Dissociation

What Is Dissociation?

Have you ever been driving and suddenly realized you've been on "autopilot" for the last 10 minutes, with no memory of the journey? This common experience is a mild form of dissociation - a temporary mental disconnect from your present reality. While most people experience mild dissociation through occasional "zoning out," it can also develop as a coping mechanism in response to trauma or chronic stress.

Clinically, dissociation is defined as "the lack of normal integration of thoughts, feelings, and experiences into the stream of consciousness and memory process." Think of it as your mind's way of creating distance from overwhelming experiences or emotions.

Dissociation can manifest in several ways:

• Dissociative amnesia: Struggling to recall specific events or periods of time, even recent ones.

• Dissociative fugue: Finding yourself somewhere with no recollection of how you got there.

• Derealization: Feeling like you're living in a dream or movie, where reality seems unreal.

• Depersonalization: Observing your feelings from a distance rather than fully experiencing them.

• Identity alteration: Experiencing shifts in how you view yourself or having difficulty maintaining a consistent sense of identity.

• Identity confusion: Struggling to understand or describe who you are as a person.

Are There Healthy Types Of Dissociation? 

Yes. Some types of dissociation, such as becoming engrossed in a book, watching a movie, listening to music, and meditating, can be healthy forms of dissociation when used consciously and in moderation. 

For example, if you are extremely stressed out and decide to listen to music to take a “pause” on life or come home after a long day of work and watch a movie, these may be considered productive ways to dissociate and decompress.

Dissociation is unhealthy when it becomes the automatic response to even a minor stressful situation. 

How Does Dissociation Relate To Eating Disorders? 

It has been suggested that binge eating is actually a form of dissociation. One study showed that the number of binge episodes in individuals was directly related to the level of dissociation of the individual. 

Furthermore, individuals who have more dissociative-related experiences have been associated with increased bingeing and purging behaviors. This means that not only is binge eating a dissociative tactic, but people who frequently dissociate are also more prone to bingeing and purging. 

This prompts the question, what if we looked at binges as attempts to dissociate? Rather than suggesting people go for a walk or do a craft when they get an urge (which are all simply healthier dissociation tactics), what if we addressed the real problem - why do you want to dissociate? Instead of allowing the dissociation to happen, what if you had to sit and deal with the uncomfortable emotion? Would this prompt a greater chance at recovery?

Personal Excerpt: 

I want to comment that I am so thankful to have had a wonderful childhood. Although many people who dissociate have learned it as a trauma response, I believe I developed this learned behavior as a response to not knowing what to do with difficult emotions, as well as a tactic for avoiding the physical pain during competitive sports that comes with pushing your body to the limit. 

For me, dissociation manifested like this:

• Frequent daydreaming 

• Memory loss - people would talk to me, but I couldn’t remember what they were saying. I was a good listener, but it was like the part of my brain that is supposed to compute and store information was on vacation. 

• The feeling that I was often in a movie.

• Laughing at inappropriate, serious situations.

• Limited memory of intimate experiences, even while sober. 

So what happened? Did I always dissociate? No. I used to feel emotions very strongly. As a child, I would cry when my team lost a soccer game. I would get frustrated if I lost a board game. I felt jealous and angry if one of my friends decided to hang out with someone else. My first recollection of dissociation came during high school when I stopped wanting to go to school. I would either sleep or daydream during many of my classes in my junior and senior years. In the military, it was like a superpower. I could dissociate from the pain of certain events or physical activities. It made the time go by faster, and I could, in a sense, have an “out of body experience,” i.e., I could pretend I wasn’t even there when we had to stand for hours "on watch" or complete physically challenging exercises. It had become habitual to “turn off my brain” when any sort of uncomfortable circumstances presented themselves. While this helped with military training, which was often uncomfortable and strenuous, I began “not turning my brain on” at all. I could flip the switch off and keep it off. 

The consequences of dissociation: 

1.  I had difficulties identifying what I was actually feeling. I either felt what can only be described as “manic-happy” or “off” which would usually send me into a sort of depressed state. There was no way to “fix” this without self-reflection, which did not happen because I enjoyed living in this sort of dreamy dissociative state. 

2. I stopped thinking about the consequences of my actions. I just “lived.” I did notice that when I was not actively engaged in an activity or around people, I was generally uncomfortable. 

3. One of the obvious issues that came with this was an inability to evaluate my binges. A binge would happen, and I tried my best to compartmentalize and forget about it. 

How Did I Stop Dissociating? 

• I participated in an intensive outpatient program for eating disorders and made an effort to engage in and complete the exercises given. 

• I started checking in with myself, asking myself, “How am I really feeling?” and writing it down. 

• I told myself I couldn’t listen to music all day. In the car, I would turn it off for periods of time and try to think about the things that were happening in my life. 

What Should I Do With This Information Moving Forward?

• I am currently in the process of evaluating my binges as if they are attempts at dissociating.

• When I feel the urge to binge, I will ask myself, “Why do you want to dissociate? What emotions are too difficult for you to deal with right now?”

• Instead of using an avoidance technique like going for a walk or doing a project, I will sit down, try to identify what I am feeling, start a timer, see how long it takes for the feeling to pass, and record it. After that, I will do a mindfulness exercise—like going for a walk or doing a project. 

Interesting Tidbit

Athletes are more prone to dissociation than the normal population. It is imperative for performance that they block out any extraneous factors about their life while competing. Some do this by focusing solely on their breathing or technique and allowing all other thoughts to pass (this is called association). Others do this by daydreaming, listening to music, or thinking of things besides the pain (dissociation). Interestingly, elite performers more commonly practice association, although many athletes rate dissociation as a more preferred state.