4 Types of Dissociation

Summary

In this video, Dr. Romney discusses the complex topic of dissociation, exploring its definition and the various dissociative disorders that stem from trauma. She outlines how dissociation can manifest on a spectrum, from mild forms of detachment to severe conditions like Dissociative Identity Disorder (DID). Key disorders covered include Dissociative Amnesia, where individuals lose memory of traumatic events; Dissociative Fugue, marked by wandering without memory; DID, involving multiple identities; and Depersonalization Disorder, where individuals feel detached from their own life. The discussion emphasizes the profound connection between trauma and dissociation, with practical implications for mental health care and legal systems.

Takeaways

• 😀 Dissociation is a trauma response that involves a splitting off of part of the self, often serving as a protective mechanism during or after traumatic events.
• 😀 Dissociation can manifest in many ways, including feeling detached from one's body or life, or perceiving the world through a gauze or in slow motion.
• 😀 Dissociation exists on a continuum, ranging from mild detachment to severe cases like Dissociative Identity Disorder (DID).
• 😀 In outpatient practices, milder dissociative symptoms are more common, often seen in clients with trauma histories or conditions like PTSD and borderline personality disorder.
• 😀 Dissociative Identity Disorder (DID) is extremely rare, characterized by the presence of distinct identities or 'alters,' each with their own memories, behaviors, and ways of thinking.
• 😀 Panic attacks may involve feelings of dissociation, with some people experiencing a sensation of being out of their body or detached from reality during an attack.
• 😀 Dissociative Amnesia occurs when an individual cannot remember significant parts of their personal history, often due to trauma, and may include gaps in memory regarding traumatic events.
• 😀 Dissociative Fugue is a rare condition where individuals suddenly travel far from home and are unaware of how they got there, often linked to a history of trauma.
• 😀 Dissociative Amnesia can be especially problematic in legal cases, as the lack of memory about trauma can be misinterpreted, leading to doubts about the authenticity of an individual's experience.
• 😀 Depersonalization Disorder is when a person feels detached from their body, often experienced during trauma or in response to certain triggers, such as sexual trauma or stress.
• 😀 Dissociative symptoms, including depersonalization, may be a defense mechanism to cope with overwhelming stress or trauma, and can also be triggered during panic attacks or other stressful situations.

Q & A

What is dissociation, and how does it manifest in individuals?

Dissociation is a psychological phenomenon where a person feels disconnected from their sense of self. It can manifest as feeling detached from one's surroundings, experiencing life from an outside perspective, or having memory gaps. It is often a trauma response and acts as a protective mechanism to help individuals cope with overwhelming experiences.

How common is dissociation in outpatient therapy practices?

While dissociation is not often the primary focus in outpatient therapy, it can occur on a continuum. At the milder end, dissociation might manifest as denial or disconnection from certain aspects of the self, which is more common. Severe cases, such as dissociative identity disorder, are rarer.

What is dissociative identity disorder (DID), and how does it differ from other dissociative experiences?

Dissociative Identity Disorder (DID) is a rare and extreme form of dissociation where a person has multiple distinct identities or 'alters.' These alters can have their own names, ages, and behaviors. This is different from other forms of dissociation, such as depersonalization, where the individual may feel detached from their body but without distinct alternate personalities.

How does dissociation serve as a protective mechanism in trauma?

Dissociation serves as a protective mechanism by creating a psychological separation from traumatic memories or experiences. This detachment allows the individual to maintain functioning in their daily life without being overwhelmed by the trauma, though it can lead to memory loss or a fragmented sense of self.

Can dissociation occur during panic attacks?

Yes, during panic attacks, some individuals may experience dissociation, such as feeling out of their body or observing the panic attack from an outside perspective. This detachment is a form of dissociation that occurs in response to the overwhelming stress of the panic attack.

What is dissociative amnesia, and how does it relate to trauma?

Dissociative amnesia is a condition where a person is unable to recall important personal information or specific events, often related to trauma. This memory loss can extend to not remembering key aspects of one’s identity or history, such as their name or the details of a traumatic event like an assault.

How does dissociative fugue differ from other dissociative states?

Dissociative fugue is a rare condition where an individual temporarily loses their sense of identity and may wander, often without clear memory of how they arrived at a new location. Unlike other forms of dissociation, the person may engage in normal activities, like traveling or driving, but cannot recall how or why they did so.

Can dissociative fugue be triggered by trauma?

Yes, dissociative fugue can be triggered by complex or recent trauma. It is typically seen in individuals who have experienced significant stress or trauma, and may occur when they are in situations that evoke memories or emotions tied to past traumatic events.

What is depersonalization disorder, and how does it manifest in trauma survivors?

Depersonalization disorder is characterized by a person feeling detached from their body or observing their life from an outside perspective. In trauma survivors, especially those with histories of sexual abuse, depersonalization can occur during stressful or intimate experiences, such as during consensual sex, where the person feels disconnected from their body.

Is depersonalization disorder a chronic condition or episodic?

Depersonalization disorder is typically episodic, meaning it occurs in distinct episodes rather than being a constant state. The frequency and intensity of episodes vary, and they are often linked to past trauma, stress, or panic attacks.