Dissociation is something of a confusing topic. Like many things, dissociation can happen across a spectrum. Not all dissociation is abnormal, pathological, or something to worry about. In fact, everyone dissociates from time to time. It the level of disruption and distress that it causes that separates everyday dissociation from dissociation that is a clinical issue.
What Dissociation Is
In a nutshell, dissociation is losing contact with or awareness of some elements of the present reality. I realize this might not clear it up for you, so I’m going to give examples.
Everyday (or “normal”) Dissociation
Let’s talk first about the “normal” end of the dissociation spectrum. As I said, everyone dissociates from time to time:
- If you are caught up in a book or movie, you might not be aware of being in your body in your living room in the present. That’s a form of dissociation.
- Or say you are in meeting of some kind or in a waiting room and bored to tears. You start daydreaming about something pleasant and lose yourself in those thoughts. For that time, you are not aware of being bored in that meeting or bored in that waiting room.
In either case, when someone calls your name or touches your shoulder to get your attention, you are immediately aware of being in the room, watching the movie or waiting for your appointment. You know who you are and you know where and when you are and recognize that your body belongs to you. At that point, you are no longer experiencing dissociation.
Abnormal Dissociation
On the clinical end of dissociation, the dissociation is more lasting and typically causes significant distress.
A person who is beginning to dissociate may feel foggy or be numb to things they are experiencing. They still know who they are, where they are, and when they are, but they are beginning to lose contact with the full experience of who, where, and when they are. The experiences seem distant rather than immediate, and muted.
At its fullest expression, dissociation results in a state of collapse. Think of someone who appears to be completely unaware of what is going on around them and doesn’t react to anyone calling their name or trying to get their attention. Their consciousness is somewhere else at that time.
Depersonalization and Derealization
Depersonalization and derealization are relatively common dissociative issues. With depersonalization, the person is dissociated from their body. Remember that I said dissociation is losing contact with or awareness of some elements of the present. In this case, it’s losing contact with the experience of knowing you are in your body. The body may feel like a machine being controlled by a remote control, for instance.
With derealization, the person loses contact with the experience of knowing that their present moment is real. It may seem like a dream or something imagined rather than something that is experienced as true and real. Depersonalization and derealization can wax and wane. That is, sometimes the dissociation increases and other times it decreases or even disappears.
Unfortunately, simply telling the person that what they are experiencing at the moment truly is real or that the body they see in the mirror really is theirs even though it doesn’t feel like it doesn’t end the dissociation for them. It’s not a fleeting dissociation like daydreaming.
Flashbacks
Flashbacks are a form of dissociation as they are memories of past events experienced as if they are happening right now.
Dissociative Identity Disorder (DID)
The most severe form of dissociation is that of Dissociative Identity Disorder. In DID, different aspects of the individual’s consciousness become separated from each other. We call these aspects alters, system members, headmates, or parts. These alters lose contact with some other alters entirely and experience the others they are aware of as completely separate. Past events, when they are known, are experienced as having happened to one alter or another rather than to the individual as a whole. To complicate matters further, any alter can begin to dissociate from the present, as well. For instance, when talking about an upsetting memory, that alter may begin to start to feel foggy and distant and have trouble responding to the person they were talking with.
It’s easy to see why dissociation is such a confusing topic! How it is experienced can be quite different depending on the cause and the intensity.