MENTAL HEALTH: Dissociation

Dissociation and dissociative disorders

What is dissociation?
Many people may experience dissociation (dissociate) during their life.

If you dissociate, you may feel disconnected from yourself and the world around you. For example, you may feel detached from your body or feel as though the world around you is unreal. Remember, everyone’s experience of dissociation is different.

Dissociation is one way the mind copes with too much stress, such as during a traumatic event.

Experiences of dissociation can last for a relatively short time (hours or days) or for much longer (weeks or months).

If you dissociate for a long time, especially when you are young, you may develop a dissociative disorder. Instead of dissociation being something you experience for a short time it becomes a far more common experience, and is often the main way you deal with stressful experiences.

“I felt like my body didn’t belong to me, it was like I was an outsider watching my own story unfold.”

When might I dissociate?
For many people, dissociation is a natural response to trauma that they can’t control. It could be a response to a one-off traumatic event or ongoing trauma and abuse.
Some people choose to dissociate as a way of calming down or focusing on a task, or as part of a religious or cultural ritual.
You might experience dissociation as a symptom of a mental health problem, for example post-traumatic stress disorder, depression, anxiety, schizophrenia, bipolar disorder or borderline personality disorder.
Or you may experience dissociation as a side effect of alcohol or some medication, or when coming off some medication.

How might I experience dissociation?
Dissociation can be experienced in lots of different ways.

Psychiatrists have tried to group these experiences and give them names. This can help doctors make a diagnosis of a specific dissociative disorder. But you can have any of these dissociative experiences even if you don’t have a diagnosed dissociative disorder.

Having difficulty remembering personal information
You might:

have gaps in your life where you can’t remember anything that happened
not be able to remember information about yourself or about things that happened in your life.
A doctor or psychiatrist might call these experiences dissociative amnesia.

Travelling to a different location or taking on a new identity
You might travel to a different location and take on a new identity for a short time (without remembering your identity).

A doctor or psychiatrist might call these experiences dissociative fugue.

Feeling like the world around you is unreal
You might:

-feel as though the world around you is unreal
-see objects changing in shape, size or colour
-see the world as ‘lifeless’ or ‘foggy’
-feel as if other people are robots (even though you know they are not).
A doctor or psychiatrist might call these experiences derealisation.

Feeling like you’re looking at yourself from the outside
You might:

-feel as though you are watching yourself in a film or looking at yourself from the outside
-feel as if you are just observing your emotions
-feel disconnected from parts of your body or your emotions
-feel as if you are floating away
-feel unsure of the boundaries between yourself and other people.
A doctor or psychiatrist might call these experiences depersonalisation.

Feeling your identity shift and change
You might:

-feel your identity shift and change
speak in a different voice or voices
use a different name or names
switch between different parts of your personality
-feel as if you are losing control to ‘someone else’
-experience different parts of your identity at different times
act like different people, including children.
A doctor or psychiatrist might call these experiences identity alteration.

Difficulty defining what kind of person you are
You might:

-find it very difficult to define what kind of person you are
-feel as though there are different people inside you.
A doctor or psychiatrist might call these experiences identify confusion.

What are triggers and flashbacks?
A trigger is a reminder of something traumatic from the past, which can cause you to experience dissociation or other reactions. It could be a sight, sound, taste, smell or touch. It could be a situation or way of moving your body. Many different things can be or become triggers.

In a flashback, you may suddenly experience traumatic sensations or feelings from the past. This might be prompted by encountering a trigger. You may experience the flashback as reliving a traumatic event in the present. A flashback may cause you to switch to another part of your identity.

If you have dissociated memories (because of amnesia or because you experience different identity states with different memories) then you may find that these resurface during flashbacks.

“A flashback is a sudden, involuntary re-experiencing of a past traumatic event as if it is happening in the present.””