Dissociation Explained

[Powder]

I've been trying to learn what Dissociation is for myself. From what I have learned, there are some experts in dissociation who have studied it from the roots of it's discovery onward, but that it is difficult to assess clinically as it is so subjective, like pain or fatigue, that it is supposedly difficult to measure in individuals. I learned that many Tdocs don't "believe in it" at all. It is seen as a working theory. Freud himself introduced what is now closest to the working hypothesis, and years later, recanted his theory that children faced with CSA and traumas dissociate the memories and use D as a coping skill as a learned response. Many of those who wish to discredit Dissociation as a result of trauma cite Freud's recanting as evidence. This is taking science into the rhetorical realm of semantics, and it is not helpful. In fact, science is not without experimental/researcher bias. It would be nice if PTSD were a problem solved scientifically, but the truth is, we are at the beginning of understanding.

I have seen multiple examples on this forum in which it is assumed that dissociation is a "reaction" or mechanistic coping tool for trauma. In fact, the experts are still trying to find out why those who report PTSD and trauma have high incidents of D. D is more often seen in women. It can be induced without trauma, especially in females, by taking the common antibiotic Minocycline. Minocycline was prescribed for me years ago for acne, and was a popular drug of choice for that then (80's-90's) in the USA. Now it is almost never given to women.

Anyway, most trauma experts see such a strong link between trauma and dissociation that for them, it is a given that one causes the other. I don't disagree, but I wish we had more research to back it all up. For now, it's in the DSM, but that doesn't mean all Tdocs and counselors buy into it. And DID is diagnosed a lot in USA but seems to be culturally understood, viewed, and constructed. Some say it's interagenic, or therapy-induced. Same with "repressed memory" which is it's own hugely contested debate, especially in USA. If you are interested in that, please message me or we can start a thread.

 

[Srain]

I have to agree with Anthony here regarding those online assessments, I took the Dissociative Experience Scale and scored an 82, which basically screamed I am DID, which has been unequivocally ruled out by psychiatrists and psychologists alike just this past year. I have all the symptoms of being such, however, what I didn't have was a tdoc coaching me along to uphold that Dx because that is NOT what I have; it's Depersonalization and Derealization which is completely treatable, especially with less meds and more grounding techniques, I've found this to be true, though I have a lot of work ahead of me.

While in trauma therapy this past year I laid the subject to rest once and for all, not only with my psyche doc but with both my TTs. What I deal with is extremely difficult, it's been highly misdiagnosed and misunderstood. It's very frightening but here it is common, it's part of the coping not just during the trauma but as part of my dealing with recovery which is a lot more difficult than surviving those horrors. I find I am struggling far more with Dissociation now than ever.

I'm not sure about the increase of DID diagnoses. (Edited by self)

 

[sea]

I have been in therapy since around Easter of this year. When I first started going I was diagnosed with DDNOS. My therapists sort of switched priority roles and now my main therapist is a support and my regular therapist works at a program that is states away and where I will be for 18 mo. Before I moved to that program my old-therapist changed my diagnosis from DDNOS to DID.

I think DID is actually a lot more subtle than people think it is...for me it is more or less just the way I think and perceive the world and interact with my own mind and my own thoughts. Instead of having one mind and one brain that does and thinks everything, my mind is sort of fractured and shattered, like broken glass that hasn't lost its shape. There are different kinds of concept-people concept-things that hold different functions and meanings, which is just how I access my thoughts.

All kinds of cracks and lines and separate pieces, but still part of the whole shape.

Each of my pieces thinks and perceives differently, and is associated with specific kinds of memories, and is responsible for having a specific function. For me, I very specifically remember telling myself some of these functions as a small child. "I cannot feel anything, I'm not allowed to feel anything, I must be like the machines, I must feel nothing." Over time I sort of shifted into this role, that was like a machine and felt nothing, and in my mind looked like farm equipment.

It was like a blend of being me and being that role, but as that role I could function doing things I couldn't by myself. This is just a ramble but basically it is complicated and being that this is not a forum for DID, I am prone to believe that the knowledge about DID on this forum may not be accurate. DID isn't about dressing up in different clothes and changing your name and forgetting your whole life and being a whole new person like on United States of Tara. I am a bit skeptical that "Tara-like" DID exists.

Anyway, that was a kind of irrelevant ramble...moving on to my point~....

What I really mean to say though is not about DID but about dissociation in general. Dissociation is basically an interruption of the proper flow of information outside of the brain to inside of the brain. That means that it can basically manifest as anything related to cognition. Spacing out, losing time, perceiving the world differently (bigger or smaller), only catching half of what was said, having hearing problems, blurry/double/unfocused vision, the way that one thinks...

My therapist told me frequently that the very way I think is dissociative. Despite being a logical person, I am still prone to fits of magical and childlike thinking that are dissociative in nature, that I live sort of above my own mind, that I perceive things in the way a person dissociates.

Dissociation is pretty useful up to a certain point.

It helps preserve your mind while your brain is flooded with an overdose of stress chemicals, adrenaline, cortisol, etc, while your sympathetic nervous system is kicked into overdrive, every muscle and cell is screaming, emotions are raging, so it is natural of course to blank out as a result of that. It's like the brain's built-in defense mechanism. Once the stress level gets too high, you simply dissociate to prevent more damage being done.

But in dissociation in PTSD, the dissociation becomes pathological when it is in response, like the PTSD responses, to benign stimuli.

It is also interesting to note that cortisol is toxic to hippocampal neurons, which are responsible for creating and storing memories. As PTSD can often overlap with symptoms of TBI and having both myself I find all of it interesting... I wonder if this could be a plausible explanation for why traumatic memory functions so differently than regular memory... We already know that adrenaline affects cognitive capabilities and higher reasoning, higher emotional processing, etc.

