Dissociation: What It Is and What It Is Not

Dissociation is a condition in which a person feels detached from themselves, their feelings, the objects around them. We all dissociate to some degree. You may be driving on the highway, entering at exit 79 and suddenly you find yourself at exit 122 and you have no memory of how you got there. This is a common experience called “highway hypnosis.” Of all the dissociative experiences on the continuum, this is the mildest form. Another mild form may be when you are at a large gathering and are barraged with a multitude of sounds, sights, flashing disco lights, and so on. You feel disconnected from yourself and from all that is going on around you, as if you are in a fog. That is called derealization and that is also somewhat common. 

In the middle part of the continuum, you may find your vision changes and the person you are looking at is either much larger as if you are seeing them from the telescopic end of a binocular or much smaller, like the other end of the binocular. Usually, something has been said or you had a thought that triggered a disturbing memory or stressor that your mind wants to protect you from.

Dissociation can also be identified in personality disorders such as borderline personality disorder, which originates because the individual doesn’t have a solid identity. They constantly adapt their identity to the situation of the moment, shifting without even realizing it. The reasons for this, in oversimplified terms, comes from their inability to tolerate any emotional stress, stress which comes from having to take a hard look at themselves, their own faults and of the need to learn how to cope with unpleasant truths.

At the most extreme end of the spectrum is full blown dissociative identity disorder, which used to be called multiple personality disorder. This is usually caused by trauma when the survivor’s identity becomes fragmented, that is, separates into different identities, each of which carries a certain part of the trauma because the trauma itself is too overwhelming to bear all at once. It originates in order to protect the person from excruciating emotional pain, but it ultimately can work against them because an internal “family” of identities has been created, and like families, they don’t all get along and all battle to be at the head of the table! All of this can be treated, and healing does take place as the trauma is resolved. Usually, the different identities are not whole personalities, and they can be aware of one another (co-conscious). In very rare cases, are the identities so strong and separate that they do not know each other and have no memory for what the other has done. That is the kind of “multiple personality” that is sensationalized on television.

Dissociation is not Asperger’s; it is not attention deficit disorder, it is not Substance-abuse disorder, it is not depression, although all those conditions can show dissociative features. 

Only a trained therapist should diagnose dissociative disorders…. And unless it is interfering with how they function in daily life, treatment may not be necessary.