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Clinical resource

How to Stop Dissociating

Despite the advancements in psychiatric research, dissociative disorders still seem to be a much less understood issue than other mental health illnesses. It is more controversial, and many clinicians still argue about their existence.…

Clinically reviewed byDr. Sarah Boss, MD
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Quick Summary

  • Dissociation involves disconnection from thoughts, memory, identity, or surroundings and may arise automatically as a coping response to trauma.
  • Sensory awareness, grounding, focused observation, and cold objects may help redirect attention to the present during a dissociative episode.
  • Professional support may include trauma-focused or behavioral therapies, while loved ones can respond calmly, respect boundaries, identify triggers, and help maintain safety.

Despite the advancements in psychiatric research, dissociative disorders still seem to be a much less understood issue than other mental health illnesses. It is more controversial, and many clinicians still argue about their existence. Because dissociative disorders can be quite challenging to detect and often go undiagnosed, no clear clinical consensus regarding the best treatment protocols for these issues has existed until now. Things are finally beginning to change as mental health professionals have embraced it and gained insight into the psychiatric problems commonly linked with dissociation. It is now widely accepted that this once-mysterious disorder not only exists as a distinct phenomenon but can respond well to the appropriate treatment protocols. 

In this article, you will learn more about dissociative disorder, its signs and symptoms, and how to deal with dissociation in the best possible way.

Dissociation refers to a state where a person loses the connection to their thoughts, sense of identity, memory, and mental processes. In simpler words, they lose touch with the awareness of their immediate surroundings. The problem often occurs with a co-existing mental issue, such as PTSD. Dissociation is now recognized as a psychiatric illness that can have symptoms with varying severities. Daydreaming is often recognized as a mild form of dissociation, whereas the most severe forms are marked by episodes where the affected person completely loses touch with reality.

According to surveys, dissociation occurs in only 1.5% of the world’s population, making it a rare mental health issue. Most people who suffer from it have usually experienced trauma in one form or another. For such people, dissociation is a coping skill they use to continue functioning during severe traumatization. Any situation, threatening or non-threatening and related or unrelated to the original trauma, can trigger these episodes. It is important to remember that dissociation is an automatic response for many people, and it happens subconsciously. In other words, they may enter an unreal world without knowledge, awareness, or planning.

Some things that can cause dissociation include:

  • Physical, emotional, or sexual abuse
  • War violence
  • Childhood trauma
  • Natural disasters
  • Extreme violence

Dissociation can trigger changes in bodily sensations, rendering a person unable to react emotionally. Some other common signs and symptoms of this issue include:

  • glazed, blank look/ staring
  • spacing out
  • mind going blank
  • a sense of the world not being real
  • mind wandering
  • out-of-body experience
  • detachment from self or identity
  • disconnection from surroundings
  • lack of sensation
  • flat affect
  • monotone voice

The symptoms mentioned above can be recurrent, fleeting, or even constant. The duration of these symptoms describes whether it is a dissociative episode or a dissociative disorder.

A few exercises can help you escape dissociative states and get in touch with reality again. Following are some examples of these exercises:

Five Senses

If you find someone in a dissociative state, ask them to describe one example of what each of their senses is experiencing. For example, ask them what they can hear, see, feel, taste, and smell around them.

Grounding

You can practice grounding exercises in multiple ways. Most people find it beneficial to give a person in a dissociative state something to feel or taste. For example, consider giving them a candy bar and ask them to explain what it tastes like. You can also put something in their hand, such as a soft blanket, and ask them to describe how it feels.

Focused Sight

Focused sight techniques include asking a person to choose something in the room and focus on it as their mind is stuck in a dissociative phase. Ask them to describe everything about it in detail and keep asking them questions to bring their attention back to the present moment.

Ice Cubes

Holding ice cubes or a pack of frozen vegetables in hand as you struggle with dissociation can be a simple yet amazing trick to snap out of the unreal phase. The cold temperature of ice cubes can bring the wandering mind back by inducing an avoidable sensation in the present moment.

Certain targeted therapies can prove highly beneficial for treating dissociation and dissociative disorders. Practicing them more frequently can also enable the patients to learn these dissociative states in the long run. Some of these targeted therapies to stop dissociation from reality include:

Eye Movement Desensitization and Reprocessing (EMDR) therapy

EMDR was originally designed to help alleviate stress due to traumatic memories. This therapy aims to deeply explore trauma and other adverse life experiences to bring about an adaptive resolution in a patient’s life. During an EMDR session, therapists utilize hand movements to induce eye movements in their clients to keep them in tune with the present moment. Sometimes, audio stimulation and hand-tapping are also used for similar purposes. Irrespective of the technique used, EMDR has been highly successful in managing traumatic dissociation with up to an 80% of success rate. The benefits of EMDR can begin appearing in as little as three sessions, each lasting 90 minutes.

Psychotherapy

Talk therapy is one of the most effective ways to uncover and process the past traumas that might be causing frequent episodes of dissociation. Psychotherapy is an umbrella term that encompasses several types of talk therapies. These therapies are usually performed one-on-one but may utilize a group setting in some situations.

Behavioral Therapies

Behavioral therapies form a subcategory of psychotherapy and include cognitive and dialectical behavioral therapy as two of its best elements. CBT, in particular, can be highly beneficial to people who frequently dissociate and suffer negative consequences. It focuses on addressing all obsessive thoughts exacerbating their dissociation and promoting developing behaviors that counteract these thoughts. Behavioral therapies also incorporate grounding techniques to manage dissociative symptoms, such as disembodiment.

