alliance on Mental Illness (NAMI), milder forms of dissociative experiences, like depersonalization or derealization episodes, happen in as many as 50 out of 100 people at least once during their lifetime.
In fact, dissociation is very frequently seen in individuals who have experienced trauma. Studies have consistently confirmed that adults who were subjected to childhood abuse, neglect, or continuous traumatic events have a much higher likelihood of developing long-term dissociative symptoms.
Dissociation Causes: Why Does It Happen?
You may not be aware that dissociation is a reaction to stress or trauma that is so intense, your system tries to protect you by psychologically detaching you from the experience changing the way you feel or perceive the time and the people around you. Here are some of the scenarios that may lead you to dissociate:
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Physical, emotional or sexual abuse, neglect or even just witnessing domestic violence are all examples of childhood trauma.
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One time traumatic events: the occurrences of accidents, natural disasters, or being assaulted
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Chronic stress: the condition of being exposed to unsafe or unpredictable environments for a long time
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Other mental health disorders: dissociation is a common symptom in PTSD, complex PTSD, anxiety disorders, and borderline personality disorder (BPD)
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Drug use: some drugs, especially when taken in large quantities, can cause dissociation phenomena.
According to a 2018 research paper published in Frontiers in Psychology, not only does childhood mistreatment lead to dissociative symptoms in adults but also emotional abuse and neglect were strongly correlated with that.
Types of Dissociative Disorders
Severe dissociation that is long-lasting and causes significant impairments in daily functioning could be a sign of any of the three dissociative disorders in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition):
|
Disorder |
Key Feature |
|
Dissociative Amnesia |
Inability to recall important personal information, usually related to trauma |
|
Depersonalization/Derealization Disorder |
Persistent feelings of detachment from self or surroundings |
|
Dissociative Identity Disorder (DID) |
Presence of two or more distinct identity states, often with memory gaps between them |
Understanding dissociative disorders shouldn't be limited to the standpoint that they're so rare as to only be found in movies. While dramatized for movies and TV shows, these disorders are real and legitimate diseases that can be identified and some of them can be cured with proper and sufficient treatment.
Like an iceberg, the tip visible to others is only a manifestation of a deeper trauma that has been ongoing for a long time and/or is very intense.
How Is Dissociation Treated?
There are different ways to help manage dissociation symptoms and address the trauma behind them. No single method works for everyone, but some therapies are well-researched and trusted.
Trauma-Focused Therapy plays a major role in treatment. The International Society for the Study of Trauma and Dissociation (ISSTD) endorses phase-based therapies - which start by creating a safe environment and equipping the person with coping skills before gradually revealing the traumatic memories. Examples of these evidence-based approaches are:
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EMDR (Eye Movement Desensitization and Reprocessing)
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Trauma-Focused CBT (Cognitive Behavioral Therapy)
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Parts-based therapies such as Internal Family Systems (IFS) and Structural Dissociation Model therapy
Grounding Techniques are strategies you can use to bring yourself back to reality when you have a dissociative episode. The 5-4-3-2-1 grounding method is popular (identifying five things you can see, four you can touch, etc.), other techniques include holding an ice cube or focusing on deep slow breathing.
While medication isn't a cure for dissociation, it might be useful for relieving symptoms of anxiety or depression that sometimes accompany it. You should discuss with a psychiatrist if you think you'd benefit from medication.
You can use things like August AI for keeping a record of your dissociative experiences, noting your triggers, and examining changes over time outside of therapy sessions. This way you and your therapist can better understand the dynamics of your episodes.
When Should You Seek Help?
It's quite common and normal to dissociate mildly once in a while. This sort of dissociation is what we call daydreaming or zoning out and doesn't even require treatment. However, you need to see a mental health professional if:
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You depersonalize or derealize very frequently
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Your lose track of your time very significantly
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You feel emotionally numb or have no sense of self all the time
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You realize that your dissociative symptoms have something to do with trauma
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You see that dissociation causes significant problems in your work, relationships, or other areas of life
Usually, you will first want to visit your primary care doctor, who can then guide you to a trauma-trained therapist or psychiatrist. Another option is to find and search specialists through the ISSTD therapist directory.
Key Takeaways
Dissociation is a protective mechanism of your brain when you face something so painful that you cannot endure it. It is reasonable that dissociation appeared during your life. However, with proper care, you will be able to comprehend, control, and resolve inceptive situations, which cause dissociation symptoms, such as depersonalization and derealization, seriously deteriorating your life quality.
A trauma specialist will be most helpful to you if you decide to see one.
August AI will be there for you between your therapeutic sessions, effectively assisting you in remembering your feelings, preparing for therapy, and most of all, not feeling left out on your path to rehabilitation.
Frequently Asked Questions
Is dissociation the same as a psychotic episode?
Is dissociation the same as a psychotic episode?
Not really. Usually in dissociation, the individual still knows that their psyche is experiencing weird things. While in psychosis, someone won't even be able to tell that their perceptions are different from reality. Only the doctor can make a distinction between the two.
Can anxiety cause dissociation?
Can anxiety cause dissociation?
Of course. Extreme anxiously and fear attacks can bring on short depersonalization or derealization episodes. Actually, this is the top reason for dissociation among those who have never been traumatized.
Is dissociation dangerous?
Is dissociation dangerous?
Dissociation by itself isn't a threat to your physical being. However, if you get very strong dissociation episodes, your ability to function normally may be compromised without your knowledge. This is an example of danger when you could be driving. Get a clinical checkup if you have very often or very long-time to get episodes.
Can dissociation be treated without therapy?
Can dissociation be treated without therapy?
If you only have mild symptoms, then grounding techniques and changing your lifestyle can be enough to help you. On the other hand, when dissociation is persistent or related to trauma, it is most effective when the patient receives professional, trauma-informed psychotherapy.
Can children experience dissociation?
Can children experience dissociation?
Absolutely, especially those children that have been victims of abuse or neglect. Early intervention can help mitigate the long-term consequences.
How do I explain dissociation to someone who hasn't experienced it?
How do I explain dissociation to someone who hasn't experienced it?
An easy way to explain it is to compare it to being in a state of autopilot. While your body is still there and even working without a problem, your conscious mind has in a way left or disengaged. A person who almost always dissociates, doesn't only feel that way, but is that way a lot, that is, those states or episodes are very strong or intense and even almost uncontrollable.
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