Dissociation: Definition, Symptoms, & Examples
What is dissociation and what does it feel like?
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In my lifetime, I have run the equivalent of back and forth across the country a couple times over. How many of those miles do I remember? Surprisingly few, especially from some of my hardest runs. Like many runners I know, I am quite practiced at zoning out while running. |
It’s not a behavior that’s very intentional; I might be in the midst of a two-hour-long run and notice suddenly that I haven’t been aware of my legs working or the sound of my breathing for several minutes. Instead of being in my body, I was off in my thoughts somewhere, or maybe thinking about pretty much nothing at all. Maybe you have experienced something similar when you’re driving—that abrupt realization that you made it home but don’t remember much of the trip itself.
This mild form of zoning out, while it might be dangerous to engage in while driving, is actually a pretty effective coping strategy for long-distance running. Marathons are painful and monotonous; there’s nothing like doing the same thing several hundred thousand times over to make you crave a distraction. When a runner checks out of their body in the midst of a run, they are dissociating from their experience. Dissociation, as this article will articulate, can be incredibly adaptive—and also a serious symptom of several psychiatric disorders.
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What Is Dissociation? (A Definition)
What might this look like in our lived experience? Going back to me out on the marathon course: When I am dissociating while running, I might stop perceiving my legs. I become disconnected from the sense of fatigue—or sometimes outright pain—radiating from my legs up my spine and into my brain. I might be aware of the breeze, the sounds of nearby runners, or the hill that’s looming ahead on the course, but I am dissociated from the sensations of running. And I’m grateful for that; it’s nice to check out from the pain of running in the midst of a long race.
Defining Dissociation
There are a couple other ways to define dissociation (Cardeña, 1994). In the field of psychology, dissociation can also refer to the process of isolating certain aspects of our experience from the rest of our lives. For example, some of our experiences in life are so harmful or upsetting that our bodies and brains decide, without much conscious input from us, to cast those memories out of conscious awareness; only if one of these memories is activated by very specific circumstances will it emerge again. As with the first example of dissociation, you may have noticed there are potential benefits to this kind of dissociation. For the most part, it is far more functional not to remember a truly traumatic event than to spend every day being continually reminded of it.
For a few of the many people who experience life as continually upsetting or harmful, this kind of defense mechanism can become so pronounced that they have entirely different identities that are dissociated from each other, perhaps to the point of not knowing the others exist (Loewenstein, 2018). Called dissociative identity disorder, this diagnosis reflects a very extreme form of coping: If life is going to be continually unpredictable and dangerous, you might develop different sides of yourself that are specifically designed to handle each of the different contexts you encounter.
Forms of Dissociation
The less severe forms of dissociation are common not just in what is called the dissociative disorders but in a wide variety of other psychiatric disorders (Spitzer et al., 2006). Dissociation features prominently in posttraumatic stress disorder (PTSD) but also in disorders such as anxiety and depressive disorders and schizophrenia.
Where dissociation can be a helpful and regular part of human experience, such as when it helped you zone out through a boring class in high school, when it appears as a psychiatric symptom, it has often become part of a person’s experience to a dysfunctional degree. If you heard a car horn honking just before you were in a car accident, it will be a problem if you fully dissociate from your present-moment experience every time you hear a car horn in the future.
For this reason, I want to differentiate between what we can call normative dissociation and pathological dissociation (Butler, 2006). Losing ourselves in fantasy or daydreams is a relatively common and pretty harmless experience, while being unable to drive because the sound of a car horn causes you to completely dissociate is quite disruptive to your life. I encourage you to think of dissociation as a psychological phenomenon or coping skill that our bodies naturally possess, one that, in addition to causing significant disruptions in our lives, can be adaptive in many situations.
Opposite of Dissociation
The opposite of dissociation is a continuity and integration of your own experience. It is the state of presence sought after by many meditators—a continuous and seamless awareness of everything that you are doing and that is happening to you. This is not a state of consciousness that most of us get to experience, at least not for very long. But perhaps you have had moments in your life that you remember vividly because of how meaningful they were: your first kiss, getting engaged, or maybe a graduation or the passing of a loved one. These are occasions when we are likely to be the opposite of dissociated: fully in the present moment, engaged fully by our environment and our sensations.
Causes of Dissociation
So the cause of a period of dissociation or an act of dissociation is usually an outside stressor, but it can also be the emergence of some kind of painful or unpleasant sensation within ourselves. Think of me out on the marathon course. There is no external threat to my safety causing me to disengage from my bodily sensations; I’m just managing the sustained pain of running for so long by checking out from it for a time.
Psychology of Dissociation
With every overwhelming experience like this that we have, we get more practiced at dissociating, at keeping ourselves safe from confronting the full reality of what is happening to us. This can happen on several different levels (Cardeña, 1994). Sometimes we forget just a particular event or aspects of that event; this is called dissociative amnesia and is common among people who are gravely injured or have their personal boundaries violated by others. In a quite rare and striking example of dissociation, some people completely lose their sense of self for hours or days at a time and even travel while doing so. This is called a dissociative fugue, and it often results in the dissociating person finding themselves many miles away from their hometown, at a loss for how they got there and often struggling to recall details about their identity.
Extreme Dissociation
In the most sensational—and sensationalized by popular media—instance of dissociation, some people develop entirely separate selves that coexist in the same body. Formerly called multiple personality disorder and now called dissociative identity disorder, this diagnosis remains controversial but is undoubtedly real. It is reported that people with this diagnosis often had highly chaotic and upsetting childhoods. Their brains figured out that one way to deal with all that unpredictability was to become a very different person from one situation to the next. Think of Dr. Jekyll and Mr. Hyde, although people with this disorder rarely have distinct personalities that are such opposites of each other.
