When you witness or experience something terrible, you may try not to think about it. To help you, your brain may call on one of its most creative and ingenious coping strategies to keep you going: dissociation. In the simplest terms, dissociation is a mental block between your awareness and parts of your world that feels too scary to know.

Dissociation happens to just about everybody at some time. It takes many different forms for different people. But for people with a complex trauma history, dissociation keeps the brain in survival mode. Nobody can endure a constant state of fear and still function well. You can’t get through life unscathed while always feeling frozen, worried, or shut down by your greatest fears. Dissociation can function as protection, by keeping people unaware of the distress of being traumatized. That’s when it can eventually cause problems for people who have been hurt very badly, especially as children.

Children are especially likely to use dissociation to manage the inescapable pain of family problems that lead to complex, developmental, and relational trauma. Such problems can include ongoing abuse, neglect or disorganized, avoidant, or insecure attachment. Children must do something to endure experiences that make them feel unsafe. They cope by becoming disconnected to the memories, feelings, and body sensations that are too much to bear. On the outside, they may look okay. But constant dissociation as a means of protection or survival for years then follows them into adult life, where it doesn’t work so well. As a coping mechanism, dissociation often interferes with the life a person wants to have when the abuse is no longer ongoing in the present.

When dissociation blocks awareness of pain, it can also obscure the path to healing. So let’s take a close look at dissociation as a coping mechanism for trauma survivors. If we can safely see where it comes from, and how it evolves, we can also see what healing looks like.

What is Dissociation?

Dissociation is a state of disconnection from the here and now. When people are dissociating, they are less aware (or unaware) of their surroundings or inner sensations. Reduced awareness is one way to cope with triggers in the environment or from memories that would otherwise reawaken a sense of immediate danger. Triggers are reminders of unhealed trauma and associated strong emotions such as panic and fear. Blocking awareness of sensations is a way to avoid possible triggers, which protects against the risk of becoming flooded by emotions like fear, anxiety, and shame.

Dissociation allows you to stop feeling. Dissociation can happen during an experience that is overwhelming and which you can’t escape (causing trauma), or later on when thinking about or being reminded of the trauma.

Dissociation is a coping mechanism allowing a person to function in daily life by continuing to avoid being overwhelmed by extremely stressful experiences, both in the past and present. Even if the threat has passed, your brain still says “danger.” Unprocessed, these fears may stop you from living the life you want or changing unhelpful behaviors as you grow.

Some level of dissociation is normal; we all do it. For example, when we get to work and have to leave the personal concerns behind, we choose to put them out of mind for a while. But when dissociation is learned as a coping strategy – especially in childhood for survival purposes – it carries over into adulthood as an automatic response, not a choice.

Children with Trauma Are More Likely to Experience Dissociation

As a protective strategy for coping with trauma, dissociation can be one of the most creative coping skills a trauma survivor perfects. It detaches awareness from one’s surroundings, body sensations, and feelings. Children who experience complex trauma are especially likely to develop dissociation. It often co-occurs with the earliest incidents of recurrent trauma, since the only way to survive the horrific experiences emotionally is to not be there consciously.

There are many possible conditions that cause dissociation. Therapists are aware and focus their understanding of dissociation in connection with the underlying trauma – what happened to you. A few simple examples of risk factors for dissociation are:

A disorganized attachment style. Trauma inflicted by abuse from a primary attachment figure, for elementary school-age children, can lead to dissociative disorders for the child. When someone the child depends on for survival is also a source of physical, sexual, or emotional abuse, a protective response is to vacate being present in their body in order to survive the abuse, while preserving the needed family tie or even their life. An insecure attachment style. A child consciously develops behaviors or habits to dissociate, like using loud music, so they don’t hear frightening arguments between parents that terrify, for example. They may turn to video games or other distractions while dad paces the floor worried because mom is out drinking. Recurrent abuse or neglect that threatens a sense of safety and survival of any kind, by anyone! Post-traumatic stress disorder (PTSD) and Complex PTSD (C-PTSD). Dissociation to cope with events that cause PTSD or C-PTSD (developmental, relational ongoing trauma) can include out-of-body responses to trauma. A neurological response causes some trauma survivors to dissociate to a level where they look out at their bodies from another perspective. This can be looking down from above or looking at a part of their body that doesn’t appear to belong to them. Dissociation occurs on a continuum, often impacted by how long or often one relies on it, whether the person has any other coping strategies, or whether other trusted helpers or a safe space is available. Helpers or places where the child feels secure can provide a way to safely be connected to feelings, sensations, and body, despite the overwhelm elsewhere.

