Dissociation
What is Dissociation?
Dissociation is a common psychological phenomenon, which can be described as distancing ourselves from our sensations and emotions, which usually has the purpose of protecting us from an uncomfortable, painful or overwhelming experience. Low-level dissociation can include daydreaming or getting lost in thought, whilst at the high end of the scale we may find a range of distressing experiences, such as hearing voices, losing touch with reality, periods of amnesia, unexplained physical symptoms, and ultimately the split of personality into discrete parts (Dissociative Identify Disorder, also known as Multiple Personality).
Low level dissociation is part of ordinary everyday life and does not usually cause problems. At the middle and higher parts of the scale difficulties begin to surface, for example, a person can feel numb and detached some of the time, and highly anxious and overwhelmed at other times; addictive behaviours, eating disorders and self-harm are common.
Sometimes dissociation shows up as unexplained physical symptoms, such as pains or aches that don't have any obvious cause, skin problems, or non-epileptic seizures.
Dissociation is often poorly understood by health professionals, and even experienced doctors, psychiatrists, counsellors and therapists can often miss the signs of dissociative problems, because often we can function quite normally in everyday life until somethings sets off a dissociative response. Even when the symptoms are recognised and examined by medics, misdiagnoses are common.
Psychotherapy for dissociative issues is usually long-term and requires patience, great skill from the therapist, commitment from the client, and a very safe environment. A warm and trusting relationship between the therapist and the client is crucial, especially because many people with severe dissociative symptoms had difficult and damaging relationship experiences in the past. The client's anxiety about their symptoms and the dissociative phenomena will need to be addressed over a period of time, and only then any suspected causes for dissociation (usually trauma) can be approached, with greatest care.
My understanding and skills of working with traumatic dissociation stems from the study of Somatic Experiencing (having completed year 1 of Practitioner Training), EMDR training (to advanced level), as well as short workshops with presenters such as Dr Onno Van Der Hart (an internationally renown expert on dissociation and one of the authors of The Haunted Self), Dr Shoshana Garfield (who has overcome her own severe childhood trauma and dissociation before gaining a doctorate in psychology and using her knowledge to help others) and Gillian Whiteman (a well-known and respected EFT therapist who is another expert by experience).
Useful information sources
International Society for the Study of Trauma & Dissociation
Somatic Experiencing Trauma Institite
Recommended books