Sunday, 30 June 2019

Disassociation

I tend to drift in and out of conversation with other people and I end up saying random things that are associated with the parts of the conversation I hear. I have no recollection to what I am doing in my mind as the conversation proceeds but it’s like I’m physically there but I am not. Why do I do this?

You may be describing disassociation. The Diagnostic and Statistical Manual of Mental Disorders, in their fifth edition, (DSM-5), the book that mental health professionals consult when diagnosing mental health disorders, defines disassociation as “a disruption, interruption, and/or discontinuity of the normal, subjective integration of behavior, memory, identity, consciousness, motion, perception, body representation, and motor control.”

In other words, disassociation involves feeling a certain level of disconnection with your mind or body. It often involves memory loss and losing track of time. Some people describe it as “getting lost,” “spacing out,” or — on the more extreme end — having an out of body-like experience.

Transient or mild dissociative experiences have been described by nearly 1/3 of the population. In that sense, it is relatively common. Individuals who experience more severe forms of disassociation, may have a dissociative disorder. According to the DSM, there are five types of dissociative disorders. These include: 1) dissociative identity disorder; 2) dissociative amnesia; 3) depersonalization/derealization disorder; 4) other unspecified dissociative disorders; and 5) unspecified dissociative disorder.

Generally speaking, disassociation is often commonly associated with trauma. This could include childhood sexual and or and physical abuse, childhood maltreatment and or neglect, adult rape, intimate partner violence, medical or other types of emotional traumas. This can also include survivors of wars and natural disasters, prisoners of wars (POWs), holocaust survivors, and other individuals who have been victims of painful experiences.

The reasons why individuals experience disassociation may vary but much of the research centers on what is called the trauma model. This model suggests that individuals are experiencing these temporary bouts of amnesia as a way to protect themselves from traumatic or overwhelming experiences. They prevent an individual from becoming overwhelmed with the full impact of the trauma. In short, they are a psychological form of protection.

Though trauma is psychological, there are physical components to it as well. Research indicates that some individuals experience a freezing type of protective response in dangerous situations. This is called tonic immobility (TI). Tonic immobility is a state of involuntary paralysis in which individuals cannot move or even speak. They are essentially temporarily paralyzed. Experiences of TI are common among individuals who have posttraumatic stress disorder (PTSD).

Not being able to physically move in the face of extreme danger can be quite a disconcerting experience. Some victims feel unnecessary guilt for their inability to remove themselves from dangerous situations. However, they should not feel that way since TI is not something that can be physically controlled or prevented. It is an involuntary mechanism that is thought to be triggered when an individual’s sensory inputs reach a critical level and they feel as though there is no escaping.

You didn’t mention whether or not you have experienced a traumatic past. If I were interviewing you, I would be attempting to assess whether or not you have a trauma history. It would be wise to record your dissociative experiences and to consult a mental health professional who specializes in trauma. They can help you to definitively determine whether these experiences are disassociation. Depending upon how often your episodes occur and their severity, the clinician will likely recommend treatment. Treatment often involves individual psychotherapy and medication, if necessary. Some individuals have found hypnosis to be particularly helpful but whether or not it would be appropriate for you depends upon the nature and severity of this issue.

I hope this answer assists you in knowing more about dissociation. Please consult a mental health professional, for in-person, individualized assistance. Good luck and please take care.

Dr. Kristina Randle



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