Defining Dissociation

General Dissociation:

Dissociation refers to the natural mechanism our brain has to disconnect us from our surroundings and ourselves. This is sometimes as a benign reaction but severe dissociation is associated with trauma and other mental illnesses.

Every Person has the capacity for dissociation and many experiences some degree of the skill like when you drive home but don’t remember it. Even people who do not develop severe mental illness will dissociate during stress. Like someone who has a medical procedure might dissociate in their body as to not feel pain or during something like a funeral someone might say it was “an out of body experience” to disconnect from emotional pain.

Also remember: there are also physiological conditions that cause and/or mimic dissociation, like seizures and migraines 

Clinical Dissociation:

Clinical and harmful dissociation is almost always linked to trauma. Because dissociation is an involuntary protective mechanism for stress trauma is the situation most likely to trigger maladaptive dissociation. The other mental effects of trauma on survivors also lend to further dissociation. Sometimes dissociation can present separate from trauma but the more severe forms cannot exist without trauma.

Clinical level dissociation is primarily associated with Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder (OSDD, Depersonalization. But can also be a symptom of Post Traumatic Stress Disorder (PTSD), Complex Post Traumatic Stress Disorder (C-PTSD), Borderline Personality Disorder (BPD), and some forms of psychosis.

Structural dissociation is the way long term dissociation and trauma alters brain function and can cause schisms in the consciousness states and memories in the brain. This can just affect the connection of emotion and stressor or memories or entire splits seen in DID. This has been seen to only happen with trauma. 

Dissociation & CSA

Dissociation is incredibly common in CSA survivors. Abuse is extremely traumatic and many kids brains use dissociation to cope with the abuse. The stress responses most common in kids are “freeze” and “feign/submit”. Dissociation often accompanies those type of responses. 

Childhood sexual abuse has been shown to be one of the most common types of trauma that causes the most severe dissociative/trauma-based disorders. 

Dissociation in Kids:

In singular events of assault dissociation often has effects on memory of the trauma and is part of how flashbacks and triggers form. Dissociation also influences: loss of sense of self, emotional dysregulation, ability to focus and interpersonal issues. Dissociation is something that often accompanies other signs of sexual trauma. These singular events tend to have more extreme effects on children because it is disrupting the formation of the ability to regulate and attach in minors.

Long-term sexual abuse has the same effects from above but kids will sometimes develop chronic dissociation and in some cases a dissociative disorder (DID, OSDD, DPDR). Chronic trauma is necessary to form secondary and tertiary structural dissociation the most extreme form witch leaves these children with a fractured consciousness.

Some effects of chronic dissociation on kids:

• Amnesia, though this is likely to be missed. It can last up to years around the trauma. Sometimes experienced around triggers in dissociative disorders. 
• Can be easily absorbed into media or their own thoughts to the point of losing time. Connected with the idea of “maladaptive daydreaming”
• Developing triggers that they don’t understand as they can’t connect it to what happened
• Disconnection from emotions, lacking the ability to name their emotions or connect it with why they are feeling what they are. Connected to emotional dysregulation. 
• Disrupted ability to have healthy attachments
• Experience a disrupted the ability to form an identity. Causes confusion within the kid but not easily seen from the outside. In the most extreme developing dissociated multiple identities
• Consistent depersonalization: Feeling as if they do not exist
• Consistent derealisation: Feelings as if reality is not real
• Long term memory and short term memory disruption. Visible but many other things can be blamed
• Sensory issues: Sometimes acting self-harming behaviours seeking stimuli
• Trouble concentrating may seem “spacy”
• Somatoform disorders may happen
• Struggling to feel connected to others or experiencing apathy

Chronic trauma, of course, has many changes to people on multiple levels and many effects of dissociation overlap with other effects of abuse. 

In Adults:

If there is not a lot of intervention and support given to the victimized kid then many of the dissociative effects we see in kids. You can also have more of what we think of like a triggered dissociative episode, something happening and we go blank and dissociate immediately at the stimulus. And to some extent, the dissociation is often even more disruptive as an adult. Dissociation is like i side an involuntary coping skill and as a little kid when we dissociate during abuse it makes sense. but it does become part of the stunting of the brain development and then when that is our learned stress response we do it way too much as an adult, and the chronic dissociative states we may have are more pronounced in adults as different levels of functioning from an eight to twenty-eight-year-old.

Conclusion:

Dissociation is highly common in survivors. It’s hard and confusing if we or a loved one is struggling with dissociative symptoms. But we can recover!

The main way people start to handle these symptoms are grounding skills. And reaching out for support in working through trauma is also very important!