What is Dissociation?
Dissociation happens to all of us from time to time when we go into automatic pilot. For example we may be driving and our mind might wander but we are still completely in control of the car, even if we have no memory of the route we took! More complex dissociation however emerges as a result of trauma, usually happening in childhood. This type of dissociation refers to the feeling of being disconnected from yourself and from others, feeling as if you are not really there. It is a completely normal response to trauma and makes you feel that what’s happening isn’t real. Dissociation is often used by the mind as a response to trauma, and when this is done repeatedly, the brain gets used to using it as a way of coping. It becomes its default mechanism. This makes total sense if we are in an environment where the reality would be too distressing for us to present and so our mind copes by dissociating. A denial of reality may mean we feel disconnected from our feelings, thoughts and body. Once we are out of this environment however, (for example an abusive home), we want the brain to find other ways to manage our emotions which are more suited to our present environment, to feel calm instead of in a constant state of fight/flight or freeze. When we are unable to do this we may develop what is known as a ‘dissociative disorder’.
Symptoms of Dissociative Disorders:
Depersonalisation/derealisation disorder
- feeling detached from mind and body,
- can include feeling as if you are outside of your body observing
- feeling the external world is less real, distant or changed
Dissociative amnesia
- not being able to remember information relating to a traumatic event
- in rare cases losing all sense of identity and personal history
Dissociative identity disorder (DID)
- previously called multiple personality disorder
- the existence of two or more separate parts
- each part may have separate memories, behaviours, thoughts though this is not always the case. Each part may also sometimes have separate ages, names and genders. These parts are not actually separate personalities in one body but are parts of an individual person that have not yet learned to function together smoothly and with co-ordination.
- ongoing gaps in memory that cannot be explained.
Other specified dissociative disorder (OSDD)
- a disturbance in identity but not clearly separated parts as in DID
- identity disturbance due to the mental torture inflicted on a person (for example cults, mind control)
- short term dissociative reactions to stressful events
- dissociative trance where a person is aware of the external world but cannot respond. (This does not include whilst under the influence of drugs).
Other more general symptoms of dissociative disorders may include:
- generalised anxiety and/or excessive social anxiety
- memory, concentration and cognitive issues
- chronic headaches and dizziness
- pseudo-seizures (non epileptic)
- hearing voices or sensing smells that don’t exist
- sleep issues such as waking night terrors and sleepwalking
- body reactions that are out of sync with the environment such as feeling cold in a hot room
It is important to remember that there is nothing wrong with your brain if you have experienced any of these symptoms or if you have been diagnosed with a dissociative disorder. Your brain has adapted to traumatic events the best way it knows how, it now needs to know how to respond appropriately to situations that are not traumatic.
How therapy with me can help with dissociative disorders:
There are many ways therapy can help you manage your dissociation as well as helping you understand your symptoms and causes. Initially the focus will be on helping you stay safe and managing your feelings. The pace of therapy will be tailored to you so that it is right for you and so that therapy feels manageable and safe. When you feel ready we will work through any traumatic memories at a pace and in a way that is manageable for you so that the trauma feels more integrated. There is no pressure to talk about anything before you are ready to and you are always in control of what happens in the therapy room. I believe that the quality of the relationship between therapist and client is paramount and so I will aim to give you warmth, empathy, engagement and attunement.