Dissociation

Dissociation is the experience of feeling disconnected from yourself and/or the world around you. This experience may be very mild, infrequent and last only a couple of seconds, or it may be more severe, frequent and last for much longer periods of time.

It can be helpful to think of dissociation as sitting along a spectrum. There are times in normal, everyday life where we may temporarily disconnect from the world, such as when we’re daydreaming. This is a very common and normal experience, where we briefly lose focus and connection with what is happening around us. For example, we may lose track of a conversation that we were involved in or may not be able to recall the route we have just driven. Importantly, we can usually reconnect the moment we realise that we have disengaged, and so the experience resolves and does not require intervention.

At the more severe end of the spectrum however, frequent and pervasive dissociation may cause significant disruption to a person’s ability to function in their day-to-day life, and it may cause them great distress. Examples of dissociation include:

–       Derealisation: feeling like the world around you is unreal, foggy or lifeless. Your emotions, physical sensations, thoughts and senses may be become numb and distant, and you may feel like your brain is shutting down. Everything feels surreal

–       Depersonalisation: feeling like you are disconnected and floating outside of your body, and/or observing yourself from the outside. As above, you may feel like you are shutting down, and an extreme experience of this may result in fainting

–       Dissociative Flashbacks: feeling like you are caught in a tug of war between the past and present, where the ‘past’ is currently stronger and keeps winning. You may feel like you are repeatedly being pulled into the past, where you vividly relive a traumatic experience as if it were happening again in the here and now. It may feel hard to keep yourself anchored in the present moment

–       Dissociative Amnesia: not being able to remember information about yourself or life, or having significant gaps where you can’t remember what happened

–       Dissociative Identity: feeling like you are switching between multiple and different identities or personalities

These types of dissociation commonly occur when a person feels emotionally, physically and cognitively overwhelmed by a situation they are confronted with, or when that person feels unable to cope with or remove themselves/escape from the stressor. Dissociation is therefore often seen as an automatic and involuntary response to trauma, which may in fact be adaptive during a traumatic event as it helps an individual to survive or ‘get through’ in that moment. However, dissociation can become problematic when it persists after a trauma has passed.

These dissociative experiences indicate the likely presence of more complex mental health needs that require intervention and support, such as:

– Childhood Abuse & Trauma

– Substance Misuse

– Personality Disorders

– Post-Traumatic Stress Disorder (PTSD)

– Psychosis

The good news is that there are many different types of treatment available to help people who struggle with Dissociation. This includes learning more about what dissociation is; identifying what causes and triggers it for you; learning skills to help you to manage dissociation and stay more grounded; and psychological therapy to address its cause.

 

Treatment for Dissociation

A combination of anti-depressant medication and psychological therapy may be used in the treatment and management of Dissociation, based on the mental health condition it is associated with. Treatments include:

·       Cognitive-Behaviour Therapy (CBT)

·       Dialectical Behaviour Therapy (DBT)

·       Eye Movement Desensitisation and Reprocessing (EMDR)

·       Mindfulness-Based Cognitive Therapy

·       Schema Therapy

·       Trauma-Focused Therapy