Dissociation

Most of us couldn’t get through the day without some kind of dissociation. Normally, dissociation takes the pressure off us in the short term, allowing space to rest and regroup. For example when we briefly day dream or tell white lies-to ourselves (like “I’ll do it later”), we are taking a little break from something that is boring, stressful,  or onerous. At this end of the continuum, it is a gentle and useful form of escape or avoidance.

After prolonged or repeated stress or trauma however, patterns of dissociation can become more frequent, more compelling or more problematic. At this end of the continuum, dissociation is an automatic fixed pattern or highly compartmentalised  state which is a defense against the terror, powerlessness, or feeling trapped experienced in the past. Symptoms can include loss of time, loss of memory, loss of sense of identity, confusion about the self, somatic conditions, loss of connection, psychosis, loss of contact with reality, significant self- neglect and other issues.

Sometimes dissociation can change our “age” from a functional everyday life adult self to younger child states- this is called structural dissociation (Steele, Boon & Van Der Harte, 2017), and it may vary from normal and healthy to maladaptive.

At the severe end of the continuum, almost anything can trigger dissociation, even positives for example the thought of going out of the house, the sight of someone smiling, a warm tone of voice, a question about how we are going, even the thought of something pleasant, and of course the need to avoid something stressful can also activate various forms of dissociation.

Exercise: Look at the list below and tick which forms of dissociation you are most familiar with:

  • Day dreaming
  • Living in a fantasy world
  • Telling lies automatically
  • Forgetting to do something you promised to do
  • Living in the past or future
  • Feeling numb
  • Not knowing what you are feeling emotionally
  • Not knowing what you are feeling physically
  • Living in our heads
  • Being clumsy and bumping into things a lot
  • Chronic lateness
  • Having strong feelings that are connected to the past that replay over and over in the present
  • Having fantasy friends or person you talk to
  • Addictions
  • Feeling as if you are not present
  • Feeling as if you are in the wrong body
  • Reacting as if something from the past is happening now
  • Hating your body and living in your head
  • Having physical symptoms for which there is no medical explanation
  • Flashbacks- physical, mental or emotional
  • Gender confusion
  • Factitious disorder (lying compulsively)
  • Addiction to the internet, games etc
  • “Vaguing out” when someone asks you a question
  • Believing you are “different”       eg from a different time/era and are “reincarnated”
  • Feeling like the body, or part of it, has disappeared
  • Insensitivity to pain in part or all of the body
  • Being told by others repeatedly that you are not listening
  • Seeing things differently than usual, eg as if looking through a tunnel
  • Feeling outside of your body
  • Cannot speak or can only whisper
  • Pan during urination that has no physical cause
  • Finding yourself somewhere but have no idea how you got there
  • Finding new belongings but do not remember buying them
  • See yourself as if looking at another person
  • Do not recognise family or friends
  • Feel that other people, objects and the world are not real
  • Feel that your body is not your own
  • Feel as though you are two different people
  • Hear voices inside your head
  • Feel that you are not responsible for your behaviour
  • Feel confused about who you are
  • See yourself as if you are a long way away
  • Avoiding things for so long you forget they are there
  • Smelling, sensing, or tasting something that is not there
  • Feeling overly detached and disconnected
  • Part of the body is paralysed for a while
  • Losing the ability to swallow for a while
  • Not able to sleep for nights on end but remain very active during the day
  • Hear sounds from nearby as if they were coming from far away
  • Have an attack that resembles an epileptic seizure
  • Not noticing the stress or tension in the body even when it is extreme

Association as the Antidote for Dissociation 

Humans normally alternate between association and dissociation. If you suffer because of too much dissociation, find a trauma and dissociation informed therapist via Blue Knot Foundation or similar.

For some people it may be safer or less uncomfortable to start working with dissociation via the body, with help from a professional trained in Sensorimotor Psychotherapy, Somatic Experiencing, Art Therapy, Sand Play or Trauma-Sensitive Yoga. Try pushing your feet gently into the floor now. What can you sense?

Exercise: Describing and Tracking Sensation

This process will help you better describe your inner sensations.

When someone asks you how you’re doing, you may typically answer in a vague way, such as “OK” or “Not so good.” But try asking yourself, “What sensation in my body tells me that I’m feeling OK?” You may well get some more information: “My head feels centred. My left shoulder is tingly. And my hand is warm.”

The way that you distinguish a sensation from an emotion or a thought is by being able to locate it in your body and experience it in a direct physical way. For example, if you’re experiencing anxiety, the next question to ask would be: “When I feel anxious, how do I know that I am feeling anxious?” In other words, where in your body do you feel it, and exactly what is the physical sensation? Is it tightness? Is it constriction? Is it a knot?

Or is it a fluttery feeling? Is it your heart palpitating? What is your breathing like? Are there butterflies in your stomach? All of these sensations might be called anxiety.

The art in naming a sensation is to understand that it has to have a location in the body. Sensations can have a size or shape. Quality of sensation such as tightness, spaciousness, constriction, heat, cold, vibration, or tingling can also be tracked.

I hope this page helps you understand that dissociation, like trauma, can be healed. For more help with dissociation, contact the Blue Knot Helpline on 1300 657 380