I didn’t realize I dissociated

“I had a therapist who was really smart and she was like, where'd you go? And I was like, what? And I didn't remember what she was talking about. I didn't remember what I was talking about.”

Jennifer* is a 40-yr old mom and professional. As a survivor of childhood abuse, Jennifer has been on a long path with her mental health journey. At this point she has arrived at a place where she can use her experiences and survival skills to help others. “I feel like I really have something to offer that other[s] don't have in that I've seen some and I've walked through my own brutal fricking gauntlet.”

What Jennifer describes is dissociation, or the separation of parts of mental functioning from conscious awareness. This is an adaptive strategy humans use under stress. Trauma researcher Bessel van der Kolk found that people with the dissociative subtype of post-traumatic stress (or PTSD) often have a history of PTSD earlier in life, more trauma exposure, and higher rates of suicidality than other folks with PTSD.

As a mental health therapist who specializes in working with adult survivors of child abuse, I’ve observed that my clients’ use of dissociation has helped them to survive many challenges, but can leave them feeling disconnected in their personal relationships and detached from their bodies and emotional experiences.

Jennifer overcame the challenges of experiencing abuse as a child and worked hard to be successful at her career. In some ways her ability to dissociate has helped her to be successful. “Part of my dissociative capacity has that other side of… hyper doing everything…. I know from what I just came from, I can hold as much pressure as I want.”

It is not uncommon for people, like Jennifer, not to realize how much they dissociate. Cassidy,* self-described as “gender-queer and 43,” shares: “a lot of the stuff I read seems more extreme, right? …And I'm like, well, maybe I don't do that, but I have experienced trauma in my childhood and adult life, and I know I totally find ways to block it out or not deal with it, or just kinda shut down when stuff's happening.  …I had a pretty abusive childhood…but, I don't really remember a lot of it so, I probably was dissociating a lot… I think a lot of the way that I deal with things emotionally and the situations I keep finding myself in… probably do stem from that.”

Symptoms of dissociation include feeling numb and disconnected from yourself and others, feeling as though you are far away watching what is happening or that the world is not real (called ‘derealisation’), and memory lapses.

While in some situations the ability to dissociate can be helpful, for example in a crisis, or when you need to put aside your personal issues to focus at work, at other times dissociating can be disruptive to a person’s life. If you find that dissociation is keeping you from enjoying your life and your relationships, or is harmful to your health, what can you do about it?

Ashley*, a professional woman who describes her identity as heterosexual, white, and Christian, describes what has helped her. “I've done a lot of work in the last 15 years, trying to understand what happened to me, how it affected me, my coping skills, and learning new tools from my toolbox.”

A therapist can help you to do work like Ashley describes, sorting through your experiences, making meaning from what you’ve been through and how it affected you, and learning tools and strategies to help your body and your brain experience safety and connection.

For folks who are working through intense childhood trauma, often a combination of body-based modalities together with mental health therapy is supportive. Allison Carr, an acupuncturist who specializes in mental health (http://elementalbalancellc.com/), describes her process of supporting such individuals with traditional Chinese medicine. “So…let's pretend that…, just in a metaphoric sense, everything you experience in your life piles up on top, right? So you're walking around in this body that's… carrying all your experiences with you. Trauma often presents as like a hard shell that the person is really invested in keeping hard because it protected them during a time when …they perceived their life was threatened. There's a couple treatments I can do that just help soften the shell, but not in a way that's going to …make them raw and exposed. So we just try to soften it enough so that the treatment can get in and we can start building them up from the inside so that they can …eventually live without the shell.”

Therapy in tandem with body-based treatments like acupuncture can offer support to build skills and practice this vulnerability Carr describes in a contained and supportive environment.

Alex*, a trans man in his 20s, describes what he has learned that helps him. “It's something that's, it's hard for me to tell it's coming on, but I can recognize my behavioral patterns now. And it's something where, my big thing with disassociating is I throw myself into a lot of fictional worlds or fictional settings so I don't have to think about what's going on in reality. So I notice sometimes I get really into a TV show or a book, and all I care about is what's going on in that. And I stop hearing about what's going on in reality, and I can better recognize now when I'm starting to do that and be like, okay.”

Dissociation in itself is not a problem, but learning skills to recognize and contain dissociation helps a person to manage it. If you recognize that you are dissociating, you have an opportunity to practice ways to bring yourself back.

One strategy is to use your five senses to connect you back to your body and the environment around you. Pause and notice five things you see, four things you hear, three sensations you can touch, two smells, and what you taste.

Because we tend to retreat to only one side of the brain while dissociating, bilateral stimulation that engages both sides of the brain can also help to bring a dissociating person back to the present time and place. There are many binaural beats available online (search binaural beats), which, when listened to with headphones, will stimulate the two sides of your brain with sounds coming from each side.

A licensed therapist who specializes in the treatment of complex trauma can help you to learn to recognize dissociation and bring some containment to this experience, so that you are more in control of when and how you dissociate. They can also help you to work through the strong emotions that are triggering dissociation for you. Therapy can help you to create the safety and stability you need to move forward feeling more present and connected in your daily life.

*names have been changed for privacy

If you recognize your experience in this article and are looking for a therapist in Alaska to support and guide you to dive deeper into understanding and managing your dissociation, check out my About page to see if we might be a good fit!

‍