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.
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 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 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
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 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.
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:
- Maintaining a sleep routine
- Getting regular exercise
- Eating nutritious foods
- Having regular social interaction
- Journaling your feelings
- Practicing mindfulness
- Engaging in meditation for PTSD
- Practicing yoga
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 find 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.