DISSOCIATION

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WHAT IS DISSOCIATION?

Do you ever space out and just need to think of nothing? We all have moments where we space out and feel somewhat disconnected. How do we know, though, what is normal amounts of "spacing out" and when do these "mental escapes" become concerning? The word dissociation means not feeling connecting to yourself.  This is a common experience individuals have, especially those who use it as a coping mechanism to escape stressful situations. 

Dissociation needs to be explained on a continuum. As with any kind of symptom, different people fall on different places on the spectrum, the question is "how severe are my symptoms" and "how does that affect me and my life"? 

Common dissociation is the kind of spacing out that we do from time to time. You may notice you're home with yourself or others and just feel like you were in a different space for a few moments, you may be driving home in autopilot and suddenly see you're home safely, but were somewhat disconnected as you were driving. These kind of moments are normal escapes for all humans. 

Farther down the spectrum is the kind of dissociation that is used as a defense mechanism to deal with feelings of feeling very overwhelmed, or existing in incredibly stressful circumstances. Common terms to describe these experiences is "feeling detached", feeling like you are watching yourself from an out-of-body experience or feeling totally "out of it". 

On the end of the spectrum is the term Dissociative Identity Disorder. At this point of the spectrum, dissociations are more frequent. What happens here is that the individual experiences a strong compartmentalization , a split of experiences, and memories become separate as well as personalities parts splitting off from the "whole self". Someone whose system learned to dissociate at a young age often did so in order to survive severe sexual, physical or psychological  abuse. As adults, these individuals may have a stronger "split" or more distinct compartments of "self states" or "identities". 

The symptoms one experiences vary, depending on the type of dissociation the person is experiencing. Some of the symptoms those with DID have, defined by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) are:

  • An inability to remember personally-relevant events, not the regular "forgetfulness" and not due to a medical condition (amnesia)
  • Confused and dazed wandering (dissociative fugue)
  • Two or more identities or personality traits within a single person.
  • Transfer of behavioral control to another part of self or internal identity.
  • Experiencing objects in the world are changing in shape and size
  • Feeling that people are automated and inhuman

DISSOCIATION IS A STRONG UNCONSCIOUS DEFENSE THAT COMES TO PLAY WHEN THE INDIVIDUAL IS SO YOUNG AND FEELS THAT THERE IS NO WAY OUT OF THE STRESSFUL SITUATION. 

They are usually too small or too weak to fight, may have nowhere to run or they may not even have fully enough developed brain to understand what is going on. Psychologically the mind knows something is off and when no others defenses help, the body disconnects as a way to survive incredible pain and/or discomfort. 

Although dissociation is a coping mechanism the brain uses to allow the person to essentially survive extreme  trauma, using this defense on a daily basis can lead to difficulties when trying to interact with the world, especially as dissociation is not something widely understood.

 The thing with trauma is, that although it has ended, the split and "walls" in the mind often lead to confusion in the person which may  cause symptoms of post traumatic stress disorder, anxiety or depression. Some parts of dissociative self may  develop self-destructive patterns, such as drinking excessively, behaving recklessly, and engaging in actions to sabotage the present self personality’s efforts to stay healthy.

Individuals who don't understand dissociation may get confused, worried or think the individual has a medical condition of some sort. It is important for family members, loved ones and those in your social network to gain some education on what this condition actually is and how to be supportive to you when you have a dissociative experience.  

THE OVERALL GOAL OF TREATMENT IS ALL ABOUT" INTEGRATION" WHICH INVOLVES BRINGING TOGETHER THE FRAGMENTED AND COMPARTMENTALIZED PARTS OF THE PERSON’S MEMORY.

Doing so helps the individual stay more connected to themselves, stay connected when they notice dissociative symptoms and navigate day-to-day life in a calmer, more successful manner. In some cases dissociation symptoms last for a a short period of time, yet for others they can last for a few years or throughout their lifetime. The goal is to lessen the occurrence, bring the intensity to a more adaptive level and become skilled in managing them.

In therapy, experiences of dissociation is discussed and new coping techniques are learned. As techniques have been learned, practiced and implemented, trauma work and understanding the initial trauma may be discussed to work through it and release its stronghold.  Crisis that arise within personalties are expected and are part of the therapy work, although it may seem to delay the trauma treatment. A vital component is trusting in the process and knowing how to ride the waves, when they are choppy and strong and slower and less frequent. At the foundation of good treatment is the core necessity and importance of a good connection and trusting relationship between client and therapist.  

As much as dissociation can be a frustrating and complicated condition for individuals to live with, it is  also important to remember that this is a natural mechanism of the brain that came "online" to survive a horrific experience, and that is an extraordinary process. 

WITH GOOD TREATMENT AND PERSISTENCE, CLIENTS WITH DISSOCIATION, WHEREVER THEY ARE ON THE SPECTRUM, CAN LEARN TO INTEGRATE AND LIVE RICH, FULFILLING LIVES.