Dissociation. Let's start with the word itself. It is not disAssociation. Just dissociation. Let's get that right first.
So what is dissociation?
Well the best way to describe it is it's a disconnection. It can take multiple forms but it is a disconnection. Think about driving your car and then all of a sudden you realize you have driven somewhere and don't remember the drive or how you got there. That is on the lowest end of the spectrum of dissociation. Daydreaming is also an extremely minor form of dissociation, because these are disconnections from the real world as you go into your head.
There are multiple forms of dissociation.
The first form of dissociation is called depersonalization. This is where there is an experience of reality outside of self remains relatively consistent, while the perception/experience of self is what gets distorted. Examples of this are things like an out of body experience, not being able to feel your entire body because you are disconnected from it, and regressive states (when people regress to younger ages). Many people who dissociate describe it as they feel like they are floating above themselves and watching everything going on like a movie.
The second form of dissociation is derealization. This is where the experience of reality outside of self gets distorted while the perception of self remains relatively consistent. Examples of this are things like flashbacks, when reality is heightened and when reality is diminished. Sometimes people experience times when they are more sensitive to their senses in the environment, like the sounds or smells of what is going on around them, heightening their reality. There are also times when people lose touch and things like tastes, smells and others senses are diminished and they less sensitive to them.
The third form of dissociation is cognitive disengagement. This is when there is a disconnect from both reality of self and reality itself. An example of this is when you driving down the road and don't remember getting there. This happens when people will "zone out" of the world completely and run on autopilot and not remember what they were doing. This is also where people will dissociate to different identities of themselves.
So why do people dissociate?
Dissociation is developed originally as a defense mechanism. It is how the brain handles things that are too difficult for it to process. These are things like trauma - physical and sexual abuse, assault, things like that. When the brain cannot process what is happening at that moment, it disconnects from reality as a defense mechanism. What ends up happening though is that dissociation continues on even after the trauma has ended. It begins to start disrupting life and becoming an issue that needs to be addressed.
So how do you address dissociation?
1. Identify and work with triggers is the first big step. Know what is a trigger and where that trigger comes from. Doing extensive trauma work is a key piece in identifying triggers and working through them to being able to lessen dissociation and being able to manage it.
2. Use grounding techniques. This is critical to managing dissociation. One of the easiest ways to practice grounding is by using 5-4-3-2-1. You list 5 things you see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste. You do this actively and engage your senses back into your present. Another big way to ground is to have a transitional object. This is an object that people can use their senses with to help ground them. This is something that a person always has with them. One example is for me, I have a special pillowcase that I have had for years. I take it everywhere with me. It helps ground me when I begin to lose touch with reality because I can use the sight, smell and feel of it to ground me back to the present. Another example would be a worry stone or for some people a necklace. There are many different ways to practice grounding but it is key when experiencing dissociation.
3. Respond effectively in the moment. Dissociation is kind of like a stoplight. Green is grounded and red is dissociation. Yellow is the warning signs. Creating pictures for what all three of those look like, especially the warning signs will help you find ways to catch yourself and choosing your response to the trigger before dissociation occurs.
So what does this look like for me?
Dissociation is a daily struggle for me and I struggle with all three forms of dissociation. I will sometimes lose touch with my body completely and not feel connected at all. I have flashbacks often, which for me are where I can still see what is going on around me but I feel all the sensory stuff plus the emotions (usually anxiety) from the flashback. So I can tell I'm having a flashback but still know what's going on. I also lose touch completely with the world. This happens a lot while I'm driving. I have been in the car and driven past where I'm going and come back from dissociating and have to figure out where I am because I don't remember driving there. I will dissociate in the middle of conversations (not intentionally) and will look like I'm listening but will be gone. The worst it's ever been happened recently when it came the end of the day and I couldn't recall most of the day because I had dissociated so much. So dissociation is a daily struggle for me.
I do my best to cope with it. I carry around my pillowcase with me, though I can't have that by my side when I'm in certain places like work. I keep essential oils in my purse, one specific blend is called Grounding and I use that when I'm dissociating to help bring me back. I use music when I'm in the car to try to help me stay in the present as much as possible. It is a daily struggle but I try my best to work with it. I am in therapy working on trauma related things and trying to maintain stability as much as possible.
Overall, it's a process. A long one. It's part of having PTSD and it will probably be a battle for the rest of my life. But it is something I will work to overcome. There is always hope.
