Dissociation
Why everyone should care about dissociation
Have you ever, after receiving bad news, felt that the world is strange; perhaps felt out of touch with your body or mind or behavior? Maybe you were left wondering if this is a joke or a dream? Congratulations, you had a mild dissociative experience. Even that feeling after watching an intense movie or reading a fantasy book and then needing a minute to adjust to the real world is an example of very mild – and harmless - dissociation.
Dissociation has two components: derealization, which is the feeling that the world around you feels unreal in some way, and depersonalization, or the feeling of being outside of your body – some people describe it as feeling they are watching themselves do something but don’t feel they are taking part in it. Of course, both of these experiences are common when on drugs – but many experience varying degrees of dissociation at certain times in their lives.
Dissociative identity disorder (formerly called multiple personality disorder) is these experiences to the extreme. Experts generally agree dissociative identity disorder (DID), in those who have it, is typically developed after trauma, especially chronic trauma (Lynn & Rhue, 1994). Still, dissociative experiences in a less extreme form are found in a number of people who have not went through a traumatic event – it is common in binge-eating disorder (eating a lot of food in a short period of time and feeling you are completely out of control when doing so) and bulimia (binge eating with the addition of a compensatory behavior, such as vomiting or overexercising) (Torem, 1986) and impulse control issues (it’s difficult to control your impulses when you don’t feel in control of your own body of surroundings) (Vermetten, Dorahy, & Spiegel, 2007). This is why everyone should take note of dissociation, why it exists, what purpose it serves, and how to reduce it if need be.
Trauma
Even if you have not experienced trauma, reading about trauma and dissociation can help you realize why it’s easy to fall into its trap when going through a difficult time or when doing something you are ashamed or not proud of. What about trauma might lead to derealization and depersonalization, long after the traumatic experience is over? The short answer to this is that, at the time of the trauma, especially if it goes on for a long time, these experiences can be adaptive (Lynn, 2005). Adaptive means that they provide some sort of benefit to the individual – they serve as coping mechanisms at the time of the act. Note that these can develop in adulthood, but are especially powerful when they begin in childhood.
Consider this: a child suffering from chronic abuse that is fully in the moment and present in their experiences will suffer extreme anguish while the abuse is going on. Over time, the child may learn to remove themselves from their experiences: try to take their minds off of it, or come up with elaborate imaginative scenarios where they live in a happy family. Especially in cases of physical and sexual abuse, children might mentally leave their body as a way to cope with the terror.
This is why adults who report dissociative symptoms after long-term abuse are sometimes told by therapists that what they are experiencing is their body’s coping mechanism – dissociation may have been extremely effective at the time the abuse was going on. Presuming the abuse is now over, the mind clings on to that previous mindset. Only now, this mindset can be very, very harmful. Dissociation is positively correlated (related, or found in increasing degrees) in people with post-traumatic stress disorder (PTSD), substance abuse, and a number of mental health disorders, including depression and anxiety (American Psychological Association, 2013). The healing process for trauma is letting go of this crutch and developing a mindset that leads to lower mental health risk. This is extraordinarily difficult – try telling someone who has used their way of thinking as a survival mechanism for a long time, that they need to change. It is also a slow process, and nobody should be rushed into it. Rather, people affected by a trauma might accept it as a goal to work towards at their own pace and in their own way.
How to reduce dissociation
Perhaps the most effective way to reduce dissociation is mindful meditation (Corrigan, 2002; Zerubavel & Messman-Moore, 2015). Meditation is daunting to many (I’m still trying to get into it!); it can feel boring or nerve wracking. It is helpful, because it helps you “stay in the moment”. The idea is that if you can clear your mind and focus on breathing in through your nose and out through your mouth (it’s generally recommended for beginners to start a timer for 20 minutes), then you’ll be better equipped to handle life’s stresses. In other words, if you can learn to clear your mind while you’re doing absolutely nothing, it might not only help you feel calm at that moment and for the rest of that day – it can actually help you bring that mindset into a stressful situation. This, of course, requires practice – finding your “zen” while waiting in a long line or resisting the urge to yell when you’re really angry isn’t easy. Learning this is called mindfulness, and it involves consciously being aware and accepting of your thoughts and feelings, without letting them control you. Some research shows that “a wandering mind is an unhappy mind” – when doing the same activity, people report greater happiness when thinking about nothing, compared to people thinking about bad or even neutral topics (Killingsworth & Gilbert, 2010; Marchetti, Koster, Klinger, & Alloy, 2016). In fact, happiness level is similar in those who think about nothing and those whose minds wander to positive topics (Killingsworth & Gilbert, 2010). There are, however, proposed benefits to mind wandering; they are beyond the scope of this article, but can be found in the works of Smallwood & Andrews-Hannah (2013).
tl;dr Dissociation is present in many of us at varying degrees. It can be helpful when dealing with trauma, but has negative consequences after the trauma has ended. Even those who have not lived through a trauma might find it useful to practice meditation and mindfulness, as it helps clear the mind and stay in the present.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Corrigan, F. M. (2002). Mindfulness, dissociation, EMDR and the anterior cingulate cortex: A hypothesis. Contemporary Hypnosis, 19(1), 8-17.
Killingsworth, M. A., & Gilbert, D. T. (2010). A wandering mind is an unhappy mind. Science, 330(6006), 932-932.
Lynn, S. J., & Rhue, J. W. (Eds.). (1994). Dissociation: Clinical and theoretical perspectives. New York: Guilford Press.
Marchetti, I., Koster, E. H., Klinger, E., & Alloy, L. B. (2016). Spontaneous thought and vulnerability to mood disorders: the dark side of the wandering mind. Clinical Psychological Science, 4(5), 835-857.
Smallwood, J., & Andrews-Hanna, J. (2013). Not all minds that wander are lost: the importance of a balanced perspective on the mind-wandering state. Frontiers in Psychology, 4, 441.
Torem, M. S. (1986). Dissociative states presenting as an eating disorder. American Journal of Clinical Hypnosis, 29(2), 137-142.
Zerubavel, N., & Messman-Moore, T. L. (2015). Staying present: incorporating mindfulness into therapy for dissociation. Mindfulness, 6(2), 303-314
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