WHAT IS DISSOCIATION AND HOW DOES IT AFFECT LIFE AFTER TRAUMA?
According to a Washington State Cognitive Behavior Therapy article (2012), dissociation is a coping mechanism that involves the avoidance of thoughts or feelings related to a traumatic event. It can occur during a trauma or much later when one thinks about or is reminded of the trauma. Being powerless to change or stop an event may lead a person to disconnect from a situation in order to cope with feelings of helplessness, fear, or pain. Being disconnected from the ‘here and now’ or from one’s surroundings can lower fear, anxiety, and shame, or block memories. Dissociation enables people to survive pain or stress but can interfere with facing up to and getting over trauma or unrealistic fear in the present. It can also interfere with one’s learning or activities requiring sustained attention.
When dissociating, a person may daydream or stare into space. The mind may go blank or wander, and an individual may have a sense that the world is not real or feel as if he is watching himself or a situation from outside his body. One can feel detached from herself, her identity, or her surroundings.
Physicians, therapists, and social workers writing for verywellmind, an online resource that provides mental health guidance, claim that the tendency to dissociate is usually the result of trauma and stress during childhood, sometimes chronic trauma such as repeated episodes of physical, emotional, or sexual abuse. Untreated, dissociation can lead to depression, anxiety, relationship and work problems, or substance abuse.
In her 2020 blog, “Dissociation: How People Cope with Trauma They Want to Forget,” Robyn E. Brickel, MA. LMFT, wrote that when people dissociate, they are less aware of their surroundings or inner sensations. Something happens that reminds them of unhealed trauma, resulting in emotions such as panic or fear. To get relief, they disengage mentally. Even though everyone dissociates sometimes, such as when we let go of personal concerns during the workday, over-reliance on this coping mechanism in adulthood can compromise one’s ability to trust, form attachments, socialize, and provide good self-care. Dissociation can interfere with forming secure relationships and connections.
Brickel described children who had ‘out of body’ experiences when being physically or sexually abused (as I remember doing when being molested by my brother). Others played loud music to block out their parents’ arguing or played video games for hours while one parent paced the floor because the other parent was out drinking or drugging. Some teens disconnected from their bodies so they couldn’t feel pain when cutting themselves. Others dissociated so they wouldn’t notice the full feeling in their stomachs while binge eating. Still others numbed out with drugs or alcohol to disconnect from their thinking brains.
“Dissociation makes surviving the abuse much easier, but it also makes living as an adult so much harder,” wrote a woman in a 2020 Beauty After Bruises blog entitled “Dissociation and Survival vs. Living: A Survivor’s Story.” “Those of us who endured trauma as children are courageously strong. We were forced to be tougher than most, and by nature or necessity, we became resilient, creative, and sharp. Little Me wasn’t connected to physical pain or sheer terror, wasn’t incapacitated by shame or disgust, wasn’t facing anger or the blistering sting of betrayal from those I loved most hurting me, wasn’t aware that it was abnormal. I was numb, hyper-focused on things I could control.”
When people congratulate this woman for surviving the abuse, for beating the odds, she wants them to know that suffering still occurs in adulthood, when the abuse confronts her with a vengeance. That it feels to her mind and body as if the physical pain, revulsion, and anger are happening NOW. “I am hypervigilant, terrified, exhausted, unsure if I’m even real. I exist in hollowing spaces of grief for Little Me and the life I should have had. This is live trauma in my body and brain, my battleground, fighting for my life NOW.” She struggles with forgetfulness, memory gaps, driving troubles, safety, and maintaining a job.
Survivors have difficulty believing that there is good in the world and benefit to connecting, even though this is vital to their sanity, safety, and healing. “Dissociation challenges this, can dull your senses, leave you numb to positive feelings, keep you at an emotional distance from love or affection shown to you, keep you trapped in the surreal in-between state of the past and the present—where you respond to what’s happening today with the same emotional maturity you had as a child. Emotional flashbacks, triggers, particularly in intimate relationships can complicate joy and frustrate those in your life. Though we want to live fully, dissociation dilutes and blurs the world, stripping it of color and beauty.”
The Washington State CBT article indicated that most of the time a person who is dissociating doesn’t realize it. Others must bring it to their attention. A crucial strategy for getting back to the ‘here and now’ is grounding. A therapist, partner, parent, teacher, or friend can say, “It looks like you spaced out. Where did you go? Where were we when you disconnected?” Asking the person to do something in the current setting can get her engaged (name five things you see or hear, chew up an Altoids and describe the flavor, sniff a cotton ball spritzed with lavender).
Brickel wants survivors to remember that they can be safe, that they no longer need dissociation. They can explore past issues in therapy and learn how dissociation made sense when they had less control, but that they no longer need it. The counselor can create a safe space where it is okay to be present in the moment, in one’s body, and in one’s feelings.
The woman who contrasted survival with living says that dissociation, like chemotherapy or emergency surgery, got her through the abuse, gave her a fighting chance. “But I should feel free, should be dancing, singing, and holding everything I love dear to my chest. But instead, now I stare down my trauma, my innocence, my perpetrators—all with adult intellect and understanding—and try to decide if this life is worth living and if I’m up for the task.”
She ultimately decides that her life is worth living and she is up for the fight. “I’m going to conquer the trauma, the feelings, the difficult relationships, the dissociation and what it made possible for me. I want Young Me to get credit for surviving the horror. But I want Adult Me to be credited for not only surviving more anguish, but for learning to LIVE, too.”
If you or someone you care about grapples with dissociation, I urge you to find a cognitive behavior therapist or a support group with experience in trauma. We were all born to live full, authentic lives in the present and to connect with others on life’s vibrant journey.
