Understanding Dissociation: Coping with Trauma-Related Symptoms

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When a person experiences a traumatic event, their mind can have difficulty processing the emotions and memories associated with the event. This can result in a range of symptoms, including dissociation. Dissociation is a mental process that can affect a person’s sense of self and consciousness. It is a common coping mechanism for those who have experienced trauma. Dissociation can take many forms, from mild feelings of detachment to more severe forms, where a person experiences a complete loss of connection with reality. Understanding dissociation and its effects is essential, particularly for those seeking psychotherapy.

Introduction

When someone experiences a traumatic event, their mind may struggle to process the emotions and memories associated with the event. This can lead to a range of symptoms, including dissociation. Dissociation is a mental process that can affect a person’s sense of self and consciousness. For those who have experienced trauma, dissociation can be a common coping mechanism.

Dissociation is a term used to describe the disconnection or lack of connection between things usually associated with each other. This disconnection can occur within the individual’s consciousness, memory, identity, or perception. When someone dissociates, they may feel as though they are watching themselves from a distance or as though they are not entirely present in their surroundings. This experience can be distressing and may contribute to other mental health conditions, such as post-traumatic stress disorder (PTSD) or borderline personality disorder (BPD).

It is important to understand dissociation, particularly for those seeking psychotherapy. Dissociation is a common experience for individuals who have experienced trauma, and it is important for therapists to recognize and understand how it can manifest in their clients. By understanding dissociation, therapists can help their clients to develop strategies for managing their symptoms and improving their mental health.

What is dissociation?

Dissociation is a psychological process affecting a person’s sense of self and consciousness. When someone dissociates, they may feel disconnected from their thoughts, feelings, and environment. Dissociation can take many forms, from mild feelings of detachment to more severe forms, where a person experiences a complete loss of connection with reality.

One common form of dissociation is emotional numbing, which is a hallmark symptom of PTSD. Emotional numbing is a dissociative experience where someone thinks about a tremendously upsetting event yet has no feelings about it. This can be distressing for the individual, as they may feel as though they cannot connect with their emotions.

Dissociation can also manifest subjectively as “made” thoughts, feelings, and actions. These experiences seem to come from nowhere and are not integrated into the individual’s usual sense of self. For example, someone may suddenly feel an intense sadness that seems to have no cause and then have the feeling leave just as suddenly. This can be confusing and distressing for the individual, as they may feel like they are not in control of their thoughts and emotions.

Dissociation is a common experience for individuals seeking mental health treatment. By understanding dissociation and its effects, therapists can help clients develop coping strategies and improve their overall mental health.

Subjective experiences of dissociation

Dissociation can also manifest subjectively, with individuals reporting experiences of “made” thoughts, feelings, and actions. These experiences seem to come from nowhere and are not integrated into the individual’s usual sense of self. For example, someone may suddenly have thoughts or feelings that seem to have no cause or may find themselves acting as if they were controlled by a force other than themselves.

Individuals experiencing dissociation may also describe feeling like a “passenger” in their own body rather than the driver. This can be a distressing experience, as they may feel like they are not in control of their thoughts and actions.

Some examples of subjective experiences of dissociation include sudden and intense feelings of fear or anxiety that seem to have no cause, feeling disconnected from one’s own body or surroundings, feeling as though one is watching oneself from a distance, or feeling as though one’s thoughts or actions are not their own.

It is important to note that not everyone who experiences dissociation will have the same subjective experiences. However, by understanding the various ways in which dissociation can manifest, therapists can better recognize and treat the symptoms of dissociative disorders.

The five main types of dissociation

Dissociation can take many forms, and the Structured Clinical Interview for Dissociative Disorders (SCID-D) identifies five primary types of dissociation: depersonalization, derealization, amnesia, identity confusion, and identity alteration. Each type of dissociation can affect an individual’s experience in different ways.

Depersonalization: Depersonalization involves a sense of detachment or disconnection from oneself. Individuals experiencing depersonalization may feel as though they are observing themselves outside their body or that their thoughts, feelings, or actions are not their own. This experience can be distressing and may lead to feelings of detachment from loved ones or difficulty engaging in daily activities.

Derealization: Derealization is similar to depersonalization, but instead of feeling disconnected from oneself, individuals experiencing derealization may feel disconnected from their surroundings. This can manifest as feeling like one is in a dreamlike state or that the world around them is not real. This experience can be disorienting and may lead to feelings of anxiety or panic.

Amnesia: Amnesia involves memory loss for a particular period or specific events. Individuals experiencing amnesia may be unable to recall important details or experiences from their past. This can be distressing and lead to difficulties in forming relationships or functioning daily.

Identity confusion: Identity confusion involves a sense of uncertainty or confusion about one’s identity. Individuals experiencing identity confusion may question their values, beliefs, or sense of self and may feel unsure of who they are. This can be distressing and lead to difficulty forming relationships or feeling a sense of purpose.

Identity alteration: Identity alteration involves a more extreme form of identity confusion, where individuals may experience distinct and separate identities or personalities. This can manifest as dissociative identity disorder (DID), where the individual experiences the presence of two or more distinct personalities or identities. This can be a distressing and often debilitating experience, as individuals may feel like they are not in control of their thoughts or actions.

By understanding the different types of dissociation and their effects on an individual’s experience, therapists can better diagnose and treat dissociative disorders. Therapy may involve a combination of techniques, including cognitive-behavioural therapy, mindfulness, and medication, aimed at helping individuals develop coping strategies and improve their overall mental health.

Diagnosing dissociative disorders

The Structured Clinical Interview for Dissociative Disorders (SCID-D) is a diagnostic tool for assessing and diagnosing dissociative disorders. The SCID-D is a standardized interview process that evaluates the presence of the five primary types of dissociation: depersonalization, derealization, amnesia, identity confusion, and identity alteration. During the interview, the therapist will ask specific questions to assess the presence and severity of dissociative symptoms.

The presence of any of the five types of dissociation may suggest a dissociative disorder diagnosis, such as dissociative identity disorder (DID), dissociative amnesia, or depersonalization/derealization disorder. The therapist will also assess the impact of dissociative symptoms on the individual’s daily life and functioning.

Diagnosing dissociative disorders can be challenging, as dissociative symptoms may overlap with symptoms of other mental health conditions. However, by using standardized diagnostic tools like the SCID-D, therapists can more accurately assess and diagnose dissociative disorders.

Conclusion

Dissociation is a common experience for individuals who have experienced trauma or other adverse life events, and it can significantly impact their mental health and overall well-being. By understanding dissociation and its effects, therapists can help individuals develop coping strategies and improve their overall mental health.

It is essential for individuals seeking psychotherapy to find a therapist who understands dissociation and its effects. Therapists specializing in trauma and dissociative disorders can provide effective treatment and support to help individuals manage their symptoms and improve their mental health.

If you or someone you know is experiencing dissociative symptoms, seeking help from a mental health professional is essential. With the right support and treatment, individuals can learn to manage their symptoms and improve their quality of life.

References

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Clayre manages a group practice of three close-knit queer and trans therapists, including youth therapist Audrey Wolfe, RCC, LGBT therapist Camber Giberson, RCC, CCC, and gender-affirming therapist Clayre Sessoms, RP, RCT, RCC, CCC, ATR-P. Work with us: book a session.