Are You Dissociating? Here’s What to Do

Like gluten or ozone, dissociation is one of those things everyone has heard of, but few can really define. This week, we’ll talk about what dissociation is, how it develops, and three ways to counter it if you recognize it as a problem in your life.

What is dissociation?

Dissociation is detachment, whether from your body, your emotions, or your surroundings. In short, dissociation is the opposite of being present in the here and now.

Everybody dissociates at least sometimes. Think about all the times you’ve had to read a page over because your mind was elsewhere, or you pulled into your driveway but didn’t remember the drive home.

Even the highly sought-after state of flow is technically dissociation: you become completely absorbed in whatever you’re doing—writing, painting, coding, or the like—and disconnected from your surroundings and the passage of time.

Dissociation isn’t a genetic trait. Instead, it’s a response that gets honed through experience and necessity. It can be useful sometimes—think of heroic soldiers wounded on the battlefield who blocked out their pain to save others. Even the highly sought-after state of flow is technically dissociation: you become completely absorbed in whatever you’re doing—writing, painting, coding, or the like—and disconnected from your surroundings and the passage of time.

Dissociation can also be an emergency survival tactic during intense pain or trauma. It cuts you off from your experience, making you numb when pain or panic would otherwise overwhelm you. This means that in the short-term, dissociation is necessary for survival.

But sometimes, this comes with a cost in the long-term. Australian researchers examined adults who were admitted to Level 1 trauma centers after traumatic injuries. They were assessed during admission and within one month, and then re-assessed three months later. They found that those who had more panic symptoms immediately after their injury opens in a new windowalso had more dissociation, which makes sense—the more overwhelming the experience, the more likely for someone to tap out of reality. But this higher dissociation also predicted more likelihood of posttraumatic stress disorder three months later. It’s as if the initial tapping out of reality only postponed the psychological pain, making it worse later.

This might be the case for survivors of childhood sexual abuse too, in some very specific ways. Adults who hallucinate—hear or see things that aren’t there—are opens in a new windowmore likely to have experienced sexual abuse as a child. This connection works at least partially through the victims’ higher tendency to dissociate. And who could blame them?

Dissociation compartmentalizes horrible events so you can get through another day. Sadly, dissociation doesn’t let these survivors to permanently shake off the psychological scars of abuse in the long term. For those who experienced childhood sexual abuse, the more they dissociated, the more they were also opens in a new windowlikely to hurt themselves as adults.

All of this speaks to dissociation as a double-edged sword. On the one hand, it offers an emergency escape pod from reality when the body and mind really need it. On the other hand, abuse survivors have gotten so much practice at dissociation that it often becomes automatic in times of stress, strong emotion, or perceived danger. But when dissociation continues to be used even when the threat ceases to exist—the child abuse survivor grows up and moves out, the abuser dies or is imprisoned—dissociation stops protecting and starts getting in the way. It leaves the person disconnected, spaced out, and, ironically, vulnerable to more danger.

What does dissociation feel like?

Two of the more common forms of dissociation are called depersonalization and derealization.

Depersonalization is feeling detached or alienated from your body. Individuals who experience depersonalization often report not recognizing themselves in a mirror, feeling like their body is not their own, feeling as if someone else is speaking, or even being temporarily unable to talk. It’s the ultimate “out of body” experience.

For many, there’s a sense of emotional numbing—just feeling kind of “meh” about things that should be emotionally intense.

For many, there’s a opens in a new windowsense of emotional numbing, too—just feeling kind of “meh” about things that should be emotionally intense. Needless to say, it can be a worrying experience if it feels profound and uncontrollable. But like most things, depersonalization exists on a spectrum. You may even be able to induce some depersonalization by staring intently at your own hand for one to two minutes.

Derealization is feeling detached or alienated from your surroundings, like being in the middle of a crowded party and feeling like you’re just vaguely watching it on TV. People will often say the world looks fake, or that they are seeing it through a veil. Others report that the world loses color and looks gray. Some people experience opens in a new windowderealization during sex, and this can contribute to having sexual dysfunction disorders.

Like depersonalization, derealization exists on a spectrum. If you’ve ever stared into a campfire or a strobe light, you may have glimpsed how this feels. You may also be able to induce some minor derealization by staring closely at a wall for a couple of minutes.

How does dissociation work in the brain?

Dissociation, just like any other psychological experience, is based in the brain. There’s still a lot of mystery surrounding how it works, but researchers have found a few ways that the brain activity of people with dissociation/derealization disorder differs from those without the disorder.

In those who often have dissociation/derealization, this brain area is always a little hyperactive, but when something stressful happens, it actually doesn’t activate as much as it should.

One difference lies in the brain system that controls the fight-or-flight response. In those who often have dissociation/derealization, this brain area is always a little hyperactive, but when something stressful happens, it actually doesn’t activate as much as it should. There’s also opens in a new windowless of a feedback loop in this brain system that tells it to cool off after it’s been activated for too long.

Another difference lies in the limbic system, the emotion-processing center of the brain. This area is also less activated than it should be during dissociation, showing again how the brain “ opens in a new windowzones out.”

How to stop dissociating

If you feel yourself dissociating, how do you bring yourself back?

First and foremost, if you’ve recognized yourself in today’s show and have survived trauma or abuse, it’s worth seeking out help. Dissociation often rides piggyback with PTSD, and both are treatable. Find a licensed mental health professional with experience treating PTSD with dissociation. The good news is that when treatment specifically addresses dissociation, opens in a new windowpeople can respond quite well.

For everyday groundedness, try these three tips.

1. Engage your senses

This is the classic way to keep yourself from slipping away. For example, pop a strong breath mint … or three. Squeeze an ice cube in your hand. Pay attention to how your feet feel pressing on the floor. Name five things you can see right now. In short, use your body! Gain some traction by feeling, seeing, hearing, smelling, and tasting your here and now.

2. Pay close attention to your breathing

You can do this anywhere, and nobody has to know what you’re up to. Slowly breathe in your nose. Feel the sensation of the cool air as it moves into your nostrils. Then, follow the air as it enters your nose and spreads to the back of your throat. Next, slowly breathe out. Feel the contrast of the warm air and the sensation as it leaves your nostrils. Again, the sensory input keeps you connected to your body and your surroundings.

3. Choose an object to keep you in the present

It could be something like a small stone, a photo, or a keepsake. Some people find it helpful to use something wearable, like a ring or a necklace charm, so you always have it with you. Build an association between it and the present—every time you see it or touch it, remind yourself that you are here and now. Then, when you need it, you can reach for it.

Dissociation is varied and often hard to describe. Plus, we’ve only had time here to touch on two common types. For more information, opens in a new windowcheck out some FAQs from the good folks at the International Society for the Study of Trauma and Dissociation.

This episode was originally written by Dr. Ellen Hendriksen. It has been significantly updated and rerecorded by Dr. Jade Wu.