Altered states - a look at dissociation

When your brain goes offline

Go to the profile of Brian Martin Shand
Aug 01, 2019
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Our minds can do all sorts of strange things to protect us when we’re in tough situations.  One of the more disturbing is dissociation. It’s when the brain effectively goes offline – usually in the face of trauma.

Trauma, in the real sense of the word, refers to experiences which are so unbearable that they overwhelm the mind’s usual defences. So dissociation is a defence of last resort.  The mind decides that the situation simply isn’t happening.  Dissociation involves switching off from one’s thoughts, feelings, memories or sense of identity.  It includes conditions like dissociative amnesia, dissociative fugue, depersonalization, derealization and dissociative identity disorder.

Although exposure to disasters, wars, terrorist attacks and the like can trigger dissociation, I’m thinking here more of prolonged exposure to childhood trauma such as might arise from severe  emotional, physical or sexual abuse.

Dissociative amnesia

In dissociative amnesia we’re not talking about normal forgetfulness as in where you left your coffee cup.  We’re talking about amnesia that significantly impacts on life.  A person may perhaps forget important personal information, often of a traumatic or distressing kind, in a way that’s too extensive just to be put down to everyday forgetfulness.

Dissociative fugue

Dissociative fugue is a rare sub-category of dissociative amnesia.  In pronounced form, a person may forget their own identity or take on a new one.  They’ll often undertake some unexpected travel – perhaps far from home and may adopt a new name and address and even engage in complex personal interactions – sometimes while appearing to behave completely normally.

Depersonalization and derealization

Depersonalization and derealization are states of altered self-awareness where there’s a sense of being detached from oneself or one’s surroundings or both.  Exhaustion, medication and recreational drugs can all create similar feelings but if the feelings recur regularly and interfere with life, then psychological factors may be at work.

In depersonalization, a person may feel separated from their own being, as if they have no self.  They may also feel detached from feelings and thoughts as well as from parts of their bodies or from sensations such as hunger or sex-drive.   A sense of agency may also diminish so that the person feels robotic or not fully in control of their words or movements.

Derealization is a distressing feeling of (sometimes dreamlike) detachment from the surrounding world which may seem to be perceived through a glass wall or on a computer screen.  Visual and auditory distortions may occur with objects appearing the wrong colour or size, sounds being either too loud or too quiet and alterations happening to two or three-dimensionality.  Time too may seem to speed up or slow down.

Dissociative identity disorder

In Dissociative identity disorder (DID), two or more distinct identities or personalities alternately take control of an individual who also exhibits severe memory loss.  Not surprisingly perhaps, alongside these symptoms there’s a discontinuity in the sense of self, emotions, behaviour, perception, consciousness and thinking.

Previously known as multiple personality disorder, the new name is better than the old one because we now know that the process going on in a person suffering from DID involves a fragmentation of their (single) identity not a proliferation of separate ones.

The pros and cons of dissociation

If a person (often a child) is the victim of unrelenting anguish, terror, pain or horror, it’s only too easy to understand why they’ll cut off these emotions.  It enables them to get outside the situation.  But there’s a big downside.

Dissociation tends to be triggered automatically in circumstances which are not the original circumstances and which are far less threatening – circumstances which call for a considerably milder response, a response which takes much less of a toll on the person themselves.

Not only may the individual be confused at the onset of a dissociative episode but so may those around them if they’re suddenly confronted by someone undergoing memory loss or the assumption of an alternate personality.

Psychotherapy may be helpful in treating dissociation but sometimes just the fact of a person knowing what’s happening to them can allay some of their fears.

© Brian Shand 2019

Many more blogs here:  https://www.guildfordtherapy.co.uk/blog/





 

 

 

Go to the profile of Brian Martin Shand

Brian Martin Shand

I have considerable professional experience in mental health settings, having worked both in the NHS and in private practice. I am one of the very few trained and qualified group psychotherapists in private practice in Surrey. I also offer individual therapy and counselling. Please see my website for more details.

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