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Dissociation

Introduction

Dissociation is a way that the mind copes with too much stress. 

It is the experience of feeling disconnected from yourself and the world around you. It can sometimes make you feel detached from your body or feel that the world around you is unreal.

 

In this section, we will take a closer look at different types of dissociation, why dissociation occurs, what the symptoms are and how other survivors have helped to cope with experiencing dissociation.

1 – Coping with Dissociation – Survivor Stories

Click the video below to hear from survivors of rape and sexual abuse about their experiences of dissociation and their journeys of healing.

 

 


Click the links below to watch the survivor interviews in full on YouTube:

 

Click the video below to hear tips and advice from survivors about what helps them to manage experiences of dissociation.


You may find that your experiences of dissociation as a survivor are different from the ones we describe in this section, and that is completely normal. Everyone experiences trauma in a different way.

 

You may find that you relate to all of the points discussed, some of them, or none at all. This guide may be a useful starting place for you to learn more about dissociation and find some ways to manage experiencing it, but it is not exhaustive. You may find the exercises and tips useful, or they might not be the right options for you at this moment in time. We are all unique in our experiences and where we are in our recovery journey, so take this section at your own pace, and explore the suggestions that feel right for you at this moment in time.

2 – The Science of Dissociation

Everyone dissociates to some degree whether through daydreaming, being on autopilot, being immersed in a pleasurable activity or being focused on a task.  This is most often experienced when absorbed in reading a good book, gardening, watching a film or when listening to music. Dissociation can also occur as a result of some drugs, medication, ceasing use of some medications and alcohol.

Trauma and Dissociation

Dissociation is a common response to complex trauma such as childhood sexual abuse (CSA), childhood physical abuse (CPA) and domestic violence (DV) as a way to manage overwhelming feelings. At the time it acts as a ‘mental shield’ to allow detachment from feelings and bodily sensations. Over time it can become the default setting to manage all bodily sensations and feelings, even pleasurable ones, to avoid all feelings.

 

Dissociation in the case of trauma occurs as a result of instinctive reactions to danger or threat which are activated outside of voluntary control resulting in flight, fight or freeze. If trauma occurs when very young, or when we are not able to run or flee (flight) or fight, the only option is to freeze or flop. The freeze response releases a cascade of chemicals which numb the body and mind, making the body immobile. The muscles become floppy resulting in feeling ‘zombie like’ and areas of the brain involved in thinking shut down. While dissociation is a normal response to trauma, it can impact on everyday functioning as you become out of contact with inner experiences and sensations. Persistent and chronic dissociation can become harmful. Dissociation is also associated with a range of somatic (bodily) symptoms which can cause significant distress or impaired functioning and can lead to a range of physical health problems. It is also a significant feature in self-harm, suicidal ideation, substance misuse and addictions, anxiety and panic disorders, obsessive compulsive disorders, depression and borderline personality disorder.

 

Video – The Physiological impact of Dissociation with Dr Allan Schore – YouTube
Click this link to watch renowned psychologist and neuropsychology researcher Allan Schore discuss how dissociation can have a physiological impact on us.

Please note: This link will take you away from The Survivors Trust Resources website. The link is being provided for informational purposes only. The Survivors Trust bears no responsibility for any advertising content shown on external websites and videos.

Click here for a guide on how to clear your YouTube browsing history.

3 – Experiencing Dissociation

What people experience when they dissociate. Copyright: Christiane Sanderson 2020

It is important to recognise that a dissociative disorder and experiences of dissociation are not the same.

People experience dissociation in a range of different ways. You may experience some or all of the following:

  • Feeling spaced out or tuning out from the world around you 
  • Being in a dazed or dreamlike, foggy or hazy state
  • Narrowing of attention 
  • The external world appears unreal or surreal
  • Changes in the perception of time in which time is speeded up or slowed down, or loss of time for minutes, hours or sometimes days
  • Gaps in memory, as well as total memory loss, both in the past and in the present, for personal information, recent events, or conversations that cannot be recalled
  • Unusual body sensations as if floating away, wading through mud, looking at yourself from a distance or as if in a dream or film
  • Feeling detached from your body, living in your head, or having out-of-body experiences
  • Feeling that your body is unreal, changing or dissolving, or that experiences are not happening to you but to someone else
  • Loss of continuity of who you are and your reality 
  • Feeling the world is unreal or that familiar places, people or objects seem alien or appear not to exist.

 

Everyone who experiences dissociation will experience it differently. This subsection will look at an overview of some of the main types of dissociative experiences.

Dissociative Trance

Dissociative trance is the experience of:

  • Losing awareness of your immediate surroundings and unresponsive to the external environment 
  • Characterised by stereotypical movements, paralysis, or loss of consciousness 
  • Often happens without warning and can be frightening for the person coming out of the trance.
Non-Epileptic Seizures

Some people may experience seizures or non-epileptic attacks (NEAD) without any medical cause. These are very real and can be frightening. The main symptoms are:

  • Going blank or staring blankly
  • Convulsions of the head, body, arms or legs which can affect the whole body or just one side
  • Biting the tongue
  • Loss of bladder control  
  • Fainting.

