By P. Casey Arrillaga, LCSW, LCDC
Dissociation is something that everyone does to some extent. It involves tuning out, letting our minds drift, daydreaming, or any other version of detaching from our immediate reality. It is normal up to a point, but it can be problematic and even pathological when it becomes too severe. People can detach enough from reality that they have trouble functioning in life. This level of dissociation is considered by many mental health practitioners to be the result of having undergone trauma, especially repeated or severe childhood trauma, but there is some controversy about this idea. This post will look at the phenomenon of dissociation, its relationship with trauma, disorders associated with dissociation, and how this knowledge can be used to help people.
What We Know So Far
Dissociation is a concept that has been studied in psychology since the 1800’s, but its meaning has expanded in ways that have created a lot more interest in the past 40 years or so. This is in part because dissociation used to refer only to one of its most extreme forms: when a person seems to have multiple personalities inside themselves, with these personalities competing for control. Often, one personality within the person will not know what has happened when another of the personalities is “in control.” This disorder, which was once called “Multiple Personality Disorder” and even thought of as part of the defunct diagnosis of “Hysteria” is now known as “Dissociative Identity Disorder [DID]”. As this disorder and related problems have undergone increased study, it has become increasingly recognized that dissociation is something that is part of many people’s experience, and thus the definition has expanded.
A modern definition of dissociation is the phenomenon of feeling detached from reality, which can show up in many ways. One is “depersonalization,” in which person feels disconnected from themselves and their senses. This can be anything from the mind wandering off into fantasy or a memory for a few moments, to a person realizing that they’ve driven a familiar route and don’t remember how they got there. More extreme forms may appear as feeling an unstable sense of self or feeling like they are seeing themselves from the outside as if watching a movie of their life. Depersonalization can also feel like numbing of emotions or physical sensations.
“Derealization” is a type of dissociation that involves feeling as though the things around that person are not real. This may show up as thinking they are actually in a movie with everyone else being actors, or it could manifest as thinking the people around them are not even real people. In less extreme forms, it may involve feeling that the person’s usual surroundings feel strange or unfamiliar. Some people get so absorbed in their daydreams that they lose track of what is actually happening around them, and they may even feel like their daydream is really happening. They may experience the world as seeming far away or unclear.
Dissociation can lead to losing track of time and experiences, sometimes referred to as dissociative amnesia. While this happens a little for most people, for some people it can be debilitating. They may lose hours staring into space and thinking of nothing. Dissociative amnesia can lead to having no memory of important life events, finding evidence that a person has done things they can’t recall doing, or finding themselves in a place with no idea of how they got there. In some rare cases, a person may wander from their home with no recollection of who they are and engage in activities such as traveling to other areas, exhibiting confusion and unpredictable behavior.
One of the most profound ways in which dissociation can affect someone is when they feel like there are one or more other personalities inside their mind. This may be experienced as having feelings or thoughts that feel like they come from outside the person, one or more “other” voices inside their head, or a general feeling that there are other personalities vying for control or attention inside them. In one of the most profound forms, this type of dissociation can lead to losing time not because the person isn’t paying attention, but because another one of the internal personalities seems to take control for a time, leading to DID.
Dissociation can also play a major part in Borderline Personality Disorder and, of course, Derealization/Depersonalization Disorder. It is also very commonly seen in people with substance addictions, with some professionals even thinking of drug use or process addictions as ways to force dissociation by helping the person escape their reality through outside means.
What Causes Dissociation?
One of the primary theories about dissociation dates back to the 19th century, in which early researchers proposed that dissociation is caused by significantly traumatic and overwhelming events, during or after which the person may dissociate as a defense. According to this idea, the earlier and more profound the trauma, the stronger the tendency to dissociate. From this perspective, dissociation is like an emergency off switch, tuning out from reality to keep the person’s brain from overloading. This can happen through extreme experiences or repeated “small” traumatic events that may not be terrible by themselves but become impactful through happening over and over again.
Unsurprisingly, there is controversy about this view. Some researchers believe that dissociation is caused more by the influence of messaging through media, society, therapists, etc. interacting with personalities that are highly suggestible and prone to fantasy rather than the dissociation coming from trauma. These professionals believe the symptoms of DID are better explained as a manipulative coping skill rather than as an involuntary switch to an actually separate personality. Under this theory, the people who experience profound dissociation are more likely to be responding to traumatic memories they have manufactured rather than things that actually happened.
The almost night-and-day differences between these views of what causes dissociation can bring up strong emotions for both clients and practitioners. Unfortunately , this gets in the way of the two schools of thought being able to see the valuable insights and challenges they carry for each other.
How Can We Use This Knowledge to Help People?
At Windmill, we know that dissociation is a major part of many of our clients’ experience. We therefore measure dissociation for our clients using proven diagnostic tools such as the Dissociative Experiences Scale [DES II] and the more detailed Multidimensional Inventory of Dissociation [MID] for those who show deeper levels of dissociation. These tools help us not only better understand our clients’ experiences, but also help guide treatment by suggesting what trauma-resolution techniques are more likely to be helpful for a given person, thus speeding the therapeutic process and removing guesswork. We also help our clients understand what leads them to dissociate so much and how to be more comfortable living in day-to-day reality. We know that what a client remembers and how they remember it happening will have a profound impact on their psychology and emotions, so we never enter into debate about whether a trauma memory “really happened.” Instead, we help them through their traumatic memories using a variety of tailored techniques, so they can be free of the effects. With time and working on themselves, many of our clients experience less and less dissociation, and thus fewer problems from it.
The Bottom Line
Dissociation takes people out of reality in ways that can be
normal for some people but debilitating for others. In its more extreme forms,
dissociation is the foundational problem for some mental health disorders, and
a major part of several others. Our understanding of dissociation and its
causes is still evolving, but there is help available regardless of what a
given person thinks causes it.
6 Things to Know About Dissociation
About The Author
P. Casey Arrillaga is the Team Leader for Education at Windmill Wellness Ranch, and he is the author of books including “Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.
Created specifically for those who have loved ones that struggle with addiction.