Have you ever found yourself feeling emotionally, psychologically, or even physically detached from reality? In other words, did you catch yourself in a strong state of daydreaming in which you “separated” in your consciousness from the world around you? As youngsters, and even some adults, daydreaming is a normal “separating from reality” for a moment of rest for the psyche. But dissociation includes 2 main processes that can become severe over time, primarily when dissociation is a coping mechanism for a history of trauma (i.e., rape, incest, severe crime, violence within the home or community, etc.). While working in a residential treatment facility of youngsters with behavioral and mental health problems, many of my child and adolescent clients struggled with severe forms of dissociation.
The mild form of dissociation will be discussed in this article with some focus on severe dissociation. I will also list ways to cope with the traumatic pain that often leads to dissociation.
Dissociation is a complicated subject, especially when discussing the severe forms of dissociation. A severe form of dissociation has been one of the most controversial “disorders” of all time: dissociative identity disorder or multiple personality disorder. While I and many other mental health providers struggle to find concrete research to support the DID diagnosis in certain populations, I have experienced, through many clients with trauma histories, the power of dissociation. Dissociation, for me, is most frightening when a child experiences it. Although childhood dissociation is rare, there are some children who exhibit signs such as those who are the victims of rape, incest, domestic violence, severe trauma, etc. For adults, dissociation can be complicated by years of trauma and is frightening to say the least.
The most common symptoms of dissociation for those who have experienced trauma include:
- De-personalization: This can be explained as feeling your body does not belong to you. You are numb. It’s another form of dissociating from reality. I have had kids tell me “I am not myself today” or “I feel different.” I admit that this is a confusing term and often sounds similar to the next dissociative symptom.
- De-realization: Most people explain de-realization as a form of feeling “spaced out” or “far away.” This does not necessarily have to occur among those with trauma histories or abusive childhoods. De-realization can be as simple as driving along the highway and “spacing out” so much that you forget where you are going or failing to realize that you have been driving for miles on the highway. A former colleague reported to me that because she had a 1 hour and a half drive to work that she found herself dissociating while driving. She was driving the speed-limit and going in the right direction but somehow “split off” from reality and lost awareness of what she was doing. She could never explain what the trigger was or how she even “came back” to reality.
- Amnesia: We all know what amnesia is: a state of mind which involves loss of memory of details. A severe form of amnesia can lead to long-term loss of memory, loss of identity, and confusion. Dissociative fugue is a state of amnesia which includes a “loss” of identity and personality. Before dissociative fugue became a specifier in the DSM-5 (the new version), it was regarded as a full blown disorder which included loss of memory and identity to the point of the sufferer taking steps to live a completely different life. For example, a dedicated husband suffering from dissociative fugue may dye his hair blue, change his name, remove his wedding band, move to California, and buy a home where he makes a living selling marijuana. It is a very drastic and severe form of amnesia/dissociation. Some cases involve a return to normalcy while other cases never return to normal.
- Sense of being detached: A sense of being detached may include someone struggling with holding on to memories that should not be that difficult to remember. For example, it should be easy to remember that just the other day you attended your 35th family reunion in which you had a great time playing games with and laughing with your aunt and cousins. Someone who feels detached from reality may find it difficult to remember how things were designed, how things felt or appeared, and who was present. You may also struggle to remember “emotional memories” such as when you felt loved, accepted, or happy.
- Feeling “un-grounded” or absent: Some people report feeling as if they are floating or as if they are outside of themselves watching everything around them happen. I previously had a client who struggled with feeling absent. His main therapeutic goal was to “feel whole again and connect with those I love.” He always felt detached emotionally and psychologically. he felt as if he was protecting himself from being let down as he was so many times in the past by his family. During family vacations or holidays he would try to engage but somehow end up feeling absent or unable to “cement” memories as things occurred during the event.
Have you ever heard of grounding exercises? Grounding exercises are tools I have recently come to appreciate, primarily when working with my young clients who struggle with internalizing their emotions. Grounding exercises are things you can do to bring you back to reality or bring you back to a place where you can function appropriately. The following are a few techniques you may want to try:
- Squeezing a piece of ice: Some kids, especially those who struggle with controlling intense emotions, can benefit from this technique. If I’m honest, this “tool” has always been a less favored one for me because I just don’t get how you can squeeze a piece of ice without causing muscular problems!! But perhaps on a hot day this can be useful. The idea is that the ice causes physical sensations to help distract yourself from painful emotions. You can use it to help you re-focus your attention. If all else fails, you can squeeze a pillow, stuffed animal, or someone’s hand.
- Learn about mindful eating: If you’re like the millions of Americans in today’s society you probably eat whenever you have the time to and possibly even while simultaneously working at your desk, working at home, or chasing kids. Americans are famous for attempting to multi-task even while eating. But for dissociative symptoms it will be important to learn how to mindfully eat your food. What this means is that you can learn to eat your food more slowly and more “consciously” in an attempt to be “present” and focused. It’s always similar to hyper-focusing (i.e., paying especially intense attention to something). In this way you avoid dissociation because you have something to focus on.
- Listen to loud music: I am certainly not a fan of loud, obnoxious music but you can certain beat dissociation by blaring music of your choice. I often suggest to my teen clients to turn their music up in their bedrooms, in the car, at the gym, or while washing the car in a public place. You want to be mindful of how your music may affect others. But the goal of this tool is to distract yourself in a healthy way without fully dissociating.
Have you ever tried these tools? Do you have ways you cope with dissociation? As always, feel free to start a conversation below.
I wish you all the best