Dissociation during exposure

Is it okay to dissociate during exposure therapy? Just started this part of therapy after a while of coping mechanisms and since starting it I frequently partially check out in session. I’m not completely gone, I can still hear but it’s distant/ foggy. He knows I’m doing it and said it’s normal to start but should decrease over time as we repeat the exposure. I had thought you didn’t want to dissociate during exposure, but maybe it’s okay since I’m still there and able to hear. I haven’t had any experiences where I’ve completely left. Would others share personal experiences or knowledge on this subject? Is this typical to start? Does it decrease over time?
 

Survivor3

MyPTSD Pro
Hi @InfiniteTangerine, I've frequently experienced dissociation during my counselling sessions. It happens when I bring up particularly traumatic events but over time it decreases because I become more sturdy and confident about what I'm talking about. I think that when you become more powerful within yourself you can focus and stay present for alot longer to get you through the conversations.
 

Wilma

Learning
Actually, as far as I know, you are not supposed to dissociate during exposure since that way you /your brain won't be able to process things and "file" them as past events. Dissociation keeps the memory in fragments and hinders the connection.
 

Chris-duck

MyPTSD Pro
Actually, as far as I know, you are not supposed to dissociate during exposure since that way you /your brain won't be able to process things and "file" them as past events. Dissociation keeps the memory in fragments and hinders the connection.
This has been my understanding too. Dissociating momentarily n being brought back immediately is all good, but staying dissociated would basically just reinforce in your head that you can't manage to think about it fully aware, so the opposite of helpful essentially.
 

Friday

Moderator
The moment I start spiking any symptom... whether my heart rate picks up, my skin shimmers right before breaking out into a sweat, the world fades... is when I back away & ground myself out. Until I’m crystal clear / totally me / completely in control. And then I begin again.

Just staying in a panic attack, or zoned out, or whatever? Is both a sign I’ve gone too far / too fast, and in my experience completely defeats the purpose. As Instead of exposure therapy chipping away & polishing out the triggers or trauma? It welds them more firmly into place.
 
Just staying in a panic attack, or zoned out, or whatever? Is both a sign I’ve gone too far / too fast, and in my experience completely defeats the purpose. As Instead of exposure therapy chipping away & polishing out the triggers or trauma? It welds them more firmly into place.
Is that why I feel so awful now? He told me I might feel a little bit worse in the following days but I feel horrible. I feel almost as bad as I did after it happened. Almost, but not entirely... it’s like so many of the things I thought I had in control feel out of control gain. It’s awful.
 

joeylittle

Administrator
Is that why I feel so awful now? He told me I might feel a little bit worse in the following days but I feel horrible.
Yeah - that's pretty much how exposure works. The good thing about it - it's reliably and remarkably effective. The bad thing? It's really, really hellish at first. And "at first" can last quite awhile, before it becomes more like an ache, then a dull ache, then an occasional ache, then a memory of an ache.

I'd encourage you to keep being honest with your therapist about when you find yourself dissociating. It will help them to help you. And as many people on this thread have said - it's very normal to be dissociating when you're beginning exposure therapy. You'll want to work towards staying present. This can be where tangible physical things help - like keeping an ice cube in a small bowl, that you can pick up when you feel yourself drifting - or some people like using frozen oranges for this purpose, because of the texture and scent as well as the cold.

It's just experimenting, and finding what works for you.
 

OliveJewel

MyPTSD Pro
The moment I start spiking any symptom... whether my heart rate picks up, my skin shimmers right before breaking out into a sweat, the world fades... is when I back away & ground myself out. Until I’m crystal clear / totally me / completely in control. And then I begin again.
Really helpful to read this. Didn’t realize that the goal might be to take action rather than just bear the brunt. Something to strive for.
 
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