Dissociation

What is Dissociation?

Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories, or sense of identity. It can range from mild, everyday experiences like daydreaming to more severe forms that can be quite disruptive to daily living (eg, feeling disconnected from your mind and body or losing big chunks of time). While mild dissociation is common and generally harmless, severe dissociation can be a sign of a group of psychological conditions, called Dissociative Disorders and/or may be post-traumatic stress response.

Symptoms of Dissociation

The symptoms of dissociation can vary widely and may include:

Causes of Dissociation

When faced with a threatening or distressing situation, we can sometimes become either hyper-aroused (accelerated energy levels in the body) or hypo-aroused (a slow down of acceleration or energy in the body). In many cases, hypo-arousal often leads to symptoms of dissociation. This means that in response to stress our mind will “shut down” to some extent and we can experience a sense of emotional numbness, memory loss and/or disconnection from reality or ourselves. This altered state serves as a psychological buffer, especially when people cannot physically leave the situation or change the stressor and is quite adaptive in protecting us emotionally in the moment.
Dissociating is quite a typical and helpful coping mechanism in response to trauma (ie, if you have had a car accident, you might feel quite numb or the situation feels surreal later at the hospital). However, it becomes a clinical condition when dissociative response become activated too easily or in response to lower-level stressors, and/or when the dissociative response is quite severe or life-impacting. Oftentimes, if an individual has experienced a significant degree of trauma or neglect or a lack of emotional attunement in their lifetime, they can be more prone to developing a Dissociative Disorder. Around 10% of the population will meet criteria for a Dissociative Disorder in their lifetime (Kate, Hopwood & Jamieson, 2020)

Understanding Dissociation and Diagnosing Dissociative Disorders

Whilst people are usually more able to identify hyper-arousal and heightened levels of distress, identifying dissociation can be a little less obvious and therefore trickier to pinpoint. Exploring this with a psychologist can allow you to understand what, if any, dissociative symptoms you may be experiencing.

Diagnosing a Dissociative Disorder is typically done in conjunction with your psychologist via clinical interview and standardised assessment tools such as the Multidimensional Inventory of Dissociation 60-item version (MID-60) [a questionnaire which was developed in Australia].

Treatment Options

Effective treatment for dissociation will often involves a combination of psychological approaches. Treating dissociative symptoms involves learning to identify when you might be experiencing stressful or triggering situations and then implementing grounding techniques and other types of distress tolerance strategies. Approaches such as Dialectical Behaviour Therapy (DBT), Cognitive Behavioural Therapy (CBT), and mindfulness therapies can be very useful. It may also be relevant to problem-solve situations creating stress in a person’s life to see if the impact of these can removed or minimised.

For individuals with a diagnosed Dissociative Disorder, it may also be appropriate to utilise trauma-focused therapies such as Eye Movement Desensitisation and Reprocessing (EMDR), Schema Therapy and Internal Family Systems (IFS). These treatment approaches focus on further integrating the individual’s sense of self as well as processing traumatic memories that might be under-pinning the dissociation. Studies published in the Journal of Trauma & Dissociation certainly highlight the effectiveness of trauma-focused therapies in reducing dissociative symptoms (Brand et al., 2012).

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