Understanding Dissociation

What is dissociation?

Dissociation refers to a sense of disconnection or lack of connection between things usually associated with each other. When it is used to describe a mental health condition, it means that a person feels disconnected from oneself, and/or from one’s surroundings.

Forms of dissociation

1. Depersonalization

• Experience of detachment from oneself
• It can feel like an out-of-body experience
• Some experience profound alienation from their bodies
• May feel detached from one’s own emotions
• Can feel robotic or feel like you are an autopilot

2. Derealization

• Experience of the world as not being real
• May experience the world as phony, foggy, or far away
• May experience oneself as watching a movie or floating around

3. Dissociative disturbances of movement and sensation

Sometimes trauma-related dissociation causes physical symptoms which cannot be explained by a physical disease or disorder. These symptoms can include:

• Unexplained loss of function after a trauma:
• Loss of senses such as sight, hearing, speech
• Loss of movement of feeling in a part of the body, including paralysis or complete numbness
• Loss of skills such as temporary inability to remember how to drive a car or cook food
• Unexplained intrusions in the body
• Involuntary movements or impulses that do not feel they are yours
• Unexplained pain or other sensations
• Seizures which are not caused by a physical disorder like epilepsy

4. Amnesia

• Inability to remember personal information that is not related to ordinary forgetfulness
• What is forgotten is often an important event, such as abuse or a troubling incident
• The amnesia can be a block of time, from minutes to years
• Micro-amnesias are common when a person cannot remember what is being discussed in a conversation

5. Identity alteration

• An individual has two or more distinct personality states
• The individual experiences discontinuity in sense of self and in sense of agency
• Each personality state has distinct pattern of perceiving, relating to, and thinking about the environment and self
• There may be different levels of awareness between the personality states

Treatment of Dissociation

Dissociation is a complex condition. An individual may experience a combination of different forms of dissociation. There is a lack of empirical studies on effective treatment for dissociation.

However, emerging research has demonstrated that certain treatments can help reduce dissociative symptoms. Most importantly, effective treatments need to help facilitate an internal and relational sense of safety. In addition, a transtheoretical model is highly recommended to address individualized presentation of various dissociative symptoms. The model can include, but is not limited to, pharmacotherapies, mindfulness and somatic-based therapies, trauma-focused interventions, and psychoanalytic/psychodynamic therapies.

Frequently Asked Questions (FAQs) About Dissociation

What causes dissociation?

Dissociation is a natural part of threat response for all species. Normally, it is activated when faced with extreme and inescapable danger. Dissociative disorders are developed if the symptoms continue after the threat has passed. Pathological dissociation is connected with early childhood trauma, insecure attachment, neglect, and other extreme and inescapable traumatic experiences.

When should I seek treatment for dissociation?

There is a wide range of presentation with dissociation. Common experiences include a strong sense of detachment and confusion. Some experience lapses of memory. If these symptoms cause significant distress and affect your day-to-day functioning, it would be helpful to seek consultation from a professional who has experience with dissociation.