It can be challenging to see a loved one experiencing the symptoms of a dissociative order, but remember that you and other family members and friends can help make a difference. There are several ways to support your loved one while also looking after your health and well-being.

Be patient and understanding.

If someone close to you is experiencing dissociation from reality, it means they may not always respond to you as you expect. So be prepared to be in some bizarre situations but try not to lose your cool as your loved ones are not in control of what they are experiencing. Constantly ask them what would help, but remember that they may not always know the answer to your question as the situation is equally confusing for them. If your loved one wishes to share their feelings with you, listen with acceptance and without judgment. Keep assuring them that you understand, but be careful with physical intimacy or touching as it might be difficult for a dissociating person to handle it.

Think about how you can deal with their identity alteration.

If a dissociative episode that your loved one is experiencing involves identity alteration, you may struggle to communicate with different parts of their body at other times. Try finding some way of relating to each part of their identity to make communication easier. Be sure to maintain calm even if your loved one is scared, angry, or upset.

Help them find the proper support.

Another way you can provide dissociation help to a loved one is by assisting them in finding a therapist to manage their issue. If practical, consider attending therapy sessions with them to maximize their chances of recovery. You can also offer them extra understanding and support before and after their sessions.

It is possible that you may not be able to extend your support to your loved one all the time. Think about the next best person they can contact if you are unavailable.

Think about how you could help keep them safe.

Sometimes, a person has specific triggers that bring dissociative symptoms and flashbacks. Identifying and understanding these triggers for your loved ones mean that you can help them avoid dissociation to a great extent. Moreover, it can also help them prepare better for their symptoms.

If you or someone you love is suffering from dissociation, the world can quickly get extremely scary for them. Suppose they suffer from specific symptoms, including flashbacks, amnesia, or identity alteration. In that case, they must get professional help to stay safe during these times and prevent the episodes as much as possible.

If left untreated, dissociation can lead to multiple health complications and induce destructive behaviors, such as addictions, self-harm, and suicidal tendencies. Though these destructive behaviors might seem to be helping them cope with their emotions, a dangerous cycle can begin as a result that may destroy their lives.

Do not wait any longer. Help is only a call away. Contact a therapy center now to book your appointment.

Questions

Frequently Asked Questions

Can a psychiatric illness induce a feeling of dissociation?
Many people who experience dissociation often have a co-occurring disorder. These include depression, posttraumatic stress disorder, epilepsy, schizophrenia, and phobic disorders. Whether these mental illnesses play a role in dissociation depends on individual circumstances and the severity of these problems. If some people, these co-existing diseases may worsen or exacerbate an episode of dissociation.
What are the different types of dissociation?
Dissociative disorders are of three primary types:
Depersonalization-derealization disorder- in which a person feels like they are observing their own life from outside their body
Dissociative amnesia- in which the person fails to remember important information about themselves or the past events
Dissociative identity disorder or multiple personalities disorder- in which a person may develop more than one persistent personality states
How long does dissociation last?
Most episodes of dissociation last from a few minutes to a few hours before eventually fading out. However, some people may experience severe episodes lasting for days, weeks, or even months. Long-term dissociation can occur during short periods of acute distress and tend to last a lifetime if nothing is done to manage it.
Remember that having fleeting moments of detachment from reality now and then is common, and many people experience them. However, when these episodes become more prevalent or persistent and start interfering with daily functioning, the problem will likely develop into a disorder.
What is the connection between dissociation and anxiety?
Dissociation occurs as a part of anxiety disorders in many people. Anxiety can make you believe that you are in grave danger, and, as a result, the body triggers a high degree of the stress response. In some instances, this stress response and the changes it starts are so dramatic that they directly affect behavior. To cope with the imbalanced emotions of fear and helplessness, you may dissociate yourself from reality.

Editorial evidence

Evidence & sources

Selected clinical guidelines, peer-reviewed research, and public-health sources used in this article.

01National Institute for Health and Care Excellence. (n.d.). Post-traumatic stress disorder (NICE guideline NG116).View source
02Cochrane Common Mental Disorders. (n.d.). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults.View source
03World Health Organization. (n.d.). International classification of diseases 11th revision (ICD-11).View source
View all 15 sourcesShow fewer sources
04National Institute on Drug Abuse. (n.d.). Comorbidity: Substance use disorders and other mental illnesses. National Institutes of Health.View source
05Agency for Healthcare Research and Quality. (n.d.). Psychological and pharmacological treatments for adults with posttraumatic stress disorder: A systematic review update.View source
06National Institute of Mental Health. (n.d.). Mental health information.View source
07American Psychiatric Association. (n.d.). What are dissociative disorders?View source
08National Health Service. (n.d.). Dissociative disorders.View source
09World Health Organization. (n.d.). ICD-11 for mortality and morbidity statistics.View source
10Department of Veterans Affairs & Department of Defense. (2023). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder.View source
11Substance Abuse and Mental Health Services Administration. (n.d.). Trauma and violence.View source
12StatPearls. (2023). Dissociative identity disorder.View source
13American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder.View source
14National Institute of Mental Health. (n.d.). Post-traumatic stress disorder. U.S. Department of Health and Human Services, National Institutes of Health.View source
15National Center for Biotechnology Information. (n.d.). Dissociative disorders. StatPearls Publishing.View source
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