Dissociation (A complete guide)

Dissociation is the mental process of disconnecting from one’s thoughts, feelings, memories or identity.

There are several dissociation disorders which need professional medical intervention, namely dissociative amnesia, dissociative disorders of movement or sensation, depersonalization disorder and dissociative identity disorder.

In this blog article, we will discuss the signs and symptoms of dissociation, who is susceptible to it, and common treatments. 

What is dissociation?

We all daydream sometimes, drifting off into another world until a noise or other outside stimulus brings us back.

This is normal. However, dissociation is an actual break in how your brain is handling information.

A disconnect occurs from your thoughts, feelings, memories, even surroundings, which can affect your sense of time, identity or self.

Some dissociation is very short lived, possibly following a traumatic life event like the loss of a parent, and generally resolve on their own in minutes, hours, weeks or months.

But others can last a lot longer.

Dissociation is a way the mind copes with an overload of stress. 

People who dissociate may feel disconnected from themselves and the world around them.

It is much like an out of body experience, which actually is a form of dissociation.

Dissociation is like an out of body experience, feeling disconnected from the world.

Like in dissociation people feel disconnected from the world, in Derealization people perceive the environment to be unreal.

Many people with dissociation have experienced a tragic event during childhood.

Dissociating from reality is a way of dealing with this. Someone with dissociation may exhibit problems with:

·      movement

·      sensation

·      seizures

·      bouts of memory loss.

What are the signs and symptoms of dissociation?

Dissociation can cause forgetfulness or leave gaps in your memory.

Some people feel that the physical world is not real, or they are not real themselves. Other symptoms can include:

·      out of body experience

·      feeling like a different person

·      pounding heart or light headed

·      emotionally numb or detached

·      feeling little or no pain.

Other more severe signs and symptoms can include:

  • an altered sense of time 
  • forgetting how you reached somewhere 
  • tunnel vision
  • hearing voices in your head
  • having intense flashbacks to the past which feel absolutely real 
  • becoming unable to move 
  • getting absorbed in a fantasy world that seems real.

What are the causes of dissociation?

The causes of dissociation are relatively poorly understood. The most documented cause is trauma.

If you psychologically disconnect from the present due to something really bad happening to you, this is called peritraumatic dissociation.

The cause could be a current or previous traumatic experience, or a tendency to develop more physical than psychological symptoms when stressed or distressed.

Physical, sexual or emotional abuse during childhood is a known cause of a range of disorders which can include dissociation. 

Some people dissociate after experiencing war, capture, kidnapping or even an invasive medical procedure.

Another trigger can be a motor vehicle accident or natural disaster.

It is a self-preservation, defense mechanism that the brain/ mind brings into play to help cope with extreme conditions, a form of denial, as if ‘this is not happening to me’. 

When the external environment is no longer traumatic but the person still acts and lives as if it is, and has not dealt with or processed the event, this can go on to become a dissociation disorder.

This can also happen if the trauma happens repeatedly.

Auto-hypnosis is another form of dissociation.

When you daydream, or your mind wanders, perhaps due to boredom or repetitive activity, then you may no longer have a strong awareness of your body. 

A trained professional can use therapeutic hypnotherapy to help patients manage pain, anxiety, additions or post-traumatic stress disorder (PTSD) by creating a deep dissociated state under controlled consitions.

You may lose your sense of identity or reality in the event that you drink alcohol or take illegal drugs.

Research shows that individuals who take psychedelics, like psilocybin or LSD, report briefly losing their sense of reality. 

Much like daydreaming, meditation is a deliberate disconnection from reality and the moment, creating mindfulness of only being, not being aware of the body or self or environment. 

Meditation can assist with dissociation, creating a sense of being and mindfulness

What are related mental health conditions to dissociation?

It is possible for a patient to have dissociation combined with, or alongside, certain mental health disorders.

Dissociation can be linked to: 

  • PTSD
  • schizophrenia
  • acute stress disorder
  • borderline personality disorder
  • affective disorders
  • obsessive-compulsive disorder
  • eating disorders.

What are the warning signs of dissociation?

It is possible to have dissociation and not actually know it, or at least know something is wrong but not realize exactly what you are suffering.

Or, further, you may choose to keep your symptoms hidden or explain them another way if challenged by a friend or family member. 

Signs can include:

  • rapid mood swings
  • difficulty remembering personal details
  • forgetfulness about things you’ve said or done 
  • having altered identities
  • depression, anxiety or panic attacks
  • thoughts of suicide or self-harm
  • substance abuse (drug or alcohol).

Children with a dissociation disorder may: 

  • seem to be not really with it
  • gaze out of the window a great deal 
  • have imaginary friends
  • forget they’ve said or done something 
  • have ADHD or other learning disabilities.


Children with dissociation can seem to be not with it or gaze out of a window a lot.

How is dissociation diagnosed?

If your primary care physician thinks you may have a dissociative disorder they will refer you to a mental health specialist for a full assessment.

They will also give you a full physical test and ask about any past physical or psychological well-being disorders, and also ask about medication, drugs or past traumas. 

