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What is Dissociation

Dissociation is being disconnected from the here and now. 

Daydreaming or mind-wandering are experiences of dissociation that can be normal. Dissociation can be a way of coping by avoiding negative thoughts or feelings related to memories of traumatic events. When people dissociate, they disconnect from their surroundings, stopping any trauma reminders and lower feelings of fear, anxiety, and shame. 

Dissociation can begin during the trauma or after the experience when thinking about the trauma or experiencing a trauma reminder. Dissociation that is connected to trauma memories is considered an avoidance coping strategy. 

Dissociation often occurs without planning or awareness; people who are dissociating are often not even aware that it is happening. Dissociation can interfere with school or other activities that require paying attention and being in the here and now. 

 Dissociation, as an avoidance coping strategy, happens because of feelings of powerlessness to do anything to change or stop the traumatic event. This may lead people’s psyche to trick itself into cutting off the harmful, unbearable, external elements of trauma and suppresses them in the unconscious to cope with feelings of helplessness, pain, and fear. When this dissociation occurs during the traumatic event, the individual is more likely to develop a pattern of dissociating as a coping strategy.

Responses to Stress, Distress, Trauma

  • No two people respond to stress the same way 
  • Can have adaptive or maladaptive responses/changes
  • Changes in cognition
  • Changes in affect
  • Changes in behaviour
  • Changes in neurophysiology
  • Changes in physiology

Healthy Dissociation Can Look Like:

  • “Vegging” (Mind-wandering)
  • Spacing out; daydreaming 
  • Reading 
  • Videogames (in moderation)
  • Film
  • Writing
  • Paint, sculpt, needlework, woodwork

Trauma-Triggered Dissociation Can Look Like… 

  • Glazed look; staring 
  • Mind going blank 
  • Sense of world not being real 
  • Watching self from outside 
  • Detachment from self or identity 
  • Out of body experience 
  • Disconnected from surroundings 
  • Nightmares, terrors

Identifying Triggers

It may be helpful to identify if anything seems to trigger dissociation. Parents and caregivers can document these common signs of dissociation: 

  • Amnesia for important or traumatic events known to have occurred, 
  • Frequent dazed or trance-like states, 
  • Perplexing forgetfulness (e.g., the child knows facts or skills one day and not the next), 
  • Rapid, profound age regression, 
  • Difficulties deriving cause-and-effect consequences from life experiences, 
  • Lying or denying responsibility for misbehavior despite obvious evidence to the contrary, 
  • Repeatedly referring to self in the third person, 
  • Unexplained injuries/recurrent self-injurious behavior
  • Vivid imaginary companionship that controls the child’s behavior (i.e., passive influence experiences), and 
  • Auditory and visual hallucinations. 

Grounding out of therapy (Child/youth or caregiver does) 

  • Have a grounding plan 
  • Notice dissociation 
  • Do physical or mental grounding activity 
  • Have a cognitive coping strategy phrase (“I know what this is”; I can handle it,” I’m fine.”) 
  • Have caregiver, friend, or teacher prompt for the use of grounding plan. Discuss this ahead of time. 
  • Balanced breathing (equal length inhales and equal length exhales)
  • Drumming music
  • Finger tap breathing: breath in 1-5, tapping one finger at a time. Breath out 6-10, tapping opposite hand one finger at a time. 
  • Take a water break 
  • Build a fort
  • Count the colours in the room 
  • Animal walks

More Information

http://www.nctsn.org/resources/audiences/parents-caregivers http://www.isst-d.org/default.asp?contentID=100

http://www.lianalowenstein.com/articlesParent.html

References

Choi, K. R., Seng, J. S., Briggs, E. C., Munro-Kramer, M. L., Graham-Bermann, S. A., Lee, R., & Ford, J. D. (2018). Dissociation and PTSD: What parents should know. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress. 

Gil, E. (2010). Working with children to heal interpersonal trauma: The power of play. The Guildford Press. New York, NY

Soosalu, G., & Oka, M. (2012). mBraining: Using your multiple brains to do cool stuff. mBIT International Pty Ltd.