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Dissociation

Dissociation sounds weird and wonderful, but it’s simply what the brain does when it encounters trauma. Dissociation is an instinctive, evolutionary mechanism that helps us to survive overwhelming life-threat. Dissociation is to trauma what fever is to infection – it’s just something we do to survive.

Understanding Dissociation

Everyone experiences dissociation at one point or other in their lives. We’re culturally familiar with the idea of out-of-body experiences, or your life flashing before your eyes and time slowing down when you’re in the early stages of a car crash. Dissociation is the term that is used to describe these involuntary, immediate and instinctive reactions in our brain and body, involving the release of perception-altering and pain-numbing chemicals, that make us feel that what’s happening isn’t real.

When dissociation is used repeatedly in childhood to survive otherwise unendurable trauma (including the trauma of being terrorised by a parent or attachment figure), the brain can become habituated to dissociation as a coping mechanism. As it’s so effective, it can mean that we fail to develop other, more situationally appropriate ways of managing intense emotions, and we can end up with what is termed a ‘dissociative disorder’ – but which again really is just the term we give to the way the brain and body have adapted to growing up in a perpetually threatening environment.

Dissociation is little understood, but actually remarkably common: it’s the third most commonly reported psychiatric symptom. Where there’s a history of trauma, we can reasonably expect there to be an experience of dissociation. In later life this takes the form not just of numbing of emotions or detachment from reality (especially resulting in denial), but a fundamental disconnection between thoughts, feelings, beliefs, sensations and behaviours.

The impact of dissociation is that we don’t join up – we don’t integrate – our experiences in the way that they normally are connected: so we may be completely out of touch with our feelings, we may have dissociative amnesia, we may be unaware of our body sensations, or we may have a shifting sense of identity. All of these symptoms can be traced back to a root response to trauma of dissociation. It’s not the brain gone wrong – it’s the brain gone right, in an attempt to protect us. It’s just that over time dissociation becomes less and less helpful in surviving a non-threatening environment. Dissociation is the right response to danger; it’s an unhelpful response to safety – and that’s what therapeutic approaches to working with trauma can focus on.

Explore my resources below, and especially my ‘Dissociation and DID: The Fundamentals‘ and ‘Working with Dissociative Disorders in Clinical Practice‘ courses to find out more.

Resources

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Working with Dissociative Disorders in Clinical Practice

Working with Dissociative Disorders in Clinical Practice

Dissociative identity disorder (DID) is the term we give to a set of responses to trauma which are the natural outcome for a childhood of unremitting unsafety, and which result in a fragmented sense of self and disorganised attachment in adulthood. Join me as I explain how to work with compassion and empathy with people who have suffered the most extreme forms of early life trauma, and expound a treatment roadmap including the principles and pitfalls of this complex work.

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Dissociation and DID: The Fundamentals

Dissociation and DID: The Fundamentals

When faced with overwhelming trauma, dissociation can be the only logical thing our brains are able do to help us to survive. Join me as I explore what happens in the brain during trauma, why dissociation is the brain’s best way of surviving when overwhelmed by life-threat, how dissociative disorders develop and how best to support trauma survivors rediscover a sense of safety with a dysregulated nervous system.

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What is dissociation?

What is dissociation?

There are many ways to describe dissociation. This article takes a closer look at dissociation as it pertains to dissociative identity disorder and trauma.

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What is dissociative identity disorder (DID)?

What is dissociative identity disorder (DID)?

Dissociative identity disorder is a creative survival mechanism for coping with overwhelming and chronic childhood trauma.

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What are the signs and symptoms of dissociative identity disorder?

What are the signs and symptoms of dissociative identity disorder?

Someone who has dissociative identity disorder may have distinct, coherent identities that are able to assume control of their behaviour and thought. Read on to find out more about this poorly-understood phenomenon.

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Help, I’ve got DID! Now what …?

Help, I’ve got DID! Now what …?

It’s scary to think you’ve ‘gone mad’. It’s scary to think you have some serious, incurable ‘mental illness’. It’s scary to not understand what on earth is going on in your brain. And perhaps what’s even scarier is finding out that what is ‘wrong’ with you has a name: dissociative identity disorder.

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Ten steps to becoming a dissociation-friendly therapist

Ten steps to becoming a dissociation-friendly therapist

You don't need to be an expert to work with people who dissociate, but you do need to understand these fundamental issues. Here are ten steps.

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Should I talk to parts?

Should I talk to parts?

Should we talk to parts? Or does that make things worse? When someone switches, is this attention-seeking behaviour? And is talking to a ‘part’ in some way dangerous – does it reinforce pathological behaviour? What should you do?

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Developing compassion for parts

Developing compassion for parts

When we have dissociative identity disorder, the problem is not always simply that we have dissociated parts of the personality. The problem more often is in the hatred we can feel for these disavowed parts: 'She is the hated child'. How do we heal the trauma of self-rejection and develop compassion for even the most traumatised and alienated parts of ourselves?

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How to find a therapist for a dissociative disorder

How to find a therapist for a dissociative disorder

The recommended treatment for dissociative disorders is psychotherapy, but how do you go about finding a therapist or counsellor? This article guides you through the process, either via the NHS or privately.

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Parts are only part of the problem

Parts are only part of the problem

I have dissociative identity disorder. I have many separate, distinct and unique ‘parts’ of my personality. My ‘parts’ or ‘alters’ collectively add up to the total person that is me. I am the sum of all my parts. They are each a letter, and I am a sentence.

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DID or OSDD: Does it matter?

DID or OSDD: Does it matter?

OSDD is a strange-sounding diagnosis and seen by many as a 'not yet' or 'not quite' version of dissociative identity disorder. This article explores the differences between the two diagnoses and whether that difference matters or is arbitrary.

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Working with a dissociative disorder diagnosis

Working with a dissociative disorder diagnosis

Once we understand dissociation as a logical response to overwhelming trauma, it stops being so dramatic and different, and the person suffering dissociation stops being ‘complex’ and ‘bizarre’ too. There is nothing bizarre about dissociative disorders—what is bizarre is how some people can be so badly mistreated that they end up with a dissociative disorder.

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Pseudogenic, iatrogenic or traumagenic? – How do we know that DID is real?

Pseudogenic, iatrogenic or traumagenic? – How do we know that DID is real?

So I’m curious. On what do you base your belief in dissociative identity disorder? This was a tweet I received from a fellow twit based in the US a few months ago. The more I use social media, the more I realise how controversial dissociative identity disorder is ...

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Feeling Unreal: depersonalisation / derealisation disorder

Feeling Unreal: depersonalisation / derealisation disorder

Depersonsaliation/derealisation disorder sounds complicated and scary. But it makes perfect sense once you understand how the brain reacts to threat, and how that reaction can become a habitual response to any form of stress. This article makes the complex simple.

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