Is this dissociation?

[Lilac5598]

Hi. I've been seeing a therapist for a bit over 2 months. I have times where when talking to her, I have periods of time where I know she is talking but I can't really hear her. While that is happening, I notice that I don't quite feel like I'm there anymore, like I'm insulated somehow. Also, during that time, I know my eyes are open but I can't remember anything I'm seeing.

I've asked her about dissociation and PTSD but she won't give be a difinitive diagnosis yet. Not knowing what is going just makes me feel more lost.

This hasn't just happened around her. It has been happening for years. I've talked to her about that and what triggers it when I'm away from her office. Can anyone give me any insight?

 

[Lilac5598]

She's intentionally asking you questions that are difficult, yes. And, you'd hope so. That's the nature of therapy. We don't go for a friendly chat. We go to solve difficult problems. Uncomfortable problems.

But what I was suggesting was the opposite. You said that she apologised when she noticed it happened. So, it sounds like (as best as can ever be examined in hindsight by someone hasn't met either of you and wasn't there) is she's trying to help you work on the stuff that needs work, and pull up when she's recognising you won't go any further.

Personally, I've found building up my distress tolerance skills has been necessary to get anywhere with therapy, because I do the same thing. When the going gets tough, I'd check out of the conversation. These days, I'm better at managing that, so we can work on stuff that I didn't have the capacity to deal with before.

How you handle it moving forward is your call.

But no, I wasn't trying to suggest for a second that she's deliberately trying to upset or trigger you. There'd be little point in that, since you can't make much progress in therapy while you're checked out. To me, it sounds like she's being a reasonably competent and experienced therapist - helping you confront the hard stuff, and stopping when she realises you've checked out.

That makes sense. I don't really like it but, like you said, we don't go there for a friendly chat.

I started with this therapist not really knowing that I would have this trouble. I didn't unterstand what was happening when I would check out before I started seeing her. I knew that when I was overwhelmed, my mind went somewhere else.

I have been able to avoid many of my triggers since the beginning of the pandemic. Many of them are in my parents home and I simply don't go there anymore. I don't talk about the situation and I won't let others around me talk about it either.

She did apologize, you are right about that. And I understand now how you didn't mean she was trying to deliberately trigger me, even if it might feel that way.

I haven't even started to talk to her about what happened. I'm quite nervous about the thoght of discussing that. I am able to email her and I have told her a bit about what happened. I have a feeling that even though I may I have shared something in a message, she will probably want me to talk about to.

 

[barefoot]

If you’ve decided that dissociation is working for you and that you want to stay with it and don’t want to work on reducing it, I think you’ll find it quite limiting what you can achieve in therapy.

Once we dissociate, we aren’t present - my therapist once described it as being like I’ve just stood up, walked out and gone into another room ie I’m not there anymore.

And if you’re not there anymore, you can’t do any work on anything. I spent over two years dissociating every time we would so much as touch on anything even slightly difficult. Hours and hours and hours in total - and thousands of pounds spent in total - me sitting there spaced out, or completely ‘gone’ or having flashbacks (which I didn’t realise were flashbacks at the time)…while she would sit trying to ground me, using all her energy to stay present and grounded herself, and worrying about whether I’d be able to get home safely.

I kept going because I wanted to get to a point when I could just sit in the room and be present throughout. Because, without being there, you can’t really work on anything.

So if you actively want to keep dissociating, I’m not sure what you’ll ultimately get out of therapy. Unless there are some very safe topics that you talk about and find useful that don’t trigger overwhelm and dissociation. If you want to crack the really hard stuff though…dissociation will be a real obstacle - especially if you don’t have the desire to be more fully present.

 

[Lilac5598]

If you’ve decided that dissociation is working for you and that you want to stay with it and don’t want to work on reducing it, I think you’ll find it quite limiting what you can achieve in therapy.

Once we dissociate, we aren’t present - my therapist once described it as being like I’ve just stood up, walked out and gone into another room ie I’m not there anymore.

And if you’re not there anymore, you can’t do any work on anything. I spent over two years dissociating every time we would so much as touch on anything even slightly difficult. Hours and hours and hours in total - and thousands of pounds spent in total - me sitting there spaced out, or completely ‘gone’ or having flashbacks (which I didn’t realise were flashbacks at the time)…while she would sit trying to ground me, using all her energy to stay present and grounded herself, and worrying about whether I’d be able to get home safely.

I kept going because I wanted to get to a point when I could just sit in the room and be present throughout. Because, without being there, you can’t really work on anything.