Cortisol-flood may have something to do with it? Who knows...

I know I must sound incredibly stupid here (so please don't make fun of me :oops:) as I like neurology but obviously have never been formally educated. I work a lot with animals, especially traumatized animals. You bang on the fishtank too hard and your fish can die from the shock, right? It's like, up to a certain point, the cortisol-flood is useful because it interrupts the mind-body process by dampening the flow of emotions and memory and sympathetic responses by causing dissociation?

But, maybe, after a while, it starts to become super damaging and explains why with PTSD, the chronic condition, it is so much more likely to have memory issues and focus issues and concentration issues, all of which are responsible for creating memories in the first place. In small animals, an excessive flood of stress chemicals can actually be fatal, and in humans can be associated with heart-attacks and high bp, etc.

So wondering just how much severe trauma affects the human brain... and how pervasive and connected it all is.

 

[anthony]

Before I moved to that program my old-therapist changed my diagnosis from DDNOS to DID.

Anyone diagnosed with DID by a psychologist, should toss it out the door and give it the attention it deserves, being none. Unless a psychiatrist tells you that you have DID, then its a money spinner and an industry of itself, especially in the US... because it allows a psychologist to literally book you for a year and get paid enormous money to do it.

If a psychiatrist diagnoses you with DID, then it has validity.

Psychologists have absolutely zero training for diagnostic medicine. Zero... They make it up based on their experience and interpretation from reading the DSM, ICD, and other authors books.

A psychiatrist is the only qualification that is trained and accredited to diagnose mental health.

 

[sea]

If a psychiatrist diagnoses you with DID, then it has validity.

My therapist was a psychiatrist... "Therapist" is just how I describe him because it describes what he does...which is that he gives me therapy. (Maybe that was not clear...sorry...) I have noticed that many members seem to have both a primary therapist and a psychiatrist as two separate people. Mine were one and the same, my therapist managed my meds, etc.

That really does not seem to be the norm.... My therapist noticed my case while I was hospitalized and volunteered to treat me (also not a normal occurrence I suspect). Now my old-therapist is acting the way most people would expect a psychiatrist to act as which is as a consultant and I have another therapist now who is my regular primary therapist and he is a psychologist, yeah.

Maybe he (the old therapist) was just acting in the interim while he found someone to act as a primary therapist, the way it is supposed to be? I'm not certain. Anyway, yes, he was a psychiatrist. Sorry for the long rambly response.

 

[Bimble]

I had another disociative reaction today. Since my accident, back in Feb 2011, where I fell down stairs at work, I have often had incredibly intense flashbacks and overwhelming anxiety when at work. I have experience these disociative reactions a few times always at work, when flashbacks are extreme. Just come back from being off work with sleep problems from ptsd and first day back have a massive disociative reaction practically the minute I stepped out of my car to walk to my office, in building next to where I had my fall.

Previous to this episode, I visited work and sat outside the office, trying to experience the feelings and try, through exposure techniques to get used to being near the scene of my accident. During this time I felt huge waves of emotions and anxiety, but felt safe in my car and simply drove away when things got too much.

This is the key I think. Today, when faced with heading into my office for real, after feeling 'safe' for so long, it just hit me like a wall. Massive, and I mean massive, flashbacks and surge of emotions hit me...next thing I know I am on the floor. Everyone thinks its a faint, but its so different. Hard to explain to people.

I don't know how to tackle this, as I need to work, but the effects seem so massive it really knocks my confidence.

Can anyone help, shed light on this, give advice? At the end of my tether at the moment. I was doing so well these past few weeks I have been off and away from work where my accident happened...help!!!

 

[mamachick]

Anthony
can you have fragments without DID without quite realizing what you are doing? Something totally out of chSo canaracter. I use to feel very intergrated as a person, behaviors consistant and expected.

Past couple of years following the worst trauma, its as though I flip a switch and go play slot machines, the higher the stress, the more likely I will go. Its not like a seperate person as I know I go and do this, but I even make attempts to stay in pajamas and not leave the house when I feel this stressed, often financially as well. I do not want to go out to the supermarket because I am afraid this compulsvie gambler will hijack my car and spend the grocery money. Sometimes I stay home and work through the stress, sometimes I go, I play, I loose, I come home, and I have something new to be stressed about. Its very self punishing behavior. While I am there-its as though I am not me, not anybodys mother or sister, I am this shell "ind of a floating" walking around seeking the winner.

I tend to think its a long shot that dissociation has anything to do with this but beause it feels so "out of body" I need to ask[

 

[anthony]

Paranoia maybe? That is just like flipping a switch internally. The reason for that is cognitive distortions, being what you describe above about futuristic what if scenario's, which the outcome is paranoia. They're primarily based from irrational fear.

So yes... does not sound like dissociation, just good old PTSD.

 

[mamachick]

Oddly, a few years ago I went to casino for dinner with friends a few times, or to listen to a band. The people looked so sad to me at those machines. What jumped out at me was so many people having no human contact-and they didnt look happy. Almost trance like. Very hyper focused in their machine.

 

[Anna]

I dissociate a lot. People often ask me where I went. I am guilty of the thousand yard stare.

Without it, I would not be here now.

When my trauma happened. I remember wishing for it to be over. I thought in my head about warm milk and dunking cookies into it. The chocolate melting in my mouth.

 

[rowean]

Does it ever get frightening for people? I literally was driving home and "came to" in the next town over, about 30 minutes away.

It is physically uncomfortable when I am in session and I am fighting to stay present.

 

[Anna]

Yes rowean. I sometimes find it disturbing when people suddenly look at me and ask "where did you just go?"

They also looked shocked or disturbed by it.