Dissociation

A battle for feeling grounded

Many people experience the feeling of ‘spacing out’ from time to time. This mental ‘pause’ can cause people to lose orientation with their surroundings a few minutes (or longer) of the day.  

While daydreaming is common and perfectly normal, someone with a dissociative disorder might experience such a significant loss of touch with reality that they lose full days or weeks from their memory. 

What Does it Mean to Dissociate?

Dissociation is a way the brain protects itself by disengaging from the present. When a person experiences a triggering situation, they may mentally remove themselves from the psychological harm that they are experiencing.

Dissociating can be as simple as ‘spacing out’ in some cases, but it’s not just daydreaming. Dissociation is a learned coping strategy to deal with trauma where one detaches themselves from reality-willingly or unwillingly. The idea is that if you’re not ‘present’, you can't get hurt.

Common symptoms of dissociation include:

  • Detachment from self or reality
  • ‘Spacing out’
  • Memory loss
  • Loss of identity
  • Feeling numb

Triggers and Flashbacks

A trigger is a very real term to describe stimuli that reminds someone of their past trauma. Triggers can cause flashbacks and dissociation. Once an event, person, or circumstance reminds someone of the trauma, they may relive that trauma in their mind and dissociate from the moment.

Causes

No matter how big or small, traumas can affect people in many different ways. Dissociative disorders are responses to traumatic events or periods in a person’s life. These events can include circumstances like a car crash, arguments, war, or any number of stimuli that are too overwhelming for the brain to cope with.

Dissociative disorders are often found in people who have experienced long-term childhood trauma. Dissociative disorders may share similar causes and symptoms, but they present themselves in different ways. 

Dissociative Amnesia

One such disorder is dissociative amnesia. As the name suggests, the primary symptom is lack of memory. These memory gaps can include people, places, and events associated with their trauma. 

These lapses in memory can last anywhere from a few hours to several years, and may not even develop for quite some time after the trauma. 

Dissociative Fugue

Dissociative fugue is a type of amnesia that is far more rare, and generally only caused by exceptionally severe trauma. People with dissociative fugue have no memory of who they are or anything about their lives. Again, this might only last a few hours, but, on occasion, it can last several months. 

Someone with dissociative fugue may put themselves in situations that are wildly out of character for them. They often don’t recognize family or friends. Occasionally, they even begin a new life in a different place that was completely different than their own.

Dissociative Identity Disorder (DID)

Also called DID, people with dissociative identity disorder have two or more distinct personalities that cannot exist simultaneously. Most people have heard it called by the now out-of-date term “multiple personality disorder.” Each personality is a fully-fleshed identity, with biographical memories, preferences, and physical characteristics. 

Some symptoms of DID line up with dissociative amnesia, such as the loss of memory for large periods of time. This usually happens while another identity is present. These two dissociative disorders often coexist.

Depersonalization-Derealization Disorder

Also referred to as DDD, this disorder has two major parts. They can occur together or individually. 

Depersonalization

Someone experiencing depersonalization might think that they are out of place in the world. They may feel as though they are ‘outside themselves looking in,’ where they observe thoughts and emotions rather than experience them.

Derealization

This part of DDD happens when the world around you just ‘feels wrong.’ Perhaps everything seems too slow or too fast, or you get the sensation that you are in a dream. If the reality surrounding you feels ‘off,’ you are experiencing derealization. This can refer to people as well as an overall environment.

Someone with DDD may experience depersonalization and derealization at the same time, at separate moments, or one without the other. Some triggers can cause episodes of DDD, but some people experience it continuously for an extended period of time. 

Structural Dissociation

The theory of structural dissociation states that everyone is born without cohesion in their personality. We develop that cohesion as we grow older. Traumas that cause dissociative disorders either disrupt that cohesion or prevent it from happening at all. 

According to structural dissociation theory, our personalities come in two parts. The ‘apparently normal parts’ or ANPs are responsible for day-to-day functionality. ANPs are your hunger, social engagement, sleep, and such.

Emotional Parts, or EPs, are your trauma responses. This includes every symptom of hypo and hyperarousal, including flight, flight, and freeze responses. Some suggest that they hold memories of the trauma. Normally, these two pieces can function and work together. With dissociative disorders, the EPs overpower the ANPs after a trigger. 

Typically, chronic childhood trauma is to blame for this disruption. When a child experiences trauma over long periods of time or is forced to be around the person that caused the trauma, they never have the opportunity to merge these parts of their personality. 

Dissociative Identity Disorder Research states that structural dissociation can be broken into three types.

Primary structural dissociation

The first type is primary. This break in cohesion is typically associated with PTSD that develops later in life. In primary structural dissociation, a person has one ANP and one EP. While the ANP is ‘in charge’ most of the time, certain triggers can bring the EP forward and cause a flashback. 

Secondary structural dissociation

Secondary structural dissociation means that a person has one ANP and many EPs, each with their own trauma response. For example, one EP presents as fight, one presents as flight.

Showing signs of secondary dissociation indicates a more traumatic childhood, and is more closely associated with Complex PTSD and several dissociative disorders.

Tertiary structural dissociation

The theory most often behind Dissociative Identity Disorder is tertiary structural dissociation. This means that a person has many ANPs and EPs. 

Each ANP is responsible for different parts of every day function — one for eating and enjoyment, one for sexuality, one for social engagement, etc. Just like secondary structural dissociation, each EP is responsible for various individual sets of trauma responses. 

Even though each ANP is considered a ‘normal’ part of a person’s identity, they can overpower each other in response to certain situations. 

Dissociation as a Symptom

Dissociative disorders each come with their own symptoms and causes, but the common definition of dissociation is a disconnect from reality. 

That disconnect from reality is also a symptom of many other mental illnesses. Anxiety disorders, various personality disorders, and depression can all present as dissociation. Dissociative disorders can be comorbid with these other ailments. It’s not uncommon for someone experiencing a dissociative disorder to develop additional mental illnesses.

PTSD and dissociation are tightly linked. PTSD is also caused by trauma, so dissociation is often a symptom. It is also not uncommon for a person to have a dissociative disorder alongside PTSD.

Treatments for Dissociative Disorders

Coping with dissociation isn’t easy, but there are some ways to reduce it or stop it early. Sometimes, feelings of dissociation can be resolved through some mindfulness practices.

One helpful exercise to stop dissociating in the moment is to bring yourself into the present by using all of your senses. This is done by observing your surroundings and naming:

  • Five (5) things you can see
  • Four (4) things you can touch
  • Three (3) things you can hear
  • Two (2) things you can smell, and
  • One (1) thing you can taste

If you can feel yourself beginning to dissociate, mindfulness exercises like this are useful for keeping yourself grounded. 

Of course, there is never a bad time to seek treatment, especially if you have memory lapses related to dissociation. Complex trauma-related dissociation often requires specialized treatment, so it’s important to consult with a licensed therapist to decide which treatment works best for you.

The trauma therapists at Inner Balance Counseling have extensive experience helping people cope with dissociative disorders. Contact us today if you are ready to begin your journey to feeling better.

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