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Maggie
Community Elder

Dissociation

he Brain in Defense Mode: How Dissociation Helps Us Survive
April 29, 2015 • By Anastasia Pollock, LCMHC, Posttraumatic Stress Topic Expert Contributor
profile portrait with brain explosion fragmentsAccording to Ross and Halpern (2011), there are several definitions of dissociation. One of them (referred to as “the general systems meaning of dissociation”) is “the opposite of association” or the disconnection of two or more things that were once associated with each other. Another definition, presented by Steinberg and Schnall (2001), defines dissociation as “an adaptive defense in response to high stress or trauma characterized by memory loss and a sense of disconnection from oneself or one’s surroundings.”

Dissociation occurs when someone disconnects from some part of himself or herself or the environment. It can occur in a number of different ways, including disconnection from one’s emotions, body sensations, memories, senses, etc. A normal and common phenomenon, dissociation can happen in mild forms even when there is not imminent danger or stress. Think of a time you drove somewhere, arrived, and then couldn’t remember the drive because your mind was wandering; an instance when you lost track of time because you were engrossed in a riveting television show; or when you disconnected from body sensations to avoid going to the bathroom when you were on a tight deadline at work.

Dissociation is something we all do, and it is a vital part of our ingrained survival system. It is a part of the system that helps us to cope with stressful situations, which may otherwise feel overwhelming (Steinberg and Schnall, 2001). It is built in and is not pathological (Ross and Halpern, 2011). However, when a trauma occurs, sometimes this built-in system disconnects to a greater degree in an effort to protect the individual from traumatic material, body sensations, emotions, or memories that may be overwhelming.

Dissociation related to trauma occurs in varying degrees. On the lower end of the dissociation spectrum, for example, let’s say someone was in a car accident. A few days after the accident, the person finds that he or she cannot recall parts of the accident, even though reports of others were that he or she was conscious and responsive during those times he or she cannot recall. On the other end of the spectrum, someone who was severely abused throughout life can dissociate to the point that he or she has more than one personality, all of whom display and contain their own characteristics and who hold different memories associated with the trauma.

The goal in therapy is not to eliminate dissociation completely, but rather to help the brain and body to update to the current circumstances. Specifically, this would include helping a person to integrate current information about the present circumstances in which they live.

For the traumatized individual, dissociation may help him or her to survive circumstances that may have otherwise been intolerable. Dissociation can help a person feel as if situations, his or her body sensations, emotions that would have been overwhelming, etc., are muted and distorted so he or she can then go into “autopilot” mode and survive extreme situations and circumstances. When trauma is ongoing, dissociation can become “fixed and automatic” (Steinberg and Schnall, 2001). When this is the case, integration of memories becomes difficult for the brain, and the brain also continues to send of signals of danger, even when the traumatic situation is over (Steinberg and Schnall, 2001). This can continue for years after a traumatic situation has ended.

According to Steinberg and Schnall (2001), the five central symptoms of dissociation are:

Amnesia: Loss of memory for short or long periods of time. This can include not recalling all or part of an incident or time period.
Depersonalization: Feeling detached from yourself, parts of your body, and your emotions—like you are on autopilot or robotic.
Derealization: Feeling detached from your surroundings and people who were once familiar—like the world around you isn’t real.
Identity confusion: Feeling “uncertainty, puzzlement, or conflict about who you are” (Steinberg and Schnall, 2001).
Identity alteration: Alterations in personality and behavior that others notice. Sometimes this manifests as feeling as if you don’t have control over other personalities or your body.
For someone who is concerned that he or she is experiencing a more-than-normal incidence of dissociative symptoms, help is available. Several accurate tests are available through therapists and psychologists who have been specially trained in diagnosing and treating dissociation and trauma.

The goal in therapy is not to eliminate dissociation completely, but rather to help the brain and body to update to the current circumstances. Specifically, this would include helping a person to integrate current information about the present circumstances in which they live. If no danger currently exists, helping the brain and body to learn how to be safe would be one part of treatment. Working toward being able to maintain awareness of the present moment, body sensations, emotions, surroundings, etc.—also known as mindfulness—is one way to start to address dissociation, especially prior to any trauma work that needs to be addressed.

As a therapist, I appreciate dissociation as a valuable gift our brains are able to give us when we endure trauma. I emphasize to the people I work with in therapy that dissociation has helped them to survive, and we can acknowledge that this is a defense that has perhaps worked for longer than it was intended. It is important to remember that experiencing more than a regular level or type of dissociation as a result of trauma does not make a person defective. Rather, it shows that he or she has been able to live through and survive extraordinary circumstances that no one would be able to endure without the brain’s ability to dissociate.

References:

Ross, C., and Halpern, N. (2009). Trauma Model Therapy: A Treatment Approach for Trauma, Dissociation and Complex Comorbidity. Richardson, Texas: Manitou Communications.
Steinberg, M., and Schnall M. (2001). The Stranger in the Mirror. New York, New York: Harper.

14 REPLIES 14

Re: Dissociation

"...been able to live through and survive extraordinary circumstances that no one would be able to endure without the brain’s ability to dissociate". 

Totally get that @Maggie - thank you for posting this - highly informative and relevant to many here.

Re: Dissociation

Hello @Maggie

 

I found myself feeling some relief rather than anxiety when reading this interpretation of dissociation...depersonalisation...derealisation...

 

In the past any research that I have read has been written with a more clinical tone...

This is written in an empathic manner allowing anyone experiencing varying levels/states of mind to feel reassured...

 

Thank you so very much for sharing....

Great that you kept the title succinct for others to easily find...

