What happens when a person dissociates? Is it the classic moment when someone “zones out” in the middle of a conversation? Is it that moment when someone shuts down when they are in a stressful conversation? As the stigmas around mental health change and more and more people are comfortable talking about their mental health and symptoms, psychological terms are more casually heard in conversation. While expanding the conversation is moving in the right direction for mental health awareness, it can also inadvertently circulate misinformation about the true nature of certain illnesses or perhaps even cause people to not see the seriousness of certain symptoms. Daydreaming and getting lost in a book are certainly mild forms of dissociation, but there are more serious conditions and effects that some may endure. When is dissociating a dilemma?
A basic definition of dissociation is a disconnection from one’s thoughts, feelings, memories, or a sense of self. If someone has a traumatic experience, such as being the victim of a crime, dissociating is the mind’s way of separating itself from the traumatic event. In this instance, it’s a helpful tool of the mind, however, it can lead to a trauma response where one disassociates whenever they encounter something that triggers memories of the event. This can be a difficult occurrence to manage in daily life, especially if there is not awareness around what triggers exist for someone. What it might feel like for someone includes:
- A sense that surroundings are not real
- One’s mind going completely blank
- A sense of watching oneself from the outside
- A disconnection from surroundings
- Glazing over or feeling lost
Dissociating is an avoidance or coping strategy, however, unlike active avoidance or the flight option in the fight-or-flight response, there is often little thought that goes into this action. The mind simply pulls away in order to avoid feelings of fear, anxiety, or pain.
Disassociation is most commonly a symptom of mental health disorders such as post-traumatic stress disorder, depression, anxiety, or borderline personality disorder, among others. It can, in some cases, also be an indication of a more serious dissociative disorder, such as dissociative amnesia (selective memory loss surrounding parts or all of a traumatic event) or depersonalization disorder (being disconnected to oneself emotionally). Sometimes dissociation resolves itself on its own but it’s always best to seek the advice of a mental health professional if symptoms are being experienced. Seeking to understand what might be triggering can be helpful for management.
For those that experience dissociation symptoms as a symptom of a mental health disorder, treatment and therapy are helpful in identifying what triggers this reaction. Because dissociation often happens without warning, a key to managing occurrences is awareness around what kinds of environments or actions are most likely to cause it. Regular dissociation can affect work, school, social interactions, sleep patterns, and attention span. Treating the underlying mental health issue that dissociation is a symptom of, through therapy and medication, can help lessen the occurrence. Dissociation might be a useful tool in helping uncover otherwise undiagnosed mental health disorders.
Grounding is one of the most helpful tools that exists while already in a dissociative episode or if there is an awareness that a disconnect has begun. Grounding is a practice used to help shift focus and awareness back to one’s immediate surroundings and pull them out of whatever mental state has caused a disconnection. Some helpful grounding techniques include:
- Hot and cold – Use water at different temperatures to help bring awareness to the body. Try holding hands in hot water, then switch to cold, let an ice cube melt in the hands, or take a hot shower that ends with a burst of cold water.
- 5-7-8 breathing – Use breathing to calm the mind. Inhale to the count of 5, hold the breath in for 7 seconds, then exhale to a count of 8. Repeat as many times as needed.
- 5-4-3-2-1 method – Use the senses. Name 5 things that can be seen, then 4 that can be heard, 3 that can be touched, 2 things that can be smelled, and one thing that can be tasted.
- Create an anchoring phrase – Use a small basic paragraph with things that are known to be true, for example: “I am (name), I am (age) years old, My birthday is (date), I live in (city and or state), I am (current location, such as ‘at work’).” and repeat it slowly as many times as needed.
- Think in categories – Think of a category such as state capitals or characters from your favorite book, and name as many as you can in one minute.
When possible, it can also be helpful to have a trusted friend or person who is aware of what it might look like during a dissociative episode. A technique used in grounding therapy is having someone directly call attention back. They might directly address one’s attention slipping, they may ask for direct eye contact or to describe surroundings. Those around you can also employ these techniques. However, before asking for the help of others it’s best to have an awareness around what things cause triggers and what specific kind of help to ask for. Seeking the advice of a professional is always the best first course of action.
As those in the field of mental health and those who experience diagnoses work to change the thinking around mental health, the opportunity to learn more about disorders and symptoms increases. Seek guidance, speak with honesty and transparency, and work with a mental health professional to gain freedom from mental health challenges like disassociation.