What is Dissociation?

Dissociation is a mental process that causes a disconnect between different cognitive processes such as one’s thoughts, feelings, sense of identity, memories, and consciousness. 

While statistics show that many people experience dissociation at some point in their lives, those who have experienced trauma dissociate at higher rates than those who have not. Research has found that sometime during a traumatic event or in the days, weeks, or months following the event, approximately three out of four people experience dissociation.¹

What are the signs and symptoms of dissociation?

The symptoms of dissociation can be grouped into two general categories, depersonalization and derealization.

• Depersonalization: the feeling that you are detached from your body and yourself
• Derealization: the feeling that the world around you is not real

The experience of dissociation has been described as:

• you are not in control of yourself
• inability to access or describe your emotions
• emotional numbness
• altered sense of time and space
• tingling sensations in skin
• trouble concentrating
• feeling like you aren’t yourself
• feeling like life is passing by like a movie
• physical sensations without cause
• feeling like you are watching yourself from outside of your body
• changes in vision
• gaps in memory

Why do people dissociate?

Experts believe that dissociation is our brain’s response to highly distressing events, experiences, and information. When people dissociate, there is distance created between themselves and the trauma, which makes the distressing event more tolerable.² People may dissociate during a traumatic event, known as peri-dissociation, or they may experience dissociation when they are reminded of the traumatic event. Sometimes, people may enter a dissociative state for no discernible reason. Those who experience chronic dissociation may meet the criteria for a dissociative disorder.

Dissociation makes trauma more tolerable for two general reasons. Firstly, dissociation causes one to be detached from their memories, thoughts, and feelings. Detachment is an altered state of consciousness characterized by feelings of alienation. As a result, feelings and emotions can be flattened. A survivor may recognize that an event was a trauma, but they may not experience the emotions they would expect to accompany trauma. Via detachment, dissociation can make it easier for trauma survivors to go about their everyday lives. However, dissociation is a maladaptive coping mechanism that delays a survivor’s ability to process the traumatic event and truly heal. Secondly, dissociation often involves some level of compartmentalization. To compartmentalize means to “section off” parts of one’s memory, making usually accessible information difficult or impossible to recall and utilize. This can also delay a survivor’s ability to process the trauma.

Dissociative Disorders

Dissociative disorders are a type of disorder in the DSM-5 involving chronic dissociation. It’s important to remember that dissociation is a mental process and a symptom of other mental health conditions, as well as a type of mental health condition itself. Not everyone who experiences dissociation meets the criteria for a dissociative disorder.

The three types of dissociative disorders can be summarized as followed:

• Dissociative Amnesia: forgetting personal information and memories of events
• Dissociative Identity Disorder: experiencing two or more persistent personality states
• Depersonalization/Derealization Disorder: disconnecting from self and surroundings

Treatment For Dissociation

While no therapy or medication is specifically designed to treat dissociation directly, therapy practices such as Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT),and Dialectical Behavioral Therapy (DBT) have been effective in reducing dissociation. Therapies that center around reprocessing traumatic events and reintegrating them into our sense of self, coping with the traumatic event, and gaining control over dissociative symptoms help to manage dissociative disorders and dissociation in general. Early intervention when one begins to notice dissociative symptoms after a traumatic event can prevent the development of post-traumatic stress disorder.³

Sources

1. Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalisation and derealisation. A systematic review. Social psychiatry and psychiatric epidemiology, 39(1), 9–18. https://doi.org/10.1007/s00127-004-0701-4
2. Lynn, S. J., Maxwell, R., Merckelbach, H., Lilienfeld, S. O., van Heugten-van der Kloet, D., & Miskovic, V. (2019). Dissociation and its disorders: Competing models, future directions, and a way forward. Clinical psychology review, 73, 101755.
3. Nöthling, J., Lammers, K., Martin, L., & Seedat, S. (2015). Traumatic dissociation as a predictor of posttraumatic stress disorder in South African female rape survivors. Medicine, 94(16), e744. https://doi.org/10.1097/MD.0000000000000744

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