What Dissociation Feels Like and How Therapy Can Help
- Lisa S. Larsen, PsyD
- Jul 26
- 4 min read
You might have heard the word “dissociation” used more commonly these days, as more information (and misinformation) about mental health concepts circulates in social media and the news. This post will go over what dissociation is, how it might manifest in you, and what you can do about it with trauma therapy.
What is Dissociation?
Dissociation is a disconnection from your own feelings, thoughts, and identity. It usually occurs as a response to overwhelming experiences as a defense against the force of what is happening to you. However, it is important to remember that it serves a valuable purpose when a crisis is going on. It also exists on a spectrum, from mild (like spacing out while engaged in a fascinating hobby or movie) to extreme (such as Dissociative Identity Disorder or Depersonalization/Derealization Disorder). There are many forms of dissociation and several mental health diagnoses that involve dissociation. These include:
Post Traumatic Stress Disorder and Acute Stress Disorder
Dissociative Identity Disorder
Depersonalization/Derealization Disorder
Borderline Personality Disorder; and
Dissociative Amnesia
However, it’s important to note that lifetime prevalence of DID is only 1.5%, so what used to be called multiple personality disorder is rare.
Additional Issues Associated with Dissociation
Dissociative disorders can be associated with ongoing self-injury, in which you try to feel something in your body by inflicting pain through burning, cutting, hitting, or biting yourself. You might engage in high-risk behaviors and feel emotionally unstable because of trauma you experienced earlier in life, including problems in attachment to your caregivers. You might prefer to be alone and avoid close relationships, but there are others who have long-term relationships with close others.
What Does Dissociation Feel Like?
Do you feel detached from yourself, like you’re observing yourself from the outside in? Does it feel like you’re not really who you are, or like the world around you is not real? Is it hard to feel emotions, even in situations where other people display strong feelings? Does it feel like time moves too fast or too slow, and sometimes you don’t know where you are or how you got where you are? These are all examples of feeling dissociated. If you are sober (not on drugs, alcohol, or mind-altering medication) when they are occurring, it is likely dissociation.
Other symptoms of dissociation are memory gaps, like not being able to remember big chunks of your childhood or traumatic memories; feeling divided where parts of you have one desire and another part wants the opposite; “finding” yourself doing something you didn’t intend to do; having pain that mysteriously comes and goes; feeling strange in your body, like heavy or light; or having unexplained physical symptoms like nonepileptic seizures or nausea, diarrhea, or headaches. If you’re having medical symptoms, it’s always important to see a medical doctor first to make sure there isn’t something going wrong with your body, before suspecting a psychological cause.
What Types of Therapy Can Help with Dissociation?
Therapy that addresses dissociation must first create a safe space for you to form a good rapport and secure relationship with your therapist. The therapist should help you build coping skills for stress and strengthen your sense of emotional tolerance. Psychiatrist Daniel Siegel coined the term “window of tolerance”[i] to explain how some experiences are within your capacity to tolerate and resolve them stress-wise, while others exceed your ability to face and resolve them. When you have dissociation, your window of tolerance is usually narrow; you avoid things habitually (but not by conscious choice). The aim of therapy for dissociation is to help you build up your capacity to become integrated again, so you can feel your emotions and body in the present and respond to stress adaptively again.
Maggie Phillips and Claire Frederick[ii], two therapists who worked with clinical hypnosis, used dissociation in a positive way to help trauma survivors re-integrate their consciousness. They used Ego State Therapy to bring the different parts of a person to greater unity. As they wrote in Healing the Divided Self, “hypnosis is of unparalleled assistance… because it enables the patient to enter the psychological and biochemical state in which state-dependent learning originally occurred” so they could get the different parts of the person involved in trauma resolution (p. 19). This restores harmony to the self-system, and allows a person to uncover the trauma without becoming flooded or overwhelmed by it.
Dialectical Behavioral Therapy (DBT) is a great way to build distress tolerance skills by using a mix of Cognitive Behavioral Therapy and mindfulness. I often use this with trauma survivors before using Eye Movement Desensitization and Reprocessing (EMDR) with them. EMDR therapy and Flash Technique can also assist with trauma resolution after you’re able to be with strong, difficult emotions and feel more mastery over your emotional reactions to reminders of the trauma.
If you’re wondering whether you experience dissociation, and would like professional help to sort it out, trauma therapy can be a good place to start. I would be happy to explore your symptoms with you and invite you to call me at 661-233-6771 or click the button below.
[i] https://www.smatsonconsulting.org/uploads/4/8/9/7/48974625/window-of-tolerance_lang_eng-us_format_full-pack.pdf
[ii] Phillips, M. and Frederick, C. (1995). Healing the Divided Self. New York, NY: W. W. Norton & Co.
