Do you ever feel numb, detached, or like you're completely separate from your body? Like you're
floating above it or watching yourself? Like you aren't even real? Or or does the world
around you sometimes feel foggy or dream-like or like time is moving super fast or super
slowly? These are all signs of dissociation, also called derealization or depersonalization. Now,
these three terms all have some overlap in symptoms. Dissociation is a common response
to trauma and other overwhelming experiences, but it can also become a chronic state or alert
response to emotions. So in this video you'll learn to identify the triggers and internal signs
leading up to dissociation, and when you have a framework to understand why dissociation happens,
then you can be more gentle with yourself and learn skills to manage overwhelming situations
more adaptively and flexibly and be more resilient. So let's get better at feeling.
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I've worked with many clients who've experienced dissociation or depersonalization, and often they
have a history of trauma. I can remember one time a young woman who I'd been working with
was sitting on the ground outside the office. She wasn't shaking or crying or speaking, but you
could tell something was very wrong. Now, there were some staff members who had tried to talk
to her, but they weren't getting any response, and her eyes seemed like they were gazing off into the
distance, like seeing right through the walls. She didn't acknowledge me or recognize me. She
seemed frozen and trapped in her world. She seemed very upset. But she wasn't moving. Right? So I
sat on the floor next to her. I probably stayed there for five to ten minutes. And then I asked
her if I could hug her. She didn't say anything, but in the past she'd been okay with side hugs,
so I put my arm around her shoulders. She barely even seemed to register that. So we just sat with
her. Sometimes the staff members or I would ask her a question, but she was, you know,
completely disconnected for a while. We started to ask her if she could hear us, if she could see us.
Um I asked her to feel the ground under her. And she started to talk, but in a pretty disconnected
way. So we decided to try something else. I asked a staff member to bring an ice cube,
which she held in her hand. And, you know, gradually she started to come back. We could see
her getting more emotional. She actually became a little bit panicky, then shaky, then crying.
And she told us that she'd had a really bad bad flashback to some childhood abuse, and that that
had triggered her to dissociate. So we we sat with her and we supported her for over an hour,
um and eventually she started to come back to herself and, you know, be able to function
again. And then with her in therapy we continued to process trauma and work through skills to
manage those intense symptoms for about a year. And over time her ability to manage her thoughts
and her emotions and her bodily sensations really increased, and those dissociative episodes became
less frequent and less intense. So so this is an example of a dissociative episode that's not
uncommon for survivors of trauma. Dissociation can vary in severity from like a severe disorder
to simple distraction. And I've I've seen how on a much smaller level like even like I slip into a
shutdown mode in certain situations. In situations like maybe like a revolving fight with your
husband or an annoying management issue at work or a difficult and unresolvable issue with your
health, like can you notice that feeling you have when you check out, when you turn off, when you
shut down and withdraw emotionally? Like this is dissociation on a very small scale. In some ways
we all seek to dissociate a little bit through daydreaming, through watching TV or diving into
social media. And some people walk through life just feeling numb or detached most of the time.
Now, this can be a common defense mechanism for many people, but when separating from
your thoughts, your memories, or reality becomes involuntary or it interferes with your ability
to function, it becomes a disorder. Now, at its most severe dissociation can cause amnesia or
the formation of alternate identities. In the DSM there are three dissociative disorders:
dissociative amnesia; dissociative identity disorder, which is also previously been
known as multiple personality disorder; and depersonalization derealization disorder. And
then by itself dissociation can just on its own be a symptom of PTSD. So first let's understand
why we dissociate. Dissociation is most common for people who have experienced childhood trauma
or other intense situations where they were unable to escape or overcome the danger. It's our body's
innate wisdom. It's a survival strategy for when things are overwhelming to protect us from feeling
the pain by temporarily disconnecting the mind from the body and environment. So for example,
in this video a cheetah chases an impala, and you can see the impala go through the
nervous system stages: safety; then flight, which is run away; fight, which is kick;
and then, after the cheetah catches, her, freeze. And the impala stops moving
and shuts down. The cheetah has her neck in his mouth. But then a hyena menaces,
and the cheetah takes off. The hyena takes a bite at the impala, and the impala appears to be dead.
It doesn't even flinch. And then the cheetah and the hyena, they fight each other for a minute,
and the impala hops up and sprints away. And it seems as though when the cheetah or the hyena
had their mouths on the impala, she was still calm and perhaps had dissociated. She wasn't
feeling the pain. She was mentally separated from her body. Now, in inescapable situations
like these it seems like dissociation protects the impala from suffering. It detaches from pain,
and in rare situations even saves her life by keeping her aggressors from causing further damage
before she can escape. So dissociation is an adaptive protective mechanism when the situation
is extreme and inescapable. Like we just have to acknowledge that it serves a function. Bessel van
der Kolk shares this story of his own experience of dissociation in the book The Body Keeps the
Score. Let me just read this for you real quick. So he said, "I was once mugged late at night in
a park close to my home, and floating above the scene I saw myself lying in the snow with a small
head wound surrounded by three knife-wielding teenagers. I dissociated the pain of their stab
wounds on my hands and did not feel the slightest fear as I calmly negotiated for the return of
my emptied wallet." Isn't that interesting? And maybe you've read or watched Life of Pi,
where a young man essentially creates a false reality to cope with overwhelming trauma. So
dissociation is a powerful method our brain uses to protect us. But when we overuse that
protective mechanism, that coping skill for things like triggers and work assignments
and stress and relationship problems, it can often interfere with our life. Like my client,
for example. She didn't even know where she was. Or if every time you get in a disagreement with
your spouse you shut down and withdraw, eventually the relationship will go cold.
Or if you chronically distract or avoid problems by watching too much TV, you won't solve a fixable
problem, and you might struggle at work or school or in your functioning in general. You know, when
dissociation becomes so severe that you have split identities or you slip into amnesia or fugue,
which is basically where you run away and you don't know who you are anymore, then obviously
this interferes with your ability to function at work, in relationships, or even live a happy
life. So what can be done to heal dissociative disorders? The first thing I would say is like get
support from a trauma expert for working through a dissociation. Like with severe childhood trauma
or severe dissociative disorders, it's actually probably best to be very cautious about trying to
do the work by yourself because you're gonna need someone to help coach you through dissociative
episodes. When you're working through trauma it's easy to get overwhelmed by these survival
responses and just revert back into old, an old survival strategy like dissociation. So the first
thing to do is to work with someone who can help you regulate your nervous system. And that's what
you do in therapy. Right? Whether it's obvious or not, a therapist uses their own nervous system to
help their client know that they are safe, that they're good, that they're loved. And they're
present there in case of an emergency. Now, other safe people and pets can also be really helpful,
but when the association is severe enough that you don't know where you are or who you are,
like definitely seek professional support from a skilled trauma expert. Okay. Number two:
create safety. Right? It's pretty hard to do any trauma work when you're still in danger and when
your body thinks that you need dissociation to survive. So do everything in your power to create
a safe and sustainable environment for yourself. That includes like leaving toxic and manipulative
relationships and developing an internal sense of safety with, you know, positive statements
and a supportive network and visualizing your safe places and, you know, just developing
this repertoire of body-calming techniques. Okay. Number three: at its core, dissociation
is your body's attempt to escape pain. So often you're trying to escape something inside of you
like a painful memory or an uncomfortable body sensation. Now, you can develop the ability to
face these triggers and memories and sensations with courage and calm. And grounding skills can
also help you with dissociation and help you regulate your stress response. You can you can
come back to your senses by literally using your senses. The 54321 grounding skill is a
great place to start. It's really simple. And you just start by focusing on five things you can see,
and then four things you can touch, and then three things you can hear, two things you can smell,
and one thing you can taste. Now, obviously, go a lot slower than what I just said right there. And
you can learn all of these in my grounding skills course. It's free. The link is in the description.
Um and some other things you can do is just trying to slow your breathing or notice your
breathing or, you know, pay attention to the pressure of your feet on the ground, you know,
pat your legs like this. Another thing that can help you, you know, get better at feeling,
get more grounded is to just engage in a physical activity like running or yoga.
Another thing that can help with dissociation is to learn mindfulness skills. Like mindfulness
skills can help you learn to face the pain and and get better at making space for it so that you
don't need to dissociate as a way to protect yourself from pain. Now, I'm not saying that
dissociation is a choice, but I am saying that you can replace the need for dissociation when
you increase your skills to manage emotions. Okay. Number five: process your trauma. Old,
unprocessed trauma can make even small triggers cause dissociation. After developing grounding,
mindfulness, and internal safety resources, and then, you know, whenever possible with the help
of a therapist, you work through your old trauma through body movement and writing and talking and
other expressive techniques. And this can help decrease the intensity of emotions around the
traumatic memories and triggers. Now, EMDR has a lot of strategies that may be helpful
for dissociation, and that includes bilateral stimulation. This involves alternating stimulation
of the left and right sides of the body. So, you know, they might have you do eye movement
where you're tracking something that's moving on a bar, or they might have you pat your legs like
this. And basically this helps you re-engage the dissociated part of the brain and allows the brain
to reprocess old memories so that they aren't so painful. A somatic experiencing practitioner would
treat dissociation by helping the individual build the skills necessary to re-establish awareness
and connection with their own body. And this could include helping the individual to gradually become
more aware of the sensations in their body and to learn to regulate their emotions and and their
bodily responses. And, you know, they, a somatic experiencing practitioner would help you develop
the ability to self-soothe and self-regulate. And then an internal family systems practitioner,
someone who does parts work would help someone acknowledge and accept all of their parts and
possibly integrate those parts into a cohesive unit. But, you know, integration isn't always
necessary. It's not always the goal. But it can be. While dissociation, whether it's mild or
severe, it can be really uncomfortable and it can get in the way of living your life,
it is treatable. So with the right skills and support, you really can learn to re-regulate your
nervous system and face and resolve pain and spend more time right here in the present moment living
your life and making it better and better each day. So thank you for watching, and take care.
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