 

Re: Dissociation

Thanks for sharing this with us @Maggie It's useful to share information like this that helps us with understanding all the ways our bodies protect us through experiences of trauma. 

Re: Dissociation

Really nice, thanks for sharing

 

I have seen some related stuff which expands the concept of dissociation to include/explain things commonly given other explanations/labels (such as psychosis or thought disorder) as being dissociated states along the same lines of thinking as in the article- that they are part of or related to protective responses to trauma.

 

It's been one of the most heartbreaking things to see that when someone's trauma manifested as something that gets called ''psychosis" or "mania" etc it would be decontextualised to a random ''chemical imbalance" and the person not given any access to trauma treatment or therapy to understand and reintegrate their experience. Often a trauma history would not even be taken. I hear that side of things is changing now(?) But I still know people who have been schooled to think their trauma symptoms are just random things unrelated to their trauma who get no help reconnecting the two and are expected to just "manage symptoms" for the rest of their lives 😞

 

Re: Dissociation

Hello, I’m new to all this. But I recently discovered that I dissociate really badly. It had happened before but not to the degree of last night. I can’t control my actions, or any part of me and I talk and talk and talk about things I can’t remember almost like there’s something I wish to say but I don’t know what it is. And I feel like the world around me is just fading like sand being washed away from a beach. My therapist and I have never be able to figure out what happened to me, but we’ve deduced it was roughly 4 years ago. And everytime I get close to thinking about it I completely dissociate who I am, where I am, who I am with, and I have an anxiety attack and everything feels like it goes a million miles per hour and I can’t keep up. I’ve just recently realized that I’ve been dissociative and I would like to know how to feel normal when I don’t know what my triggers are? Anyways I hope this thread isn’t lost. 

Re: Dissociation

That all sounds extremely tough @RynieGotTheBag Smiley Sad

It does make it really difficult when you don't know your triggers - have you tried keeping a diary of everytime this happens and what you were doing leading up to it happening? It may help to work out some triggers/patterns.

Re: Dissociation

Hi Fredd,

ive been in and out of psych institutions, hospitals and wards public and private since the old institutions still ran. 

I have seen a positive change in more trauma and dissociation questions being asked. 

People living with extreme forms of dissociation like Dissociative Identity Disorder where they have more than one person living in them who periodically takes over what the outside "person" does, are estimated to be misdiagnosed with things like bipolar and schizophrenia from between 7-9 years on average before they are finally given the diagnosis of DID and finally treated for it. Personally I was misgiagnosed for 23 years before I was finally understood to have DID and could then start getting the treatment I needed. There is more and more hope for people like us. 

Part of the reason is most psychiatrists still today went through university and medical training when DID, called multiple personalities then, was not even considered a true, possible disorder (or adaptive survival response). It was deemed fictitious. So even now in 2018 there is still sadly quite a lot of stigma attached to it and there are large gaps in psychiatrists' understanding of it and understanding of best practice treatment for it. 

Luckily the International Society For the Study of Trauma and Dissociation (ISSTD) regularly publishes international guidelines for its treatment, and some psychiatrists are choosing to specialise in treating DID now it is officially recognised in the DSM-5 as a bonafide early extreme ongoing trauma response.

Even adding basic trauma and dissociation questions to standard psychiatric assessment interviews is happening more commonly and bringing to light dissociative disorders (or adaptive survival patterns) much more routinely. 

Predictably psychiatrists and hospitals are finding more and more dissociative clients in their services, mostly because they are being better identified. 

-Twerp. 

Re: Dissociation

Hi RynieGotTheBag,
It's great you're working with a therapist on this. When your mind knows you are ready it might give you the information you are looking for. It is actually less important what happened to cause the dissociation than how do you manage it, and why does it take over more at certain times/what does it mean to you. Seeing a therapist well experienced treating dissociation or with a supervisor well experienced in treating dissociation, is really important when working these three things out.
-Twerp.

Re: Dissociation

Hi Maggie,

i really appreciate you sharing this book excerpt about dissociation. I'm always happy to find discussions about it and seeing people are giving it thought and learning more about it. 

As I wrote in a response to Fredd's comment here about Dissociative Identity Disorder (DID), it is a fairly new official diagnosis in the DSM-5 (the official bonafide international diagnostic "bible" of mental health classifications). So most psychiatrists practicing now went through medical training and university and placements, etc, while DID was considered a fictitious disorder for some sort of pay-off (attention or money or care, etc). There is still a lot of stigma around DID. Many psychiatrists don't even want to be associated with treating it because of this. And others avoid treating it because all they were officially trained about it in med school was it is not real. Luckily it is getting better and better understood. Even posts like yours help educate people and open up dialogue and learning about dissociation. 

 

Psychologists or psychiatrists would be remiss to see DID as maladaptive or something to be eliminated. 

Luckily even integration is being seen less and less as a treatment for DID too, and is being recognised as more abusive and ineffectual. 

There are some very knowledgeable psychiatrists and psychologists now who have DID themselves, and ones who don't have it, who are able to help their DID clients embrace DID more and "fix" it less to help their clients live well with it instead of against it. I love that! 

One psychologist in San Diego, USA, who treats dozens of people with DID, has come up with a very interesting specific attachment based theory as to why some people develop DID and others don't. He's about to publish a book about his theory. His theory fits my life and the lives of each DID system/person/people I've specifically asked about the theory he has come up with. So new information is being developed and honed to be better, all the time now, about DID and treating it and thriving with it. 

It is nearly sunrise which is my bed time so I'm struggling to stay focused on this reply. So sorry. I've enjoyed your thread!! Thank you Maggie!

-Twerp

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