What is Dissociation?

In my counseling office, dissociation shows up in several different ways and for several different reasons. It’s one of many things that happens to people who have experienced suffering, and it’s a signal that healing may be needed. Fortunately, we as Christians belong to the Great Healer, Jesus Christ. He is eager to “…bring good news to the poor…to bind up the broken-hearted, to proclaim liberty to the captives, and the opening of the prison to those who are bound” (Isaiah 61:1). The Lord knows the needs of those who are suffering, and He gives us the incredible gift of mirroring His heart by embodying compassion, kindness and patience. 

Dissociation is not something to be nervous about or shy away from – it’s simply a manifestation of a person’s suffering. The American Psychiatric Association has created this definition of dissociation:

Dissociation is a disconnection between a person’s thoughts, memories, feelings, actions or sense of who he or she is. This is a normal process that everyone has experienced. Examples of mild, common dissociation include daydreaming, highway hypnosis or “getting lost” in a book or movie, all of which involve “losing touch” with awareness of one’s immediate surroundings.

American Psychiatric Association

During a traumatic experience such as an accident, disaster or crime victimization, dissociation can help a person tolerate what might otherwise be too difficult to bear. In situations like these, a person may dissociate the memory of the place, circumstances or feelings about the overwhelming event, mentally escaping from the fear, pain and horror. This may make it difficult to later remember the details of the experience, as reported by many disaster and accident survivors. ¹

If you’ve experienced trauma or are caring for someone who has experienced trauma, this is a topic you’ll want to be familiar with. The disconnection described above can happen at any time, and sometimes we don’t see it coming. Here are a few signs that dissociation may be occurring:

• Gaps in memory
• Feeling like you’re watching yourself as if outside your own body
• Significant detachment from thoughts, feelings or body sensations
• Forgetting how to do something you would normally do easily

How should we respond when dissociation occurs? First let me say that if you’re experiencing these types of symptoms and they are affecting your daily functioning, please seek guidance from a mental health professional. Dissociation that hinders your work, relationships and personal life is a signal that your mind may be struggling to process something painful. Getting help from a professional is a wise step toward growth and healing.

If you are a helper, you probably won’t know whether a person is experiencing dissociation unless you see it happening during a conversation. The most common thing you may notice is that a person seems to be ‘somewhere else’ as you are talking. Her face and body may seem stiff or limp, and perhaps she no longer makes eye contact with you. She may not have words for what she is experiencing, since dissociation includes a ‘powering down’ of the part of the brain that produces language. If you notice these things, the first thing you will want to do is to slow down. It won’t be helpful for you to ask more questions at that moment. Instead, you engage with her and seek to bring her back to the present moment. 

Say out loud what you are noticing: “I’m noticing that your body language has changed. It seems like maybe you are ‘somewhere else.’  I’d like to try moving our bodies to try to get the mind back to the present moment. We’ll take it slow.” Then you can coach her through some exercises. Here are four things you can do:

1. Start by wiggling your toes inside your shoes or clasping your hands together. Just notice what it feels like. 
2. Notice the sensations in your body when you move around. Is there a word you can use to describe what you’re noticing? (You’re trying to help her reengage the language center of the brain.)
3. The body has slowed down, and we need to help wake it back up. Next we’ll try taking some breaths, but we want them to be short breaths – in and out from the mouth. After taking five short breaths, we can take one long breath.
4. Once she begins to come back into the present moment, you can reflect on what she experienced. Try not to ask too many questions, just invite her to share anything she noticed. 

Keep in mind that if this experience occurs during a meeting with you, she is likely to experience it in other settings as well. You can coach her to do these exercises when she notices dissociation, and you’ll also want to learn whether she is experiencing other symptoms in her daily life. If so, she will need access to some assessment measures. If you’re not trained in how to assess complex dissociation, please consult with a professional who can help. 

Sometimes it can feel scary when someone experiences dissociation. You may not know what to do. But keep in mind that the best thing you can do is to stay present. Offer your kindness and intentionality. Our Lord comes near to us with compassion and patience when we are suffering, and we have the opportunity to model these qualities as He empowers us by His Spirit.

The four exercises listed above have been formatted into a graphic handout available to CTHN members from Tools and Handouts.

¹ From psychiatry.org: https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders