Trauma and dissociation go hand in hand. Approximately 73% of individuals exposed to a traumatic incident will experience dissociative states during the incident or in the hours, days and weeks following the incident. To dissociate is a natural built in survival strategy that our body has to manage intense stress and fear. The dictionary defines dissociation as, “the disconnection or separation of something from something else or the state of being disconnected.” Dissociation can be viewed on a continuum where mild dissociation is on one end and Dissociative Identity Disorder (DID) formerly known as multiple personality disorder is on the other. Our mind is a beautiful thing. It can compartmentalize traumatic experiences into partial aspects of the traumatic event because seeing the whole picture would be too much to handle at one time.
Nearly everyone experiences mild dissociation, such a daydreaming, getting lost in a moment, spacing out, going blank, numbing out, or your mind wandering. We have all experienced a mild form of dissociation when we are driving and find that we have spaced out for a few moments and have arrived somewhere without really remembering how we go there. DID is a significantly more severe form of dissociation that the person can’t just “snap out of.” There are many myths in the media which leave people stigmatizing those with dissociative disorders. Dissociation gets a bad rap mostly because of what is shown in the media. DID in the media like the movie Me, Myself, and Irene or Split is portrayed as comical or dangerous, misleading the public and don’t truly convey the suffering of people with DID.
Trauma and dissociation in our society is not going away anytime soon therefore it is helpful to educate ourselves about this human condition. Below are 5 little known facts about trauma and dissociation.
- Dissociative disorders most often form in children exposed to long-term physical, sexual emotional abuse and chronic neglect.
Because children are extremely vulnerable to their environments they are at great risk of experiencing dissociation. Children under the age of 5 are most at risk. In fact, the earlier the onset of abuse or neglect the greater degree of dissociation a person can experience. Abuse in combination with a disruptive connection with caregivers causes dissociation and in particular DID. Many people with dissociation have experienced extreme neglect and emotional abuse, as well as physical and sexual abuse. Dissociation is one of the few tools that young children have to cope with trauma and abuse. However, suffering from childhood abuse does not necessarily mean you will experience a dissociative disorder. Dissociation does not always begin in childhood. Other ways that people can be affected are from natural disasters and combat stress.
- Women are 9 times more likely to develop a dissociative disorder compared to men.
Research shows that females experience more childhood abuse than males at a ratio of 10:1 and therefore more females suffer from DID. Other reasons why this condition is seen more in women than men is because of the greater numbers of women seeking mental health services as well as the way women express their symptoms differently then men.
- Dissociation affects people across all income levels, genders and ethnic groups.
No one is immune to trauma and therefore at risk of experiencing some form of dissociation. Dissociation is natural to experience after a traumatic incident, or a “shock trauma.” Most dissociation goes away within weeks after an event has occurred. Dissociative Identity Disorder is relatively common, affecting around 1-3% of the population. Other distress symptoms may also occur with dissociation such as depression, anxiety and eating disorders. Also, dissociation is not a genetically caused condition or inherited by parents.
- Some researchers have suggested that a form of dissociation called, Depersonalization Disorder, is the third most common psychological disorder following depression and anxiety.
When a person is experiencing depersonalization they feel detached from their body and from reality. Besides depersonalization there are other ways that a person can exhibit dissociation. They include, derealization, amnesia, identity confusion, and identity alteration. These survival mechanisms allow painful memories and life experiences to be blocked out. Because dissociation develops as a way of dealing with trauma people experiencing dissociation will have any or all of the following symptoms. They can experience significant memory loss of specific times, people and events, out-of-body experiences, such as feeling as though you are watching a movie of yourself, mental health problems such as depression, anxiety and thoughts of suicide, a sense of detachment from your emotions, or emotional numbness and a lack of a sense of self-identity.
- PTSD, Substance Abuse and Dissociation-
In general research shows that a person with dissociation is more likely to use drugs rather than alcohol, be a female and has experienced childhood trauma rather than later trauma. Substance use can function as a form of dissociation for some men and women. Substance use may also be a form of “chemical dissociation” to ward off PTSD (Post Traumatic Stress Disorder) symptoms (Roesler et al, 1993). Other reasons why people with dissociation might use substances to avoid trauma-related emotions and memories. It is likely not one function, but various ones that occur in different people and at different times in their life. Lastly, substance use and withdrawal may be confused with dissociation in some people.
After reading this you might wonder if you or someone you know has dissociation. If you believe that you have some dissociative symptoms or DID there is help and support available to you. More and more therapists are being trained to work with dissociation. Modified EMDR therapy approaches for dissociation can be helpful to people who are experiencing trauma and dissociation. EMDR therapy, Structural Dissociation, Ego State therapy, Internal Family Systems and Attachment therapy can be used in combination with the classic treatment approach as described by the International Society for the Study of Trauma and Dissociation (ISSTD) Treatment Guidelines. A phase-oriented trauma therapy consists of three phases: 1) stabilization, 2) trauma-work and 3) integration.
There are things that you can do to prevent someone that you know from experiencing a chronic dissociative condition. If you know someone who is experiencing dissociation the best thing to do is to encourage anyone who has experienced a highly traumatic event in their life such as death, divorce or stressful incident like an armed robbery to be proactive and seek counseling with a professional that specializes in trauma treatment and dissociation. Also, helping to identify children who are being abused and getting them the treatment they need right away helps to prevent dissociative disorders from forming. Children, teens and adults with untreated dissociation tend to be more at risk of further abuse.
Getting help allows people to safely express and process painful memories, develop new and healthy coping skills, be successful at daily functioning and tasks and improve relationships. It can help individuals not just survive but to feel liberated from the past. This helps clients to be their best self. The person they were intended to be before the trauma.