Dissociation and Personality Disorders
How dissociation shows up in the world
What could dissociation look like?
Depersonalization
Depersonalization is a psychological phenomenon characterized by a sense of detachment from oneself and one’s surroundings. It can manifest as feeling as though you are observing your life from a distance or that your thoughts, emotions, and actions are not truly your own. While depersonalization can be distressing, it’s important to know that it is a common experience and often linked to stress, anxiety, and other mental health factors.
Symptoms of Depersonalization:
- Feeling disconnected from your body or physical sensations.
- Sensation of being in a dream-like state or living in a fog.
- Perceiving your actions as automated or robotic.
- Distorted sense of time passing.
- Emotional numbness or inability to experience feelings fully.
- Difficulty forming emotional connections with others.
Derealization
two or more distinct and relatively enduring “identities” (i.e. dissociative personality states) are experienced as controlling someone’s behaviour, accompanied by significant memory impairment. (This was formerly known as “multiple personality disorder”.)
Dissociative Identity Disorder
Dissociative Identity Disorder (DID), previously known as Multiple Personality Disorder, is a complex and often misunderstood mental health condition. This disorder is characterized by the presence of two or more distinct identities, each with its own set of thoughts, behaviors, emotions, and memories. DID is a genuine and valid condition that requires careful consideration and support.
Key Features of DID:
- Altered Identities: Individuals with DID may switch between different identities, often referred to as “alters” or “parts.” These identities can vary in age, gender, temperament, and even knowledge.
- Gaps in Memory: Switching between identities is often accompanied by gaps in memory, which can be extensive and affect day-to-day functioning.
- Amnesia: Individuals may experience amnesia for events that occurred when another identity was in control.
- Triggers and Stressors: Switching between identities can be triggered by stress, trauma, or reminders of past traumatic experiences.
- Coexistence: The various identities coexist within the same person, and they might have differing perceptions of the world and experiences.
Causes of DID: The development of DID is believed to be linked to severe and repeated childhood trauma, often occurring before the age of 9. Coping with overwhelming experiences may lead to the compartmentalization of memories and identities as a way to manage emotional distress.
Borderline Personality Disorder
Borderline Personality Disorder is not always seen as a dissociative disorder, however, at Sauna Therapy we treat borderline from the same trauma lens as DID and dissociation.
Borderline Personality Disorder (BPD) is a complex mental health condition that affects how individuals think, feel, and interact with others. While the term “borderline” may suggest a marginal condition, BPD is a serious and valid disorder that requires understanding and compassionate support.
Key Features of BPD:
- Emotional Instability: People with BPD often experience intense and rapidly changing emotions. Their mood can shift from one extreme to another, causing distress and difficulty in managing feelings.
- Unstable Relationships: Individuals with BPD may struggle with maintaining stable and healthy relationships. Fear of abandonment and a tendency to idealize or devalue others can lead to stormy interpersonal dynamics.
- Impulsive Behavior: BPD can manifest as impulsive actions, such as excessive spending, risky behaviors, substance misuse, or self-harm.
- Distorted Self-Image: A person with BPD might have an unstable sense of self, struggling to establish a consistent identity and goals.
- Chronic Feelings of Emptiness: Many individuals with BPD report feelings of emptiness and an ongoing sense of inner void.
- Intense Anger: Episodes of intense anger, often disproportionate to the situation, are common in BPD.
Relaxation and Trauma Treatment for Dissociation and Personality Disorders
How do I stay in my body?
We aim to always normalise and validate dissociative behaviour; to explain it is “a normal response to abnormal situations”. We aim to clarify: people don’t choose to dissociate. It is an automatic, unconscious, involuntary response. We might say something like: “It is your mind & body trying to protect you from the fear and horror and pain of harmful, dangerous or intensely painful events.” We link this to the client’s history of trauma, abuse, neglect, etc. We help him to see how dissociation helped him to survive these difficult events.
Is Dissociating Still Helping You?
Having validated and normalised dissociation, and explained its main purpose, we can go on to explore:
a) In the past it was helpful to dissociate; it protected you from the horror/terror/ pain/hurt of whatever was happening in your life. This helped you to survive. This was your nervous system protecting you!
b) In the present, dissociation still helps you to escape painful thoughts and feelings, emotions and memories. But what does it cost you? Is it making your life richer in the long term, or poorer?
Symptoms of Dissociation
Dissociation is being disconnected from the here and now. Everyone occasionally has times of daydreaming or mind wandering, which is normal. Sometimes dissociation is a way of coping by avoiding negative thoughts or feelings related to memories of traumatic events. When people are dissociating they disconnect from their surroundings, which can stop the trauma memories and lower fear, anxiety and shame. Dissociation can happen during the trauma or later on when thinking about or being reminded of the trauma. When dissociation is connected to trauma memories or reminders, it is considered an avoidance coping strategy
Zoning Out
Mind going blank, feeling like you are losing track of time, difficulty concentrating
Sleep Paralysis
Sleep paralysis in nightmares feeling like you're watching yourself from your own dreams
Thoughts of Suicidality
Feeling and emotions can feel like a fire hose and the only way to make it feel a little bit better is possibly making it stop
Identity Diffusion
Feeling like a chameleon and not understanding which identity is your own identity
Gaps in Memory
Significant gaps in memory for everyday events, personal experiences, or specific time periods. Alters may have their own memories, and individuals may not remember actions or events that occurred while a different identity was in control.
Fear
Stress causes fear; therefore, individuals experiencing anxiety may have an impending sense of doom or fear
I Did not mean to trigger you
What are the Triggers?
Triggers are sensory stimuli connected with a person’s trauma, and dissociation is an overload response. Even years after the traumatic event or circumstances have ceased, certain sights, sounds, smells, touches, and even tastes can set off, or trigger, a cascade of unwanted memories and feelings. When they do, the survivor might react with an adrenalin-charged fight-flight-or-freeze response or by dissociating.
Dissociation separates a person emotionally from the trauma and, sometimes, from the current setting. Triggers initiate an emotion reflex Though triggers can be generalized, as in the case of a loud noise, they may involve specific qualities, such as a particular song or the scent of aftershave.
These are some common triggers:
A sense of being ignored, Aggressive behavior Angry facial expressions Anniversaries Bright lights Colors Completing forms Crowds Darkness Disorder/chaos Impatient authorities Lack of choices or options Long waits for services Lost privileges Loud or abrupt noises Not being believed Odors Requests to repeat one’s story Signs and images Small spaces Songs Tone of voice
Dissociation is hiding the real you
Dissociation ranges from a conscious decision to postpone dealing with feelings to a complete loss of touch with the present. When something utterly overwhelming happens, some people detach from their emotions in order to function, perhaps even to survive. As a coping mechanism in the short term, this sort of dissociation can help a person carry on, do what needs to be done, get through the event, and even respond effectively to a threat. However, as a habitual response to stress, dissociation creates a wall between an event and its natural psychological consequences. Eventually, and often with the help of food or mood altering substances, people can become mentally detached from their feelings and their bodies. Most of the time, they seem normal, but there can be an unempathetic hardness about them. In some extreme moments of traumatic stress, a person might suddenly “space out.” Whereas they seemed fully present, talking and participating, they suddenly became vacant, staring into the distance. At such times, they are likely to need help reorienting. It can help to prompt them to breathe slowly, look around the room, notice the feel of the chair or the floor under their feet. They may not recall what was happening or being said when they triggered, and they might need reminding.
