Dissociation

Dissociation is defined in a variety of ways and can include very different types of personal experiences, which can be confusing.  The American Psychiatric Association defines dissociation as “A disruption and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”.  As the word itself suggests, the experience is fundamentally a dis-association of what would typically be associated, or integrated.

Dissociation exists on a continuum from normal everyday experiences of absorption (e.g., daydreaming) to the most extreme experiences of your sense of self being fragmented (e.g., dissociative identity disorder).  One helpful distinction is often considering “detachment” forms of dissociation and “compartmentalization” forms of dissociation.  Detachment forms involve the subjective alteration of consciousness, typically involving a sense of alienation from your own body.  This would include what are referred to as depersonalization (feeling that your body or part of the body is not yours) and derealization (feeling as though the world around you is not real).  In contrast, compartmentalization forms refer to various forms of changes in consciousness (e.g., dissociative amnesia).  This involves normal capacities to function but without awareness or sense of control over your behavior.  In these types of dissociation you might discover that you’ve done things that you do not recall.

Estimates of the prevalence of dissociative disorders vary due largely to how unrecognized they tend to be.  It’s been repeatedly found that dissociative disorders are the most under-recognized disorders in the general and psychiatric populations.  Research has also found that dissociation can cause the most severe impairments in someone’s life.  Estimates of the prevalence of dissociative disorders range from 10 to 18% of people in the general population.  There is common overlap with PTSD, complex PTSD, depression, self-injury, borderline personality disorder, disordered eating, and other disorders.

At the Chrysalis Center our psychologists are familiar with and sensitive to experiences of dissociation.  We understand that the development of dissociation is often a necessary psychological function to survive situations that would otherwise be truly unbearable.  It may be that you would like to be more present in your life in various ways but find that these experiences happen outside of your current control.  It can often feel very upsetting or frightening to feel that your experience is unreal, you are not present, or that you can’t recall periods of time.  We will work to help you stay present, tolerate, and modulate your painful or frightening experiences with the goal to feel like a more active agent in your own life.  In addition to helping you develop self-regulation skills to alleviate dissociation, we believe in the necessity of a safe therapy relationship that provides co-regulation of these difficult states.  There is hope that you can inhabit your life more fully and consistently and our psychologists are here to help.