Trauma And Dissociation: Understanding Your Mind’s Protective Mechanism
Are you struggling with spells of intense fogginess after painful experiences? Feeling at times as though you’re ‘out of your body’? Wondering about trauma and dissociation? Read on to find out how trauma dissociation works and what to do to break through it.
First things first: what is trauma?
Since there are different ways to talk about it, first let’s clarify what we mean by ‘trauma’.
Trauma is often used to describe extremely stressful or frightening (‘traumatic’) experiences that overwhelm our ability to cope. People (including mental health professionals) also often use the word ‘trauma’ to describe the mental and emotional responses to those traumatic events.
There are many different kinds of trauma events including:
- Life-threatening traumas (such as war or an armed attack)
- Non life-threatening traumas like marital infidelity or a lawsuit.
Traumas may be:
- One-time events, such as a car accident (acute trauma)
- Repetitive experiences over long periods, for example broken attachment relationships or neglect and abuse (‘complex trauma’)
In mental and emotional terms, trauma can present with:
- Intrusive memories and flashbacks
- Arousal (anxiety, disturbed sleep, irritability, restlessness and trouble concentrating)
- Avoiding ‘triggers’ and reminders (places, people or things associated with the traumatic event/s)
- Numbness and dissociation
How trauma can impact daily life
Trauma can impact our lives in far-reaching ways. It can lead to:
- Emotional problems including mood swings, intense fear, shame, and numbness
- Cognitive problems such as difficulty concentrating, poor memory, difficulty making decisions
- Arousal – anxiety, restlessness, irritability, disturbed sleep
- Flashbacks and intrusive thoughts
- Social withdrawal
- Avoidance of places, people or things that remind you of the traumatic event/s
- Problems with work, often due to difficulties concentrating
- A sense of detachment from others
- Stress on the body due to being in a prolonged state of ‘fight or flight’
- Dissociation
The link between trauma and dissociation
Dissociation is a common response to trauma, The majority of people who suffer a traumatic event (such as a car accident or violent attack) will go into a dissociative state either during the experience itself or in the following hours, days or weeks.
Most of these people find these experiences of dissociation go away on their own within a few weeks. Not all do though.
For some people, particularly those who have experienced prolonged or recurring trauma especially in childhood (often referred to as ‘complex trauma’), chronic dissociative symptoms are more common.
Am I dissociating? What does dissociation feel like?
Dissociation can feel different to different people. And it varies in severity and duration. But if you’re experiencing dissociation, you’ll probably recognise at least one of these sensations:
- Feeling ‘out of your own body’
- Having a sense of profound detachment from your environment and yourself
- A sense that nothing is quite ‘real’
- A feeling of fogginess or a dreamlike quality to the world around you
- Being unable to recall specific events or having ‘holes’ in your memory
- Finding yourself suddenly unable to remember certain information or how to perform tasks that you’ve been able to do easily in the past
- The sense that common words, objects, or even the people around you suddenly seem strange, as if you don’t recognise them
- A feeling of disconnection from your emotions
How dissociation works
While dissociation can feel deeply scary, it’s actually your brain’s way of trying to help you. In fact, dissociation is a key tool in our human threat response system.
To understand the relationship between trauma and dissociation, we need to recognise dissociation as:
A survival strategy:
- As researchers on dissociation have observed, the freeze response to a threat (part of ‘fight/flight/freeze’) has served an evolutionary purpose for millions of years, helping to shape the development of all animals with a central nervous system – we humans among them.
- Dissociation is very often associated with the freeze response. When you can’t escape from the threat, going ‘somewhere else’ in your mind can defend you from distress.
- It’s little wonder then that some form of dissociation during or soon after a traumatic event occurs more often than not.
A coping mechanism:
“Your brain is doing its best to help you. When it comes to trauma, dissociation is your brain’s way of reducing access to certain thoughts, feelings, bodily sensations or memories in order to protect you from overwhelming distress,” says Dr Christina Collins, Clinical Psychologist at The London Psychiatry Centre.
As we’ve learned, dissociation is a common response during traumatic events but mostly goes away in the weeks following. For some people though, particularly for those who’ve experienced lasting or repeated trauma, dissociation can become chronic. The brain ‘learns’ that dissociation helped you survive and keeps reaching for the same response long after the threat has passed.
Like most coping mechanisms, dissociation helped you at one stage. But if it becomes chronic, it can have negative effects on mental health, quality of life, and your all-round sense of yourself as a person.
Potential long-term effects of repeated dissociation
Chronic dissociation can lead to significant problems including:
- Impaired ability to manage and successfully bring together your emotions, thoughts and memories
- A feeling of not being a ‘whole person’
- Risk of mental health problems such as depression and anxiety
- Memory issues
- Impaired attention, executive function (e.g. planning and decision-making skills), and general cognition
- Difficulties relating to others
Treatment and coping strategies
If you’ve been struggling with trauma and dissociation, you’re understandably concerned. It can be very scary and disorientating to feel ‘outside of yourself’ or that the world around you is foggy or unreal.
The first step is acknowledging there’s an issue. Reading an article like this is part of that process, so pat yourself on the back for taking the initiative in your own self-care.
Coping strategies for dissociation often include
Grounding techniques such as:
- The 5-4-3-2-1 method (when you feel yourself dissociating, bring yourself back into your body and the present moment by identifying 5 things you can see around you, 4 things you can touch, 3 things you can hear, 2 you can smell, and 1 you can taste.
- Temperature contrast – splash your face with cold water, hold a hot drink, put an ice cube against your skin.
- Movement – walk around, wiggle your toes, press your hands against a wall.
Other coping strategies such as:
- Affirmations – e.g. affirming that you are safe and present.
- Journalling to identify any patterns to the dissociative episodes.
- Confiding in supportive friends and family.
If you are experiencing repeated dissociation, the best thing you can do is to seek good mental health support. Talking to your GP is often a good place to start.
Treatment for trauma and dissociation may include:
- Eye movement desensitisation and reprocessing (EMDR) for dissociation – this is a very effective, evidence-based therapy for trauma. Depending on the extent to which you tend to dissociate, an experienced EMDR practitioner will adjust the sessions accordingly, to make them safe and supportive for your recovery. Here at The London Psychiatry Centre we are highly experienced in EMDR, having successfully delivered the technique for survivors of the 9/11 and 7/7 terrorist attacks, the Thailand Tsunami, and many other extreme events, as well as a host of ‘non-life threatening traumas’ from lawsuits to infidelity.
- Talking therapies such as trauma-focused Cognitive Behavioural Therapy (CBT)
- rTMS – A leading-edge intervention for treatment-resistant depression and now bipolar disorder pioneered in the UK by The London Psychiatry Centre, repetitive Transcranial Magnetic Stimulation has been shown to be effective for dissociation too. By stimulating parts of the brain that are crucial in governing executive function and emotion, or that integrate sensory information with things like attention, social cognition and distinguishing the self from others, dissociation may be alleviated.
Yes dissociation can be scary, but try to take heart. Millions have recovered from trauma and dissociation and so can you, with the right support.
The London Psychiatry Centre is at the leading-edge of treatment for trauma and dissociation. Make an appointment by calling 020 7580 4224 or email info@psychiatrycentre.co.uk
