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  • Mental Health Issues
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  • What Is Dissociation?What Is Dissociation?
  • Trauma DissociationTrauma Dissociation
  • PTSD & DissociationPTSD & Dissociation
  • Negative Effects of PTSD DissociationNegative Effects of PTSD Dissociation
  • TreatmentTreatment
  • Tips on How to CopeTips on How to Cope
  • ConclusionConclusion
  • InfographicsInfographics

PTSD Dissociation: Why It Happens & How to Heal

Silvi Saxena MBA, MSW, LSW, CCTP, OSW-C

Written by: Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C

Headshot of Naveed Saleh MD, MS

Reviewed by: Naveed Saleh, MD, MS

Published: July 26, 2022

Dissociation is a state of mind that occurs when someone separates themselves from their emotions, and is a common trauma defense mechanism in people with Post Traumatic Stress Disorder (PTSD). Dissociation can feel like an out-of-body experience or like disconnection from the world around you.

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What Is Dissociation?

Dissociation describes a disconnect between a person’s sense of self and their thought processes. In mild forms, dissociations are common and frequently occur in the form of daydreaming or even when someone experiences their mind wandering on a long drive. In  more severe cases, when it becomes a dissociation disorder, it can impact someone’s memory, awareness, and identity, leading to substantial consequences in their daily life, limiting their ability to work and interact with the world and people around them.1

Dissociative Disorders

Dissociative disorders differ from everyday dissociative experiences as they interfere with one’s functioning with friends, family, coworkers, and other interpersonal relationships. A person experiencing this disorder frequently engages in unhealthy and involuntary dissociations to escape reality. These disorders can be triggered by reminders of previous trauma, thus leading to memory loss and stress, among other symptoms.

Four different types of dissociative disorders include:

  • Dissociative Identity Disorder (DID): DID is a disorder where in the face of trauma, a person will develop several unique personalities. During dissociation, the alternate identities can take control, allowing the original person to not be present in reality.
  • Dissociative Amnesia: This disorder leads to gaps in memory relating to experiences of trauma or reminders of it, usually remembering information surrounding the event but not the exact moment.
  • Dissociative Fatigue: Extended and repetitive dissociation can lead to fatigue, exhaustion, sense of hopelessness from the constant sensation and threat of danger.
  • Depersonalization: This disorder involves the constant experience of feeling detached from one’s body and thoughts, almost like an outside observer of their life, also feeling detached from one’s surroundings.

Trauma Dissociation

Trauma and dissociation go hand in hand. Those who have experienced childhood abuse or neglect make up a large portion of those diagnosed with dissociative disorder. However, dissociation can also be a coping strategy for those who have had extended exposure to trauma, including firefighters, healthcare professionals, and military personnel.

Dissociation as a Coping Strategy

Dissociation is the brain’s way of protecting itself from traumatic emotional experiences and allows a person to override their emotions to survive the perceived threats around them. Without this coping mechanism, some people may not be able to perform the necessary functions of daily life without becoming overwhelmed. Dissociation tendencies may go away with time but can become debilitating if left untreated.

Age of Trauma & Developing a Dissociative Disorder

Because our minds are still developing during childhood, those who experience trauma at a young age are more susceptible to dissociative disorders.1 Children who are abused or neglected—specifically between the ages of four and nine—are not yet mentally equipped to handle these stress levels.3 As they have experienced continual exposure to adverse situations, childhood trauma can groom and condition someone to operate in true dysfunction.

PTSD & Dissociation

PTSD typically develops after someone lives through a traumatic event, such as witnessing an active war zone, being involved in a car accident, or experiencing persistent abuse. PTSD can impact anyone at any age.

While it is possible to develop PTSD and dissociative disorders independently, it is more common for the conditions to occur simultaneously. When a person experiences prolonged exposure to trauma, they are likely to develop dissociative techniques to cope. Additionally, chronic trauma can further ingrain dissociative tendencies into one’s automatic brain responses, making these tendencies harder to combat and treat.5

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Negative Effects of PTSD Dissociation

Dissociation as a coping strategy can be effective momentarily but can wreak havoc if left unaddressed. Eventually, people may enter dissociative states without exposure to potential threats or environmental triggers. This unpredictable disconnection can become problematic for relationships, work, and other commitments.

Additional adverse long-term effects of dissociation may include:3

  • Having “blackout” periods of amnesia
  • Forgetting essential personal information
  • Feeling as if others are not real people
  • Inability to recognize yourself
  • Loss of self-identity
  • Development of multiple personas or personality disorders
  • Forgetting the people you know
  • Confusion from your inner monologue

Brain Changes in Trauma & Dissociative PTSD

Trauma can cause physical damage to a person’s brain structure, resulting in a higher likelihood of one developing dementia later in life. Damaged neural connections can lead to mood, functional ability, and cognition changes in anyone at any age.  Moreover, trauma may cause additional harm to someone’s frontal lobe, which plays a vital role in relational behaviors and communication.4

Treatment for Trauma-Related Dissociation

Therapy and medication are very effective for treating trauma-related conditions. Finding a safe space in which you can uncover the root cause of your trauma is the first step toward recovery. Untreated symptoms of  PTSD can lead to further interpersonal conflicts, anxiety, and depression.

Therapy

Therapy can teach you productive ways to deal with symptoms of PTSD and trauma.5 Speaking with a professional can help yourself, your partner, and your family feel better about your diagnosis while also addressing its causes and possible triggers.

