Dissociation or dissociative identity disorder, in its mildest form is an everyday phenomena and entirely normal human experience e.g. forgetfulness or when daydreaming now and then, drifting off or zoning out’ whilst driving. It is an experience that many people describe as feeling ‘disconnected’ or having an ‘out-of-body’ sensation. According to the National Alliance on Mental Illness (NAMI), up to 75% of people may experience at least one episode of dissociation in their lifetime.
In its more severe form it can be a symptom of a mental health problem such as depression, anxiety, acute stress, Post Traumatic Stress Disorder (PTSD) or Dissociative Identity Disorder (DID).
In this post, we take a look at what dissociation is, its symptoms, causes and treatments. Read on to learn more.
What is Dissociation?
Dissociation is a break in how your mind handles information. It occurs when there’s a lack of continuity between thoughts, feelings, memories, surroundings. For example, you might suddenly feel detached from your surroundings or as though you’re observing your life from an external viewpoint. It can affect your sense of identity and your perception of time is altered.
This disconnection can be emotionally unsettling, with people describing varied experiences, from feeling a ‘brain fog’ to experiencing memory lapses or even feeling completely alienated from their environment. Sometimes, these symptoms go away on their own, e.g. after a few hours, days or weeks particularly after an acute stressful or distressing event. However, if this experience goes on longer or is distressing and affecting your daily functioning including work and or relationships then it is important to seek help and advice from your GP or a mental health professional.
How Does the Brain Respond to Dissociation?
Researchers suggest that dissociative disorders are an advanced form of the ‘fight-or-flight’ mechanism. When under severe stress, the brain releases adrenaline. In cases of dissociation, the body goes a step further to conserve energy by shutting down certain functions.
This serves as a last line of defence to prepare the body for potential harm. Chemical processes are also at play. The brain releases opioids and cannabinoids, which dull both physical and emotional pain, enhancing the detached feeling.
What Are Symptoms of Dissociation?
Forgetfulness or gaps in memory. You may think the physical world isn’t real or that you aren’t real. Other changes in the way you feel include;
- Having an out-of-body experience
- Feel like you are a different person sometimes
- Physical symptoms such as pounding, dizziness, ‘brain fog’ or lightheaded
- Feel emotionally numb and detached
- Become immobile or ‘freeze’ state
- Feel little or no pain
- Altered sense of time
It is possible to have dissociation and not know it or not be aware of your symptoms. Sometimes, people close to you might notice and comment on your actions and behaviours as these may appear confusing or conflicting with who you really are. You may keep your symptoms hidden or explain them another way such as anxiety or depression.
What are the Underlying Causes?
Essentially, it’s a psychological response that helps individuals cope with stress or trauma by creating a sense of detachment. When it is linked to past or historical traumatic experiences particularly in childhood then it has been developed to adapt to and cope with overwhelming feelings and is seen as a trauma response.
Trauma
If something really bad or traumatic has happened to you may psychologically disconnect from the present moment (temporarily). This is known as ‘peritraumatic dissociation’ and experts believe that this is a technique your mind uses to protect you from the full impact of the upsetting experience you had.
Dissociation can occur when you have been through experiences including:
- Natural disasters
- Combat
- Emotional abuse
- Sexual or physical assault
- Motor vehicle accident
- Sexual or physical assault
- Childhood abuse
Complex Trauma
If you have experienced disturbing experiences repeatedly, over a prolonged period of time and where escape has not been possible, usually in early childhood and by a key attachment figure then you are likely to feel a severe and complex form of dissociation known as dissociative disorders’. This means you are likely to leave your normal consciousness, forget things or form different identities within your mind such as Dissociative Identity Disorder (DID).
Certain Drugs
If you use substances such as alcohol or take illicit drugs you may also lose your sense of identity, surroundings and a sense of control of your mind and body.
Diagnosis of Dissociation
Your doctor will ask about any past physical or mental health issues, substance misuse, may run some physical tests to rule out an illness or other medical condition. You may then be referred to a psychiatrist or psychologist and carry out an assessment of your past and present experiences that you have been bothered by. They may give you other tests including the Dissociative Experiences Scale (DES) and the Structured Clinical Interview for Dissociation.
What are the Available Treatments?
Psychotherapeutic treatments can help to find the root cause(s) of your dissociation. The goal of these therapies are to help you manage and reduce your dissociative symptoms so that you can improve your daily functioning.
Trauma Focused Cognitive Behavioural Therapy (T-CBT) is frequently recommended for the treatment of dissociation which is in line with NICE Guidance and has been proven to help process key traumatic memories that may be keeping the dissociation going. A phasic approach to trauma treatment can be helpful to stop suicidal thoughts or other self-destructive or addictive behaviours first and once these are stabilised you will be slowly guided through processing any traumatic memories and re-integrate your memories and identities.
Eye Movement Desensitisation and Reprocessing (EMDR) uses visualisation and imagery techniques to help you work through disturbing memories. It has been found to stop your nightmares, flashbacks and other symptoms of PTSD and Complex PTSD. It is endorsed by the International Society for the Study of Trauma and Dissociation (ISSTD) and NICE Guidance and guides individuals through their traumatic memories in a controlled environment, aiming to alter the emotional responses tied to those memories.
You may be prescribed add-on medication by your doctor like antidepressant medication to help control physical symptoms commonly associated with Dissociation.
What to Do Next
Dissociation can be a bewildering and disorienting experience, yet it’s more common than you might think. If you find yourself struggling with symptoms of dissociation, it’s crucial to consult with a professional for a thorough diagnosis and tailored treatment plan.
Help is always available, and effective treatment can make a world of difference in improving your quality of life. If you or someone you know is experiencing symptoms of dissociation, professional guidance can provide the necessary support and direction for treatment.
Working with Mariam Majid
Dr Mariam Majid is a Clinical Psychologist with over 20 years of experience in the NHS and private practice. Based in Gosforth, Newcastle upon Tyne, she specialises in Cognitive-Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR), both evidence-based approaches and trained in Dissociation and Dissociative Disorders.
Dr Mariam Majid takes an integrative approach to treatment, combining different therapeutic methods to create bespoke plans tailored to individual needs. She also has advanced training in treating trauma and Post-Traumatic Stress Disorder (PTSD) and Complex-PTSD along with other emotional and psychological issues.
Dr. Mariam Majid provides both remote and face-to-face consultations, including evening and weekend appointments. If you would like to get in touch, you can contact 07505 632 399 or email at mmajid05@aol.com.
