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Larry Beall, Ph.D.
The purpose of this information is to assist in the identification of dissociation and to furnish a few suggestions as
to what can be done about it. What is dissociation? It is the opposite of association. When things are associated they
are connected with one another, such as members of a group. When things become dissociated, they become separated from a
previous association. A person can become dissociated from the group and no longer be considered a member.
There are two main types of dissociation. 1) ordinary and 2) traumatic. Ordinary dissociation is something we have all
experienced. For example, when driving down a boring stretch of freeway, the driver may be day-dreaming or be preoccupied
with something and become unaware of her surroundings. A period of time may pass without the driver being aware of the passage
of time or the miles that have been driven. This example of ordinary dissociation simply means her conscious mind has become
dissociated from the part of her mind that is doing the driving. You can probably think of other examples when you have experienced
ordinary dissociation in which something is being done that has been done many times before, and is accomplished on autopilot,
or without conscious awareness.
The mind is made up of many elements that are connected with one another under normal conditions. Under traumatic conditions,
especially in childhood, these elements can become separated or dissociated. This is known as traumatic dissociation. When
this happens, the mind dissociates as a way to separate the conscious mind from the part of the mind that experiences the
painful trauma. One example of this is the natural human tendency to react to pain with avoidance and denial. Each of us
has a pain threshold. When it is passed we remove our consciousness so we do not experience the pain. You probably know someone
who cannot remember an extremely painful experience. The experience was automatically dissociated and repressed, to keep
it out of reach of conscious awareness.
Traumatic dissociation is a more common experience than you might think. Most people associate dissociation with multiple
personalities but MPD is relatively rare. What is more common is traumatic dissociation. For example, dissociation is common
in the medical field where it is correlated with the following disorders: migraine headaches, gastro-intestinal problems,
muscle tension disorders, and various medical problems resulting from psychological factors being converted into physical
symptoms. (If you have any of these disorders it does not mean you automatically have dissociation, but they can be correlated).
Traumatic dissociation can become a way to function or relate to the world full of painful experiences. For children
who are being abused for example, it is natural for them to check out in a way like the bored driver, and not experience the
pain. But the experience must be dealt with somehow, and that is where other elements of the mind become involved. With
repeated traumatic events, the checking out of consciousness and the checking in of a mental element can become automatic
and unconscious. Traumatic dissociation could be considered a wonderful survival tool, that makes it possible for the trauma
survivor to go on with life, despite difficult traumatic experiences.
Symptoms of dissociation fall into three main areas: 1)amnesia, 2) absorption and
3) depersonalization. Amnesia is a more common feature of dissociation. Some of the manifestations of amnesia include
not remembering how one got somewhere, or not remembering buying or doing something. Often a person cannot be sure whether
something was done or just dreamed about or thought of. Missing time is often reported in which one misses or loses blocks
of time from two to four hours a day to an entire day or two.
Absorption means one becomes so focused or involved in something that surroundings are not noticed. Some examples of
absorption could be remembering a past event so vividly it feels like it being relived or becoming so involved in TV or a
movie you are unaware of what is going around you. Also, you may become so involved in a fantasy or daydream that it feels
as if it were real. It is not unusual when one is dissociating to sit starting off into space, thinking of nothing, and being
unaware of the passage of time.
Depersonalization is a more extreme form of dissociation. Contact with reality is more difficult to maintain and the
individuals ability to function declines. Some of the symptoms include feeling that other people, objects, and the world
around her are not real, hearing voices inside her head that tell her to do things or comment on things she is doing, not
recognizing herself in the mirror, and finding familiar places and people unfamiliar.
As can be seen from these symptoms, one of the main problems with dissociation is how it interferes with the ability to
carry out daily activities, be employed, or just function. Unfortunately, too many individuals with some form of dissociation
do not understand why they function so poorly and are often seen as being irresponsible. They often cannot get the help they
need to solve their problems or improve their situation. On average, a person is involved in the mental health system for
seven years before a Dissociative Disorder is accurately diagnosed. It is hoped that with increased information, dissociation
may be detected and treated earlier.
What can be done to treat dissociation? There are four main stages of treatment:
1) Establishing safety; 2) Trauma resolution; 3) Cognitive restructuring; and 4) Life skills development.
1. Establishing safety (both externally and internally) for the survivor, means her ability to feel safe in her environment
and manage extreme emotions.
2. Trauma resolution to help remove the psychological pain that has accumulated through repeated traumatic experiences.
Remembering ones traumatic past is not the key to overcoming dissociation, it is removing the pain of the trauma.
3. Cognitive restructuring to help the survivor remove from her mind negative mental conditioning and to acquire new ways
of thinking that are more realistic and functional.
4. Life skills development includes self-assertiveness training, stress-management, managing emotions and creating a
new lifestyle.
We at the Trauma Center invite the reader to call us with any questions. Dissociation is not a mystery that cannot be
solved. It is treatable if principles of healing are followed that can bring predictable, positive results.
Larry Beall, Ph.D. PH: 263-6367
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