Types of therapy used in treating trauma and PTSD may include:

  • Dialectal Behavioral Therapy (DBT): DBT is used to help one reduce self-harm behaviors, such as suicide ideations, unsafe sexual practices, and substance misuse. DBT sessions focus on mindfulness, distress tolerance, emotional regulation, and interpersonal skills. These skills can help teach patients how to acknowledge and accept their feelings without judgment, improve communication, and recognize situations they cannot change.6
  • Cognitive Behavioral Therapy (CBT): CBT aims to help people identify patterns of negative thoughts and replace them with positive alternatives. With CBT, patients are taught to combat difficult emotions and behaviors in realistic and constructive ways.7 You can specialize this treatment more with trauma-focused CBT, which can be used as a stand-alone therapy or in conjunction with DBT.

Medication

PTSD Medications can be helpful when treating dissociations related to trauma. Medication can allow you to manage symptoms more effectively so you’re ready to focus on healing. It’s important to consider all of your options before starting a prescription regimen, so be sure to discuss this with your medical team first.

How to Cope With Trauma-Related Dissociation

It is possible to recover from trauma and PTSD. However, achieving this takes time and support. Understanding the underlying causes of your episodes is critical, as it allows you to address them in healthy ways.  Practicing restorative coping techniques can be valuable to your treatment plan when combating negative emotions that can lead to dissociation.

Here are eight healthy coping strategies for PTSD dissociation:

  1. Maintaining a sleep routine
  2. Getting regular exercise
  3. Eating nutritious foods
  4. Having regular social interaction
  5. Journaling about trauma
  6. Practicing mindfulness
  7. Engaging in meditation for PTSD
  8. Practicing yoga

Final Thoughts

You may feel that what you’re experiencing is unique to you, but you’re not alone. Dealing with dissociation can be scary and frustrating, but there are ways to heal. Speaking with a therapist who specializes in trauma-informed therapy can help you develop a plan to regulate these complex coping mechanisms and change your relationship with your past. You can start finding a therapist specializing in trauma-based treatments by asking for a referral from your healthcare provider, a trusted loved one, or by consulting an online therapist directory.

Additional Resources

To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.

Online Therapy 

BetterHelp – Get support and guidance from a licensed therapist. BetterHelp has over 25,000 therapists who provide convenient and affordable online therapy. Take A Free Online Assessment and get matched with the right therapist for you. Free Assessment

Online PTSD treatment

Talkiatry offers personalized care from psychiatrists who listen, and take insurance. Get matched with a specialist in just 15 minutes. Take our assessment.

Treatment For Trauma & OCD

Half of people diagnosed with OCD have experienced a traumatic life event. The chronic exposure to stressful situations, such as ongoing bullying, or an abusive relationship can lead to the development of OCD symptoms. NOCD therapists specialize in treating both trauma and OCD and are in-network with many insurance plans. Visit NOCD

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For Further Reading

  • Anxiety & Dissociation: How Are They Connected?
  • Best PTSD & Trauma Books for 2021
  • Jed Foundation
  • National Alliance on Mental Health

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Self-punishment is a term that refers to behaviors or actions people engage in to inflict pain or harm upon themselves. These actions can show up in all kinds of ways and can include self-harm, negative self-talk, or engaging in risky behaviors. Understanding the underlying causes of self-punishment is crucial for identifying and providing appropriate support to people caught up in these damaging habits.

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Obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are two commonly known anxiety disorders that can often co-occur in people with a history of trauma. While OCD is thought to affect millions of people, studies have found that nearly 30% of people with PTSD also experience OCD.

 

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PTSD Dissociation Infographics

What Is Dissociation? Negative Effects of PTSD Dissociation How to Cope With Trauma-Related Dissociation

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Sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Loewenstein R. J. (2018). Dissociation debates: everything you know is wrong. Dialogues in clinical neuroscience, 20(3), 229–242.

  • Lawson, D. M., & Akay-Sullivan, S. (2020). Considerations of dissociation, betrayal trauma, and complex trauma in the treatment of incest. Journal of child sexual abuse, 29(6), 677-696.

  • Panisch, L. S., Rogers, R. G., Breen, M. T., Nutt, S., Dahud, S., & Salazar, C. A. (2022). Childhood betrayal trauma, dissociation, and shame impact health-related quality of life among individuals with chronic pelvic pain. Child Abuse & Neglect, 131, 105744.

  • 4-Lebois, L. A., Li, M., Baker, J. T., Wolff, J. D., Wang, D., Lambros, A. M., … & Kaufman, M. L. (2021). Large-scale functional brain network architecture changes associated with trauma-related dissociation. American Journal of Psychiatry, 178(2), 165-173.

  • Beasley, C. C., & Ager, R. (2019). Emotionally focused couples therapy: a systematic review of its effectiveness over the past 19 years. Journal of Evidence-Based Social Work, 16(2), 144-159.

  • Prada, P., Perroud, N., Rüfenacht, E., & Nicastro, R. (2018). Strategies to deal with suicide and non-suicidal self-injury in borderline personality disorder, the case of DBT. Frontiers in psychology, 9, 2595.

  • Kredlow, M. A., Szuhany, K. L., Lo, S., Xie, H., Gottlieb, J. D., Rosenberg, S. D., & Mueser, K. T. (2017). Cognitive behavioral therapy for posttraumatic stress disorder in individuals with severe mental illness and borderline personality disorder. Psychiatry research, 249, 86-93.

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  • What Is Dissociation?What Is Dissociation?
  • Trauma DissociationTrauma Dissociation
  • PTSD & DissociationPTSD & Dissociation
  • Negative Effects of PTSD DissociationNegative Effects of PTSD Dissociation
  • TreatmentTreatment
  • Tips on How to CopeTips on How to Cope
  • ConclusionConclusion
  • InfographicsInfographics
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