In the next topic, we explore dissociative disorders. Experiencing dissociative symptoms does not necessarily mean that you have a dissociative disorder, nor that your experiences will develop into a disorder.

4 – Dissociative Disorders

Dissociative disorders are complex, and their symptoms are common to several other conditions, which can make diagnosis difficult. Disorders require specific diagnosis, advice and support which can better assist with managing symptoms and consideration of treatment options.

Range of Dissociation
Copyright: Christiane Sanderson 2020

Everyone who experiences dissociation will experience it differently. This subsection will look at an overview of some of the main types of dissociative disorders.

Depersonalisation

Depersonalisation may cause you to experience:

  • Feeling as though you are looking down at your body from above
  • Feeling as though you are floating away
  • Having an ‘out of body’ experience
  • Feeling as though your identity is shifting and changing.
Derealisation

If you experience derealisation, you may find that you:

  • Feel as though the world around you is unreal
  • See objects changing in shape, size or colour
  • See the world as ‘lifeless’ or ‘foggy’
  • Feel as if other people are robots (even though you know they are not)
  • Feel as though you are watching yourself in a film or looking at yourself from the outside
  • Feel as if you are just observing your emotions
  • Feel disconnected from parts of your body or your emotions
  • Feel as if you are floating away
  • Feel unsure of the boundaries between yourself and other people.
Dissociative Amnesia

Dissociative amnesia may cause you to experience:

  • Memory gaps in your life where you can’t remember anything that happened (can be both in the past and present)
  • Not being able to remember information about yourself or about things that happened in your life
  • Travelling to a different location and taking on a new identity for a short time without remembering your past identity (known as dissociative fugue)
  • Can last for seconds, minutes or hours.
Dissociative fugue

Dissociative fugue (psychogenic fugue) can be experienced as:

  • A temporary loss of a sense of personal identity
  • An impulse to wander or travel away from homes or places of work
  • Feelings of confusion about who you are
  • Creating new identities.
Dissociative Identity Disorder (DID) (formerly known as Multiple Personality Disorder)

DID is described as a disruption of identity characterised by two or more distinct personality states or an experience of possession (DSM V). In addition, a diagnosis will include other dissociative disorders as well as additional conditions.

If you have DID, you might experience:

  • Two or more distinct personalities appear to inhabit the same body
  • Significant changes in your identity which can interfere with your everyday functioning, such as discontinuity in self and self-agency
  • Feeling different aspects of your identity are in control of your thoughts, behaviour, and/or way of relating to the world
  • Your identity states may come across as different ages and genders, and have different memories and experiences 
  • Feeling as though you have one ‘main’ part of your identity that feels most like ‘you’ – called the ‘host identity’, while the other different parts are called ‘alters’ or ‘parts’
  • Switching between different parts of your identity outside of voluntary or conscious control, and not remembering what happens when another ‘part’ is in control.
  • Alterations in emotions, thinking, behaviour, consciousness, perception, memory and sensory motor functioning
  • Gaps in memory or recall of everyday events (e.g., childhood events; important personal information; skills such as driving, using a computer, reading)
  • No recollection of activities, tasks or actions such as: unexplained items in shopping bags; writing or drawing; injuries; coming to in the midst of something or areas in the home; dissociated travel.

Video – Mind Dissociation – YouTube
Click this link to watch a video produced by the charity Mind in which people with dissociative disorders talk about their experiences.

Video – Living with Dissociative Disorders – YouTube

Click this link to watch an ITV interview during which Alexandra Garrick, a person with a dissociative disorder, talks about her experience of coming to terms with her condition.

Please note: These links will take you away from The Survivors Trust Resources website. The links are being provided for informational purposes only. The Survivors Trust bears no responsibility for any advertising content shown on external websites and videos.

Click here for a guide on how to clear your YouTube browsing history.

Identity confusion

This can cause the following experiences:

  • Feeling as though there are different people inside you
  • Speaking in a different voice or voices
  • Using a different name or names
  • Switching between different parts of your personality
  • Feeling as if you are losing control to ‘someone else’
  • Experiencing different parts of your identity at different times
  • Acting like different people, including children.
Additional disorders (co-morbidities)

People with dissociative disorders may experience other disorders (co-morbidities) and symptoms, these can include:


This list is not exhaustive, and everyone is different in their own experience.

In the next topic, we explore some techniques that can help you to manage these symptoms and experiences.


*Please note: these links will take you away from The Survivors Trust Resources website. The links are being provided for informational purposes only. The Survivors Trust bears no responsibility for any advertising content shown on external websites and videos.

5 – Dissociation Toolkit

Survivors with Dissociative Identity Disorder (DID) may find parts of this section helpful, may want to amend some of these ideas to fit their situation, or may find that the ideas are not right for them.

 

Please do not try and ‘make’ any suggestions work for you if they are causing you additional distress.

