We are seeing the term “dissociation” used more and more online, but what exactly does it mean?
Dissociation is a term that is used to describe of a variety of experiences that involve feeling some level of detachment from aspects of reality. Dissociation is a disruption in our normal continuity of experience that can cause us to feel somehow separated from our own thoughts and feelings or from the external world.
It is not uncommon to experience mild forms of dissociation. Many people report a sense of mental “fog” or “numbness” at some point in their lives, which is not necessarily a cause for concern if it is transient and does not interfere with one’s life. We may, for example, inadvertently “tune out” of a conversation or realize we have been mindlessly repeating a task, like washing the same dish over again. However, some people struggle with dissociation on a more extreme level, which can be quite scary and disruptive.
Depersonalization versus Derealization
Two types of dissociation we discuss in clinical settings are depersonalization and derealization.
Depersonalization refers to a sense of detachment from one’s own body, thoughts, and/or feelings. People may describe this as a sense that they are observing themselves from a distance, not feeling directly in control of their actions (perhaps feeling like they are on “autopilot”). Depersonalization can also feel like a loss of touch with one’s feelings and difficulty naming them.
Derealization refers to a sense of detachment from one’s surroundings, where other people and objects can feel unreal or distorted from how they usually look or sound. Some people describe feeling as if they are in a dreamlike state or a fog.
Why do we dissociate?
Dissociation is a complex phenomenon with many different causal factors. Mental health professionals see that dissociation often arises during or after a traumatic experience or period of intense stress. It may be an unconscious attempt to avoid or suppress some painful internal experience, such as fear, overwhelm, upsetting memories, or unpleasant thoughts. It can also be triggered by substance use, particularly hallucinogenic drugs.
When we think of dissociation as a response to trauma or extreme stress, it actually makes a lot of sense. Dissociation may be part of the “freeze” in the “fight/flight/freeze” reaction our nervous system engages to help us respond to threats. Dissociation can be seen as a way to mentally “turn away” from a difficult situation that feels inescapable. If it persists, however, dissociation can become a serious mental health concern that needs treatment. If you are struggling with episodes of dissociation, you should tell your doctor and/or a mental health professional. You may be diagnosed with a dissociative disorder or another mental health condition like post-traumatic stress disorder.
Read on for some examples of coping strategies that may help with mild forms of dissociation and general stress.
1. Track Your Triggers
It can be very helpful to gain a better understanding of the antecedents (triggers) and consequences that come with dissociation or mental fog. Take note of what situations, thoughts, or feelings trigger it and what helps you to come out of that state. Also consider what benefits there are to gain from dissociating(other than escaping mental pain/discomfort). Does it force you to take a break? Does it help you to receive help from others? This may be a sign that you are overburdened and need more support with various life stressors.
2. Grounding Techniques/Mindfulness of External World
There are a multitude of mindfulness techniques you can learn to help you feel more grounded in the present moment. Many of these strategies focus on engaging the senses, such as:
- Hold an ice cube in your hands or splash your face with cool water
- Notice the different colours and textures you can see in the room around you. Count 5 things that are blue, five that are red, etc. Look outside a window and then try to recall everything you saw after you’ve looked away.
- Stretch your body and bring your awareness to the sensation of your muscles in different states (e.g., slouched versus sitting upright, arms folded versus up in the air)
- Carry a sensory kit containing items you can taste, feel, and smell (e.g., sour candies, fluffy toys, scented room spray)
3. Challenge Negative Thinking Patterns
When we feel out of it, we may fall into negative thinking traps that only serve to make the situation worse. Harsh, self-judging thoughts such as “What is wrong with me?” or “I’ll never get anywhere if I have this much trouble focusing”can just perpetuate the cycle of self-criticism and detachment. Try to show yourself some patience and compassion. Acknowledge the struggle you’re facing and find a safe place to take a break and recuperate.
Some people find themselves becoming fixated on self-observation in an effort to stay present. This may actually have the opposite effect though, as it can make one hyperaware of any sensation of “fogginess” or “unreality,” which in turn can heighten that experience. If you notice this happening, it may be helpful to remind yourself to turn towards the external world (i.e., by using grounding techniques).
4. Seek Support
As mentioned above, if you struggle with symptoms of dissociation it is important that you consult with your doctor. Further, a clinical counsellor may be able to help you to identify the causes of dissociative symptoms and develop tools to cope with them. Through therapy, people can often uncover internal conflicts that lead them to seek distance from certain feelings or situations.
About the Author
References and Further Reading:
Gentile, J. P., Snyder, M., & Marie Gillig, P. (2014). Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder. Innovations in Clinical Neuroscience, 11(7-8), 37–41.
Harris, R. (2016). Working With Dissociation: Some Powerful Practical Tips. Retrieved from https://drive.google.com/file/d/0B2BTleMeaRFfUlJRMDE1WWVtaWs/view?resourcekey=0-H0_0uvwCbhIGFMVYNVQt6w
International Society for the Study of Trauma and Dissociation. (n.d.) Dissociation FAQs. https://www.isst-d.org/resources/dissociation-faqs/
Mayo Clinic. (2017, November 17). Dissociative disorders. https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/diagnosis-treatment/drc-20355221
Spiegel, D. (2021, March). Depersonalization/Derealization Disorder. Merck Manual