All that said, dissociation in the sense of checking out from one’s lived experience is a common behavior across many different psychological disorders (Holmes et al., 2005). To me, this just reflects how ubiquitous and functional—up to a point—dissociation is when negative feelings arise.
Examples of Dissociation
We can find examples of dissociation any time one’s thoughts, feelings, and experiences are not fully conscious or remembered (Giesbrecht et al., 2008). Sometimes these examples might be driven by avoidance of unpleasant experiences, but they may also reflect our innate capacity to have our minds wander. We can call this the difference between dissociation that is “compartmentalization” and dissociation that is “detachment” (Spitzer et al., 2006).
So dissociation could be happening when you lose track of what somebody is saying and have to ask them to repeat it, or when I have music playing while getting work done and realize I haven’t heard the last three songs at all. It is also at play in more distressing and painful situations, such as when a young child escapes into fantasy to drown out the sounds of their parents fighting.
Other common experiences of dissociation include being greeted by people you do not remember meeting, finding yourself in a place and not being sure how you got there, being in a familiar place and finding it strange and unfamiliar, and even looking in the mirror and truly not recognizing yourself (Bernstein & Putnam, 1986).
Symptoms of Dissociation
How would you know that you are dissociating? There are many different symptoms of dissociation, and not all of them occur at the same time (Brown, 2006). Perhaps the overarching characteristic of dissociation is a reduced awareness of what is happening around and within you. At times, this can become so intense that it feels as though you have entered a trance. In this state, some people report feeling as though they are disconnected from reality or are even witnessing events unfold from outside their own bodies—these are called instances of derealization and depersonalization, respectively. Sometimes these dissociative symptoms are related to or initiated by intrusive, distressing thoughts or even full-on flashbacks to previous experiences.
Types of Dissociation
Dissociation can happen to varying degrees as well (Spitzer et al., 2006). Some people dissociate from important biographical information or events; this is called dissociative amnesia. Others lose track of hours or even days of their own behavior; in a dissociative fugue like this, they often end up somewhere many miles from home, confused as to who and where they are (Jasper, 2003). Still others have periods of time when they experience derealization and/or depersonalization, and, perhaps most famously, some people are diagnosed with dissociative identity disorder, formerly known as multiple personality disorder.
Dissociation After Trauma
Treatment for Dissociation
Many symptoms of dissociation go away on their own, but for people who dissociate because of intense traumatic experiences, reducing their dissociative symptoms means facing their trauma. Psychotherapy for trauma typically involves gradually talking about and revisiting whatever painful events have happened in one’s life and learning to cope with the reminders of those events without dissociating (Resick et al., 2012). This is rarely a pleasant experience, as the video below describes, but it is necessary for resolving trauma—and dissociative symptoms.
Video: When ‘Getting Better’ from Dissociation Feels Worse
Articles Related to Dissociation
Books Related to Dissociation
Final Thoughts on Dissociation
I hope it is clear from this article that dissociation exists on a continuum of behaviors, from the frequent and nonpathological to the intense, distressing, and impairing (Butler, 2006). Hopefully we can have compassion for ourselves and others when dissociation happens; it is a natural response to getting overloaded and stressed out.
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References
- Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease, 174(12), 727–735.
- Brown, R. J. (2006). Different types of “dissociation” have different psychological mechanisms. Journal of Trauma & Dissociation, 7(4), 7–28.
- Butler, L. D. (2006). Normative dissociation. Psychiatric Clinics, 29(1), 45–62.
- Cardeña, E. (1994). The domain of dissociation. In S. J. Lynn & J. W. Rhue (Eds.), Dissociation: Clinical and theoretical perspectives (pp. 15–31). Guilford Press.
- Carlson, E. A., Yates, T. M., & Sroufe, L. A. (2009). Development of dissociation and development of the self. In P. F. Dell & J. A. O’Neil (Eds.), Dissociation and the dissociative disorders: DSM-V and beyond (pp. 39–52). Routledge.
- Giesbrecht, T., Lynn, S. J., Lilienfeld, S. O., & Merckelbach, H. (2008). Cognitive processes in dissociation: an analysis of core theoretical assumptions. Psychological Bulletin, 134(5), 617–647.
- Holmes, E. A., Brown, R. J., Mansell, W., Fearon, R. P., Hunter, E. C., Frasquilho, F., & Oakley, D. A. (2005). Are there two qualitatively distinct forms of dissociation? A review and some clinical implications. Clinical Psychology Review, 25(1), 1–23.
- Jasper, F. J. (2003). Working with dissociative fugue in a general psychotherapy practice: A cautionary tale. American Journal of Clinical Hypnosis, 45(4), 311–322.
- Loewenstein, R. J. (2018). Dissociation debates: Everything you know is wrong. Dialogues in Clinical Neuroscience, 20(3), 229–242.
- Resick, P. A., Suvak, M. K., Johnides, B. D., Mitchell, K. S., & Iverson, K. M. (2012). The impact of dissociation on PTSD treatment with cognitive processing therapy. Depression and Anxiety, 29(8), 718–730.
- Spitzer, C., Barnow, S., Freyberger, H. J., & Grabe, H. J. (2006). Recent developments in the theory of dissociation. World Psychiatry, 5(2), 82–86.
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