How to Manage Dissociating

Dissociation is one of those things everyone has heard of but few can define.

Posted Nov 05, 2020

Think about all the times you’ve had to read a text over because your mind was elsewhere, or you pulled into your driveway with no memory of the actual drive home. That’s dissociation and it happens to everyone at least sometimes. 

Dissociation is detachment, whether from your body, your emotions, or your surroundings. It’s the opposite of being present in the here and now.

Dissociation isn't a genetic trait; it’s a response that gets honed through experience and necessity. Sometimes, it can be useful. Think of heroic soldiers wounded on the battlefield who blocked out their pain to save others. Even the highly sought-after state of flow is technically dissociation: you become completely absorbed in whatever you’re doing—writing, drawing, baking, or the like—and disconnected from your surroundings and time. 

Dissociation can also be an emergency survival tactic during intense pain or trauma. It cuts you off from your experience, making you numb when pain or panic would otherwise overwhelm you. This means that in the short-term, dissociation can be necessary for survival.

But other times, this comes with a cost in the long-term. Australian researchers examined adults who were admitted to Level 1 trauma centers after traumatic injuries. They were assessed during admission and within one month, and then re-assessed three months later. They found that those who had more panic symptoms immediately after their injury also had more dissociation, which makes sense—the more overwhelming the experience, the more likely for someone to tap out of reality. But this higher dissociation also predicted more likelihood of posttraumatic stress disorder three months later. 

Adults who hallucinate—hear or see things that aren’t there—are more likely to have experienced sexual abuse as a child. Dissociation compartmentalizes horrible events so you can survive another day. Unfortunately, dissociation doesn’t heal these psychological scars in the long term. For those who experienced childhood sexual abuse, the more they dissociated, the more they were also likely to hurt themselves as adults.

It’s as if the initial tapping out of reality only postponed the psychological pain, making it worse later.

All of this speaks to dissociation as a double-edged sword. On the one hand, it offers an emergency exit from reality when the body and mind need it most. But on the other hand, abuse survivors have gotten so much practice at dissociation that it often becomes automatic in times of stress, strong emotion, or perceived danger. When dissociation continues to be used even when the threat ceases to exist—when the child survivor grows up or when the abuser is no longer a threat—dissociation stops protecting and starts getting in the way. It leaves the person disengaged, detached, and, ironically, vulnerable to more danger.

Shutterstock/Song_about_summer
Source: Shutterstock/Song_about_summer

What does dissociation feel like?

There are two most common forms of dissociation: depersonalization and derealization. Both depersonalization and derealization exist on a spectrum. If you’ve ever stared into a campfire or a strobe light, you may have glimpsed how this feels.

Depersonalization is feeling severed or alienated from your body. Individuals who experience depersonalization often report not recognizing themselves in a mirror, feeling like their body is not their own, or even being temporarily unable to talk. It’s the ultimate “out of body” experience.

For many, there’s a sense of emotional numbing, too—just feeling kind of “meh” about things that should be emotionally intense. Needless to say, it can be a worrying experience if it feels profound and uncontrollable. You may even be able to induce some depersonalization by staring intently at your reflection or a wall for a few minutes. 

Derealization is feeling isolated from your surroundings, like being in the middle of a crowded party and feeling like you’re just vaguely watching it on TV. People will often say the world looks fake, or that they are seeing it through a veil. Others report that the world loses color. Some people also experience derealization during sex, and this can contribute to having sexual dysfunction disorders.

How does dissociation work in the brain?

Just like any other psychological experience, dissociation is based in the brain. There's still a lot of mystery surrounding how it works, but researchers have found a few ways that the brain activity of people with dissociation/derealization disorder differs from those without the disorder.

One difference lies in the brain system that controls the fight-or-flight response. In those who often have dissociation/derealization, this brain area is always a little hyperactive, but when something stressful happens, it actually doesn’t activate as much as it should. There’s also less of a feedback loop in this brain system that tells it to take a breather after it’s been activated for too long.

Another difference lies in the limbic system, the emotion-processing center of the brain. This area is also less activated than it should be during dissociation, showing again how the brain “zones out.”

How to stop dissociating

If you feel yourself dissociating, how do you bring yourself back?

First and foremost, if any of what I’ve covered here sounds familiar, it’s worth seeking help. Dissociation often rides piggyback with PTSD, and both are treatable. The good news is that when treatment specifically addresses dissociation, people can respond quite well.

For everyday groundedness, try these three tips.

1. Engage your senses

This is a classic way to keep yourself in the moment. Squeeze an ice cube in your hand. Pay attention to how your feet feel pressing on the floor. Name five things you can see right now. In short, use your body! Gain some traction by feeling, seeing, hearing, smelling, and tasting your here and now.

2. Pay close attention to your breathing

You can do this anywhere and the best part is nobody has to know what you’re even doing. Slowly breathe in your nose. Feel the sensation of the cool air as it moves into your nostrils. Then, follow the air as it enters your nose and spreads to the back of your throat. Next, slowly breathe out. Feel the contrast of the warm air and the sensation as it leaves your nostrils. Again, the sensory input keeps you connected to your body and your surroundings.

3. Choose an object to keep you in the present

This could truly be anything, like a photo, piece of jewelry, or any other small keepsake. Build an association between it and the present—every time you see it or touch it, remind yourself that you are in the moment. Then, when you need it, you can reach for it.

Dissociation is varied and there’s no one-size-fits-all solution for those experiencing it. For more information, check out some FAQs from experts at the International Society for the Study of Trauma and Dissociation.

A version of this article is also published on Quick and Dirty Tips.

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