Dissociation
WHAT IS DISSOCIATION?
Dissociation is a mental disconnection between a person’s feelings, thoughts, actions, and memories. It can also cause uncertainty about one’s sense of identity. When a person dissociates, he/she disconnects certain information from other information and develops gaps in memory.
For example, following a traumatic experience a person may not remember some or all of what happened. People who have had a series of traumatic experiences may begin to dissociate repeatedly, with amnesia or memory gaps as a result. Such people not only have trouble remembering much about things that have happened to them but may even be confused about who they are.
Dissociation has a wide range of severity. The least severe are the completely normal, mild dissociative experiences that most people have, including such experiences as daydreaming, "spacing out," or becoming completely absorbed while watching a movie or reading a book. During these experiences, a person becomes unaware of what is going on around him/her. Dissociation can, however, become more severe and serious. The most serious are chronic dissociative experiences that impair a person’s ability to carry on a normal life. A person with severe and disabling dissociative symptoms may be diagnosed with dissociative identity disorder (DID) or other dissociative disorders.
Anyone who experiences dissociative symptoms more severe than simple daydreaming or mesmerizing should seek an assessment from a licensed mental health professional with experience in working with dissociative disorders.
WHAT ARE THE SYMPTOMS OF DISSOCIATION?
People with dissociative disorders may experience a variety of troublesome symptoms, including any of the following:
- Alcohol and drug abuse
- Amnesia and memory gaps
- Compulsive behavior
- Depression
- Eating disorders
- Flashbacks
- Hallucinations
- Insomnia
- Mood swings
- Night terrors
- Panic attacks
- Phobias
- Self-mutilation
- Suicide attempts
- Violent behavior
WHAT CAUSES DISSOCIATION?
Most people who are diagnosed with dissociative disorders experienced trauma as children. Children who experience extreme physical, sexual, or emotional abuse often begin to dissociate or escape mentally from the trauma for which physical escape is not possible. They learn to separate their feelings, thoughts, and perceptions of the traumatic experience as a defense against the horror and pain. This process, which is an effective survival technique, enables the child to function in life as if the trauma had never happened.
Dissociation is a very effective means of escape, and children who experience repeated abuse and trauma sometimes use it when they feel anxious or frightened. They may use it with increasing frequency, even in situations where there is no threat of abuse. As children grow older, they may increasingly resort to dissociation even if they no longer face trauma or danger. As this behavior becomes chronic, it damages the person’s ability to function at work and in social relationships. It can become so extreme that the person develops a series of mental states or entities forming separate identities.
People diagnosed with DID have within them two or more distinct identities, or personality states. Each of these identities, which are sometimes called alters, has a distinct way of perceiving and thinking about itself, including a unique personal history and name. Each identity alternates in taking control of the person’s behavior, and even though each identity seems unique and separate from the others, they all exist within a single person. The person is only aware of the identity that is in control at the moment and is completely unaware of the other identities. This separation of identities is why the disorder is called dissociation.
A dissociative disorder that begins in childhood may become less troublesome in adulthood but can resurface during times of distress or as the result of substance abuse.
FACTS AND FIGURES
It is estimated that about 1 percent of the general population has DID. Most people with this disorder are women. Many DID patients also have a secondary diagnosis of depression, anxiety, or panic disorder.
HOW ARE DISSOCIATIVE DISORDERS TREATED?
The prognosis for a person with a dissociative disorder is very positive. These disorders respond well to individual psychotherapy, hypnotherapy, art therapy, and antidepression or antianxiety medication. Treatment should also include learning about the disorder, learning to develop coping and social skills, and learning to structure one’s time. Patients who are dangerous to themselves or to others may require hospitalization until they stabilize. Treatment for these disorders is usually intense, demanding, and long. Therapy is often emotionally painful because it involves recalling and integrating the dissociated traumatic experiences. Even so, people with these disorders have successfully recovered and have built satisfying, productive lives.
WHERE CAN I GO FOR MORE INFORMATION?
Alderman, Tracy, and Marshall, Karen. Amongst Ourselves: A Self-Help Guide to Living with Dissociative Identity Disorder. Oakland, CA: New Harbinger Publications, 1998.
Dragon, Judy, and Popp, Terry. Multiple Journeys to One: Spiritual Stories of Integrating from Dissociative Identity Disorder. Santa Rosa, CA: Dancing Serpents Press, 1999.
Haddock, Deborah Bray. The Dissociative Identity Disorder Sourcebook. New York: McGraw-Hill, 2001.