What is the treatment for dissociation?

A full recovery can be made with treatment and support.

If there are specific physical symptoms, for example paralysis, speech loss or walking difficulties, these may be handled using physical therapy.

There is no specific medicine for dissociation, but associated medicines such as antidepressants, or sedatives maybe prescribed to treat linked conditions such as depression, anxiety or panic attacks.

Talking therapies are often recommended as the best approach to getting to the heart of this condition.

Counselling and psychotherapy are two of the main ones applied.

Treatment may include: 

  • Cognitive-behavioral therapy: CBT – helps recognize and ultimately change negative thoughts and feelings
  • Hypnotherapy: induces a deeply relaxed state, in which you can find it easier to explore and process trauma or bad memories. This should only be done with a certified professional hypnotherapist.
  • Phasic trauma treatment: This treatment aims to prevent suicidal thoughts, followed by a slow process to help process traumatic memories.
  • Dialectical behavioral therapy: A common treatment for borderline personality disorder, this can help learn skills to control emotions and stop harmful behavior. 
  • Eye movement desensitization and reprocessing (EMDR): EMDR uses CBT techniques, and includes visual exercises to help work through memories of seriously troubling events in the past. It could help prevent nightmares, flashbacks or other PTSD manifestations. 

In this article, we discussed the symptoms of dissociation, what causes it, and how it can be treated. 

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Frequently asked questions (FAQs) about dissociation: 

1.    Can you be aware of dissociation?

Many times, people who are dissociating are not even aware that it is happening, it is often other people who notice it.

2.    What does dissociation feel like?

If you dissociate, you may feel disconnected from yourself and the world around you.

You may feel detached from your body or feel as though the world around you is unreal.

Dissociation feels as if the world around you is unreal.

3.    Does dissociation cause memory loss?

Dissociation is a disruption in the integrated functions of consciousness, memory, identity, and perception.

Dissociative symptoms include derealization/depersonalization, absorption, and amnesia.

These experiences can cause a loss of control over mental processes, including memory and attention.

4.    How long does dissociation last?

Periods of dissociation can last for a relatively short time (hours or days) or for much longer (weeks or months).

It can sometimes last for years, but usually if a person has other dissociative disorders.

5.    How do you know if a client is dissociating?

Daydreaming, spacing out, or eyes glazed over.

Acting different, or using a different tone of voice or different gestures.

Suddenly switching between emotions or reactions to an event, such as appearing frightened and timid, then becoming strident and violent.

6.    What is dissociation in PTSD?

Having flashbacks to traumatic events related to your PTSD.

Feeling that you’re briefly losing touch with events going on around you (similar to daydreaming), “blanking out” or being unable to remember anything for a period of time.

7.    What is defensive dissociation?

Dissociation as a psychological defence mechanism.

Dissociation is a disconnection from events and states that are usually integrated.

This dissociation means the person is emotionally withdrawn from their healthy sense of self and the world, and this cannot protect against future trauma.

8.    Is dissociation a symptom of depression?

Symptoms and signs of dissociative disorders include significant memory loss of specific times, people and events, out-of-body experiences, such as feeling as though you are watching a movie of yourself, mental health problems such as depression, anxiety and thoughts of suicide.

9.    Why do I dissociate so much?

Dissociation commonly goes along with traumatic events and PTSD.

Dissociation as avoidance coping usually happens because of a traumatic event.

Being powerless to do anything to change or stop a traumatic event may lead people to disconnect from the situation to cope with feelings of helplessness, fear or pain.

Dissociation (A complete guide)

Want to learn more about dissociation? Try these recommended readings!

Coping with Trauma-Related Dissociation: Skills Training for Patients and Therapists (Norton Series on Interpersonal Neurobiology) 1st Edition

This is a training manual for patients who have a trauma-related dissociative disorder.

It includes short educational pieces, homework sheets and exercises that address ways in which dissociation interferes with essential emotional and life skills, and supports inner communication and collaboration with dissociative parts of the personality.

Topics include understanding dissociation and PTSD, using inner reflection, emotion regulation, coping with dissociative problems related to triggers and traumatic memories, resolving sleep problems related to dissociation, coping with relational difficulties and help with many other difficulties with daily life.

The Mental Health Clinician’s Workbook: Locking In Your Professional Skills Workbook Edition

This is a hands-on workbook to help mental health practitioners and students build essential skills for clinical evaluation and differential diagnosis.

Renowned diagnostician and bestselling author James Morrison (DSM-5 Made Easy and other works) invites the reader to interview and evaluate 26 patients with a wide spectrum of presenting complaints and ultimate diagnoses.

Understanding Trauma and Dissociation Paperback – March 15, 2007

Dissociation, trauma . . . you’ve heard the buzzwords from psychology experts on the talk shows. Dr. Lynn Mary Karjala unravels the mysteries of dissociation, its roots, its effects, and its treatment in this must-read book for psychotherapists, patients and loved ones.

References:

What is Dissociation? -WebMD – August 2019

National Health Service (UK) – April 2019

MIND.org.uk – January 2020

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