What is Dissociation?
Have you ever found yourself in the middle of a conversation with someone when you realise that you have completely zoned out and have no idea what they’ve been talking about? Have you ever driven home with almost no recollection of the journey there? Have you ever been so immersed in your work that you lose complete awareness of how much time has gone past? If so, you may have been experiencing something called dissociation.
Dissociation essentially refers to a psychological experience in which people feel a sense of disconnection from their sensory experiences, thoughts, personal history, consciousness, memory or sense of self.
The thing is … we all dissociate in some way or another, however there are distinctions in the types of dissociation people experience. Normative Dissociation is what the majority of people will have experienced and may even experience on a daily basis. These experiences refer to a change in consciousness that does not occur as a part of a psychiatric disorder and involves a temporary alteration of what we normally experience. So what might this look like?
Daydreaming
Daydreaming refers to a vivid and deeply captivating visual and auditory experience in which we shift our attention inwards rather than outwards, often temporarily decreasing our awareness of time, space or even identity. In daydreams people often anticipate, rehearse, create, plan, revisit, imagine or address problems that require attention. Daydreaming often enables us to process and work through different experiences or issues that we may not necessarily have addressed otherwise by decreasing our self-consciousness. While daydreaming generally yields positive or neutral effects, it can become problematic if daydreams revolve around repetitive intrusive thoughts, flashbacks or traumatic re-experiencing.
Absorption and Flow
Often when we become completely absorbed in something, whether it’s a movie, a book or our work we can also experience dissociation. This often presents itself in the form of flow. Flow is essentially a psychological state in which a person performing an activity becomes fully immersed in this activity, often experiencing an energised focus and complete absorption and enjoyment of the activity undertaken. When we are experiencing a flow state we tend to lose our sense of time, space and self-consciousness. Flow is a little different to other dissociative states in that there is often a feeling of intrinsic reward associated with the activity.
Pathological dissociation refers to experiences of dissociation that represent a more intense form of detachment, loss of memory and loss of identity. Many pathological forms of dissociation are symptoms of mental illnesses. So what do these look like?
Dissociative amnesia
Dissociative amnesia is a type of dissociative disorder in which a person becomes unable to remember important personal information that would not generally be lost through ordinary forgetting. Generalised amnesia is when a person becomes unable to remember anything, this might include who they are, what they are currently doing or their history. Localised or selective amnesia refer to a failure to recall specific events, these are usually traumatic events that occur during a specific period.A subtype of dissociative amnesia is dissociative fuge. Fuge literally means flight and in this case, individuals tend to take off on an unexpected trip, later finding themselves in a new place and unable to remember why or how they got there. People who experience this are usually leaving behind an intolerable situation, generally one that has resulted in trauma. People may also sometimes adopt a new identity or express confusion regarding their identity.
Depersonalization and Derealization Disorder
During an episode of depersonalization people experience a sense of unreality, detachment or being an outside observer of their own thoughts, feelings, sensations, body or actions. This might include a distorted sense of time, an absent self or even emotional and/or physical numbing. During an episode of derealization, there is still an experience of unreality or detachment however this is generally regarding their surroundings. Often people or objects may be experienced as unreal, dreamlike, lifeless or visually distorted.These symptoms may be present throughout periods of severe stress or even when experiencing an intense panic attack. However, when persistent, severe and recurrent experiences of depersonalization and derealization are the primary problem it is more likely that this person might fit the criteria for depersonalization-derealization disorder.
Dissociative Identity Disorder
Dissociative identity disorder (DID) was previously referred to as multiple personality disorder however our perception of this has somewhat changed over time. When a person is experiencing this form of dissociation they essentially adopt two or more identities. In some cases the identities are complete, each with its own name, age, history, gender, mood etc. However in other cases, only a few characteristics are distinct and the identities are only partially independent. People experiencing DID may also experience memory loss or confusion due to fluctuating between two or more different personality states. If you’d like to learn more about DID please refer to my previous blog.
In my next blog I will cover the causes of dissociative experiences, touch briefly on the neurobiology of dissociation and talk about treatment options.