Childhood Dissociation Persists In Adulthood

As children with trauma get older, they may use self-harm, food, drugs, alcohol, or any other coping mechanism to maintain the disconnection from unhealed trauma. As therapists, we see these behaviors serving two functions for trauma survivors

As a dissociative mechanism or way to dissociate (for example, using alcohol or drugs to physically disconnect them from their thinking brain)

As a way to sustain behaviors that keep them dissociated (I’m not connected to my body, so I can cut without pain, or I’m not connected to my body, so I don’t notice that I’m full and don’t need more food to consume).

Ultimately, this coping strategy that was useful in childhood, in adulthood compromises the ability to trust, attach, socialize, and provide good self-care. These challenges follow trauma survivors throughout their life, if not attended to.

Recognizing Dissociation In Adults

Adults don’t just outgrow dissociation learned as a childhood coping skill. It likely becomes a go-to coping mechanism for maintaining life. Adults may not be aware of their ongoing state of dissociation, while words and actions like these tell a different story:

Someone tells a therapist their most traumatic experiences without knowing or trusting them first and does so without emotion connected to the story; they are speaking from a dissociated place.

Someone uses drugs, alcohol, cutting, food, pornography, or other forms of self-injurious behavior to continue to dissociate and not be present with their feelings.

Someone disconnects from the here and now when they’re triggered by a certain situation or even a scent, such as cologne, and find themselves inside a flashback which feels very real.

A veteran hears a noise that causes a flashback to a wartime event.

Someone is arguing with their spouse, but when their spouse yells, they “check out.”

Dissociation is sometimes the best way a person can survive a terrifying ordeal in the moment, or chronic developmental trauma over many years. Yet it actually becomes a problem, a roadblock, in adult life. Dissociation interferes with forming secure relationships and connections. Dissociation can prevent you from developing these relationships or being present for them.

The reality is, in your adult life, you may actually be safer today learning to notice, reconnect, and reintegrate the dissociated parts. Perhaps you are safe now and don’t need this coping mechanism to protect you anymore!

Most times, an individual will show up in therapy for some other reason besides the use of “dissociation” or even trauma—they are there because they feel sad, or are drinking too much or fighting with their spouse. They can’t figure out why these issues persist, as they have a nice life now. As trauma-informed therapists, we can help people safely discover what issues are showing up due to their past history. We can help them discover and notice what made sense at the time given what was going on in their life that they had to survive. We can help people understand they are not “bad” and something is not wrong with them – their issues are based on the dissociative coping skills they learned in childhood to survive (which were very useful at the time, but not anymore)!

In therapy, we work to create a place of safety and stability—where it’s okay for you to be present in the moment, in your body, and in your feelings. We work through recovery in stages to help you ground yourself in the present day. When you feel grounded, you are able to know that you’re safe in the present moment, even if something triggers familiar alarms, by using things like the flashback halting protocol.

We work to help you be present in your adult self and be able to decide if you need to dissociate or not today to survive. Through reparative work, we help you to stop just surviving life, but instead, to live it.

Resources:

• Beauty After Bruises: What is C-PTSD?
• Why the answer ‘I don’t know’ is helping me understand my partner’s dissociative disorder, by Heather Tuba
• Reconnecting to your Body after Peritraumatic Dissociation
• Loving a Trauma Survivor: Understanding Childhood Trauma’s Impact On Relationships
• 3 Concepts to Help Trauma Survivors Move Forward Into Healthier Relationships
• Coping with Trauma-Related Dissociation: Skills Training for Patients and Therapists (Norton Series on Interpersonal Neurobiology)

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Robyn Brickel

Robyn is a Licensed Marriage and Family Therapist with 20+ years of experience providing psychotherapy, as well as the founder and clinical director of a private practice, Brickel and Associates, LLC in Old Town, Alexandria, Virginia. She and her team bring a strengths-based, trauma-informed, systems approach to the treatment of individuals (adolescents and adults), couples and families. She specializes in trauma (including attachment trauma) and the use of dissociative mechanisms; such as: self-harm, eating disorders and addictions. She also approaches treatment of perinatal mental health from a trauma-informed lens.

Robyn also guides clients and clinicians who wish to better understand the impact of trauma on mental health and relationships. She has a wide range of post graduate trauma and addictions education and is trained in numerous relational models of practice, including Emotionally Focused Couple Therapy (EFT), the Psychobiological Approach to Couple Therapy (PACT), and Imago therapy. She is a trained Sensorimotor Psychotherapist and is a Certified EMDRIA therapist and Approved Consultant. Utilizing all of these tools, along with mindfulness and ego state work to provide the best care to her clients. She prides herself in always learning and expanding her knowledge on a daily basis about the intricacies of treating complex trauma and trauma’s impact on perinatal distress.

She frequently shares insights, resources and links to mental health news on Facebook and Twitter as well as in her blog at BrickelandAssociates.com

To contact Robyn directly:

[email protected]

www.BrickelandAssociates.com