How to Recognize Dissociation and What to Do About It

Larry Beall, Ph.D.  (2008)

 

The purpose of this information is to assist in the identification of dissociation and to furnish a few suggestions as to what can be done about it.  What is dissociation?  It is the opposite of association.  When things are associated they are connected with one another, such as members of a group.  When things become dissociated, they become separated from a previous association.  A person can become dissociated from the group and no longer be considered a member.

 

There are two main types of dissociation.  1) ordinary and 2) traumatic.  Ordinary dissociation is something we have all experienced.  For example, when driving down a boring stretch of freeway, the driver may be day-dreaming or be preoccupied with something and become unaware of her surroundings.  A period of time may pass without the driver being aware of the passage of time or the miles that have been driven.  This example of ordinary dissociation simply means her conscious mind has become dissociated from the part of her mind that is doing the driving.  You can probably think of other examples when you have experienced ordinary dissociation in which something is being done that has been done many times before, and is accomplished on “autopilot,” or without conscious awareness.

 

The mind is made up of many elements that are connected with one another under normal conditions.  Under traumatic conditions, especially in childhood, these elements can become separated or dissociated.  This is known as traumatic dissociation. When this happens, the mind dissociates as a way to separate the conscious mind from the part of the mind that experiences the painful trauma.  One example of this is the natural human tendency to react to pain with avoidance and denial.  Each of us has a pain threshold.  When it is passed we remove our consciousness so we don’t experience the pain. You probably know someone who can’t remember an extremely painful experience.  The experience was automatically dissociated and repressed, to keep it out of reach of conscious awareness.

 

Traumatic dissociation is a more common experience than you might think.  Most people associate dissociation with multiple personalities but MPD is relatively rare.  What is more common is traumatic dissociation.  For example, dissociation is common in the medical field where it is correlated with the following disorders: migraine headaches, gastro-intestinal problems, muscle tension disorders, and various medical problems resulting from psychological factors being converted into physical symptoms.  (If you have any of these disorders it doesn’t mean you automatically have dissociation, but they can be correlated).

 

Traumatic dissociation can become a way to function or relate to the world full of painful experiences.  For children who are being abused for example, it is natural for them to “check out,” in a way like the bored driver, and not experience the pain.  But the experience must be dealt with somehow, and that’s where other elements of the mind become involved.  With repeated traumatic events, the checking out of consciousness and the checking in of a mental element can become automatic and unconscious.  Traumatic dissociation could be considered a wonderful survival tool that makes it possible for the trauma survivor to go on with life, despite difficult traumatic experiences.

 

Symptoms of dissociation fall into three main areas:

  1. Amnesia
  2. Absorption
  3. Depersonalization

Amnesia is a more common feature of dissociation.  Some of the manifestations of amnesia include not remembering how one got somewhere, or not remembering buying or doing something.  Often a person cannot be sure whether something was done or just dreamed about or thought of.  “Missing time” is often reported in which one misses or loses blocks of time from two to four hours a day to an entire day or two.

 

Absorption means one becomes so focused or involved in something that surroundings are not noticed.  Some examples of absorption could be remembering a past event so vividly it feels like it’s being relived or becoming so involved in TV or a movie you are unaware of what’s going around you.  Also, you may become so involved in a fantasy or daydream that it feels as if it were real.  It is not unusual when one is dissociating to sit starting off into space, thinking of nothing, and being unaware of the passage of time.

 

Depersonalization is a more extreme form of dissociation.  Contact with reality is more difficult to maintain and the individual’s ability to function declines.  Some of the symptoms include feeling that other people, objects, and the world around her are not real,  hearing voices inside her head that tell her to do things or comment on things she is doing, not recognizing herself in the mirror, and finding familiar places and people unfamiliar.

 

As can be seen from these symptoms, one of the main problems with dissociation is how it interferes with the ability to carry out daily activities, be employed, or just function.  Unfortunately, too many individuals with some form of dissociation do not understand why they function so poorly and are often seen as being irresponsible.  They often cannot get the help they need to solve their problems or improve their situation.  On average, a person is involved in the mental health system for seven years before a Dissociative Disorder is accurately diagnosed.  It is hoped that with increased information, dissociation may be detected and treated earlier.

 

What can be done to treat dissociation?  There are four main stages of treatment: 

  1. Establishing safety
  2. Trauma resolution
  3. Cognitive restructuring
  4. Life skills development.

 

1. Establishing safety (both externally and internally) for the survivor, means her ability to feel safe in her environment and manage extreme emotions. 

2. Trauma resolution to help remove the psychological pain that has accumulated through repeated traumatic experiences.  Remembering one’s traumatic past is not the key to overcoming dissociation, it is removing the pain of the trauma.

3. Cognitive restructuring to help the survivor remove from her mind negative mental conditioning and to acquire new ways of thinking that are more realistic and functional.

4. Life skills development includes self-assertiveness training, stress-management, managing emotions and creating a new lifestyle.

 

We at the Trauma Center invite the reader to call us with any questions.  Dissociation is not a mystery that cannot be solved.  It is treatable if principles of healing are followed that can bring predictable, positive results.