Dissociation is a psychological process whereby someone disconnects from reality, their thoughts and feelings, or loses memories and their sense of identity. It is a coping mechanism from the mind, to protect a person from a traumatic event and allow them to “switch off” and distance themselves from a situation they cannot handle and observe it rather than being part of it.
Disassociation is common in people with Borderline Personality Disorder, who report watching events unfold as though it was a TV programme, or find that they have “lost” whole chunks of time and have no memory of what they did then.
While any person of any age can experience disassociation and it can resolve itself without treatment over time, it is more often related to childhood trauma such as sexual abuse and leads to long-term dissociative disorders. Being emotionally neglected, living in an unsafe and frightening environment can all contribute to the development of disassociation as the child disconnects from his or her surroundings. In addition, the severity of the trauma in childhood is directly linked to the severity of the disassociation in adulthood.
Traumatic events can also cause the onset of disassociation during adulthood, such as experiencing a natural disaster, torture, war or any other similarly life-changing event.
What are the symptoms?
If you are concerned that you or a loved one suffer from disassociation, there are common signs to look out for, such as significant memory loss not caused by injury or a medical condition, ‘derealisation’, i.e. feeling that what is happening around you isn’t real, behaving in a way that is unlike you but being unable to control it, or emotional problems such as difficulty in coping with strong emotions or sudden and intense mood shifts.
There may, of course, be other reasons why you are experiencing these symptoms, but if you would like to discuss your concerns with a therapist in Auckland, the Robert Street Clinic has a range of specialist clinicians you can talk to confidentially.
Types of dissociative disorders
Disassociation can take several forms, and covers a wide spectrum of severity.
With dissociative amnesia for example, a person loses some of their memories. It can be limited to the traumatic event itself and can be partial or complete, and it can be as severe as generalised amnesia.
A perhaps even more distressing disorder is what is called dissociative fugue when someone suddenly forgets who they are and their past. Likewise, when they come out of that state, they may have no recollection of that episode and anything they did then.
With depersonalisation disorder, people feel detached from their life and find it difficult to feel emotionally connected to anyone, which can result in relationship breakdowns. They may also have issues concentrating.
Dissociative identity disorder, previously named multiple personality disorder, is the most severe of those conditions, where several personas co-exist inside someone, with their own personalities and lives. The ‘real’ self may or may not be aware of them, or only of some of them, but will see them as being other people, rather than a part of themselves, and has no control over their actions. The switch from one personality to the other will usually occur under stress or in response to specific triggers.
Can it be treated?
Dissociative disorders are very complex and will usually require long-term treatment plans including medication and some form of therapy. Left untreated, it will only worsen, and can contribute to other issues such as insomnia, severe depression, anorexia or bulimia, addictions and self-harm, including suicide.
The social cost is also not to be neglected, as, unsurprisingly, people with dissociative disorders find it difficult to maintain relationships or keep a job.
As far as medical treatment is concerned, doctors may recommend barbiturates or other psychiatric drugs, as well as anxiety medication to help control the symptoms, which are often triggered by stress.
For the same reason, teaching a patient stress management skills is recommended as it can lead to an improvement of the symptoms.
On a psychological level, psychotherapy and counselling will be necessary to make real progress, and doctors and therapists will endeavour to make patients feel safe, which can be enough to recall the traumatic memory in a constructive way.
Cognitive therapies such Dialectical Behaviour Therapy (DBT) may be a good approach as it can improve concentration and feeling in control of overwhelming emotions, as the patient gradually learns to focus on the present moment.
Disassociation disorders are complex and deeply rooted and require professional treatment. If you are looking for a DBT therapist in Auckland, email the Robert Street Clinic or call us on 09 973 5950.