Staying Safe

It is crucial to stay safe during and immediately after dissociation. It will help you to know what triggers lead to dissociation and identify a range of grounding techniques that enable you to come back into and stay in the present.

 

It also helps to develop a crisis plan in advance and put these on a safety card, such as contacting a trusted family member or friend who can help calm and soothe you and help you to stay in the present. If dissociation is a frequent occurrence you might benefit from specialist therapeutic help or from talking to others who suffer from dissociation.

Common Triggers to Dissociation
  • Trauma cues such as threat, sensory stimuli linked to trauma, flashbacks, intrusive memories, being touched or held
  • Being too close to someone else, intimacy, threat of abandonment or loss of connection 
  • Sensory overload either internally (such as anxiety, fear, anger, or overwhelming trauma symptoms) or externally (such as people, social situations, or places associated with trauma)
  • Uncertainty or ambiguity, or having to make decisions
  • Shame, especially when scrutinised by others or for having dependency needs, feeling vulnerable, or not knowing something.

                                                     

One way of restoring control over triggers and traumatic reactions is to find grounding techniques that will allow you to stay connected to current reality. Grounding techniques will also remind you that you are safe and no longer in danger. The aim is to encourage you to reconnect to your body and the physical world.

 

Hear about techniques that have helped other survivors:

Resources referenced in video:

The following techniques might be helpful if you experience dissociation:

  • Movement to release trapped energy in the body – try standing, star jumps, or do some light exercises such as sit ups, dance, get up and walk into another room, or go for a walk as long as you feel safe to do so
  • Rubbing your arms or legs, or planting your feet on the ground
  • Touch or hold something cold such as an ice-cold aluminium can, or drink, or a packet of frozen peas. You could also put your hand in a bucket of ice, or have a cold shower
  • Have a warm drink, being careful not to burn yourself
  • Eating or drinking something with a strong taste or texture such as dark, bitter chocolate, chilli, lemon, a crunchy apple, or something cold such as ice cream or sucking an ice cube.
  • Brush your teeth
  • Look around the room and name three objects or colours, say these out loud and describe them
  • Notice ordinary things around you to remind yourself that the environment is not threatening
  • Sing or recite a poem out loud
  • Scream or shout into a pillow
  • Hear your voice out loud – try listening to a recording of your voice, or a voice message to yourself noting the date, your age, where you currently live and the names of family members, partner, children or pets. You could also read aloud to yourself, look at and describe your favourite painting or poster, or sing a song from the present day as loud as you can
  • Speak to someone who you know and trust and tell what you are experiencing
  • Punch a pillow
  • Use a tangle toy, or a stress ball or juggling balls to keep focused
  • Inhale a grounding smell such as scented tea bag, lemon zest, strong spice, or favourite scent or scented candle
  • Listen to music that is energising or uplifting and sing to it, as this can make you more alert, as long as it does not remind you of the past.

How can family, friends, partners and practitioners help?

  • Try to understand the triggers and cues to dissociation
  • Be accepting, calm and patient even when the person is unresponsive
  • Ask them what would help and listen if they want to talk
  • Be mindful of your own capacity to dissociate and shutdown or retreat when you are trying to support someone who is dissociating 
  • Remember closeness and being touched can be triggering so make sure to discuss this to know what is comfortable.

6 – Useful Resources for Dissociation

Useful contacts

The Survivors Trust
www.thesurvivorstrust.org

Umbrella agency for over 120 member organisations which provide specialist support to men, women and children who are survivors of sexual violence.
Helpline: 08088 010818

 

One in Four
www.oneinfour.org.uk

Support for survivors of sexual violence and abuse, particularly survivors of child sexual abuse and trauma.

Helpline: 020 8697 2112

 

Izzy’s Promise (RANS)
www.rans.org.uk

Support services for male and female survivors of ritual abuse.

 

Clinic for Dissociative Studies

www.clinicds.co.uk
Accepts NHS referrals. Website has useful information about dissociative disorders.

European Society for Trauma and Dissociation

www.estd.org
Includes links to online information on psychological trauma and dissociative disorders.

 

First Person Plural

www.firstpersonplural.org.uk
Support and information for people who experience complex dissociative disorders and their family and friends.

The International Society for the Study of Trauma and Dissociation (ISSTD)

www.isst-d.org
Academic society providing information for professionals and the general public about trauma and dissociation research.

NEAD Non-Epileptic Attack Disorder

www.nonepilepticattackdisorder.org.uk
Provides information and support for people who experience non-epileptic attacks.

 

ESTD-UK (European Society for Trauma & Dissociation, United Kingdom)

www.estduk.org

A society for clinicians, academics, researchers and education in the field in the field of complex traumatic dissociation.

Books
  • Sanderson, C (2016). The Warrior Within: A One in Four Handbook to Aid Recovery from Sexual Violence 3rd Edition. London, One in Four
  • Sinason, V (2020). The Truth about Dissociation. Carolyn Spring Publishing.