So if you actively want to keep dissociating, I’m not sure what you’ll ultimately get out of therapy. Unless there are some very safe topics that you talk about and find useful that don’t trigger overwhelm and dissociation. If you want to crack the really hard stuff though…dissociation will be a real obstacle - especially if you don’t have the desire to be more fully present.

I do want to work on the hard stuff, that was the point of starting this. I can see it's going to be a more difficult journey than I imagined but in the long run, it will be worth it.

 

[barefoot]

I do want to work on the hard stuff, that was the point of starting this. I can see it's going to be a more difficult journey than I imagined but in the long run, it will be worth it.

Yes, I relate to that a lot…intellectually wanting to dive deep and do the hard, important work…but each tiny dip of the toe is overwhelming and dissociation kicks in. For me, that has made my years in therapy incredibly frustrating. Yet it has been worth it too.

The last time I full-on dissociated was about three years ago, maybe longer. I still get spacey sometimes but nothing like how deep I used to get into it and now I can ‘come back’ much more quickly. We didn’t do anything specific to make it suddenly stop. It was just that showing up and showing up and T remaining steady and supportive seemed to chip away at it tiny piece by tiny piece until it just didn’t really happen to that extent anymore. There was no grand eureka moment. Just slow realisation of, ‘oh, I don’t think I’ve really done that for a while, have I…?’

Your want (partial want, at least) to stay dissociated at difficult times because that feels safer and easier, while being present to the experiences and feelings feels overwhelming/painful/uncomfortable/frightening/excruciating/whatever it feels, is totally understandable. Who wants to be with the unpleasant and uncomfortable?! But, if you really want to ‘do the work’ you cannot do it in a dissociated state. So, there is an internal conflict there. The desire to do it vs fear and avoidance of doing it. Perhaps speaking to your therapist about that conflict could help?

You could also explore how safe you currently feel with your T and what, if anything, could help you to feel more safe. Lack of feeling safe will likely keep the pattern of dissociation going.

Perhaps it’s also useful to think about what might make not dissociating worth it. What symptoms are you wanting to ease/erase? What are you struggling with that you would anticipate improvement with if you could do the hard work in therapy? What would you like to be better in your internal world/life? Every time you choose (consciously or unconsciously) to dissociate, you’re saying no to achieving these things. And I say that with absolutely no judgement or criticism, I really do, because I relate so strongly to your predicament. I do feel though that by saying to yourself and saying here that you want to keep dissociating, that is quite a strong message repeatedly embedding that response in your brain. So, if you intellectually want to do the hard stuff (even if you feel you can’t do it yet) I would encourage you to say those things to yourself too, if you don’t already. Not in a way to give yourself a hard time about not being able to stop dissociating at the moment. More just to keep strengthening and embedding the thought and intention that you do want to ‘go there’ and that your brain doesn’t have to rely on this mechanism because you will be ok and safe without it (even though it might feel uncomfortable)

Sorry, I’m rambling on and I know you didn’t ask for advice around stopping dissociation. But as you went from ‘I don’t want to stop dissociating’ to ‘I do want to work on the hard stuff’ I thought I’d throw in some possible things to think about. If not helpful, please ignore, of course! But I recognise and identify with this dilemma very much.

 

[Lilac5598]

Yes, I relate to that a lot…intellectually wanting to dive deep and do the hard, important work…but each tiny dip of the toe is overwhelming and dissociation kicks in. For me, that has made my years in therapy incredibly frustrating. Yet it has been worth it too.

The last time I full-on dissociated was about three years ago, maybe longer. I still get spacey sometimes but nothing like how deep I used to get into it and now I can ‘come back’ much more quickly. We didn’t do anything specific to make it suddenly stop. It was just that showing up and showing up and T remaining steady and supportive seemed to chip away at it tiny piece by tiny piece until it just didn’t really happen to that extent anymore. There was no grand eureka moment. Just slow realisation of, ‘oh, I don’t think I’ve really done that for a while, have I…?’

Your want (partial want, at least) to stay dissociated at difficult times because that feels safer and easier, while being present to the experiences and feelings feels overwhelming/painful/uncomfortable/frightening/excruciating/whatever it feels, is totally understandable. Who wants to be with the unpleasant and uncomfortable?! But, if you really want to ‘do the work’ you cannot do it in a dissociated state. So, there is an internal conflict there. The desire to do it vs fear and avoidance of doing it. Perhaps speaking to your therapist about that conflict could help?

You could also explore how safe you currently feel with your T and what, if anything, could help you to feel more safe. Lack of feeling safe will likely keep the pattern of dissociation going.

Perhaps it’s also useful to think about what might make not dissociating worth it. What symptoms are you wanting to ease/erase? What are you struggling with that you would anticipate improvement with if you could do the hard work in therapy? What would you like to be better in your internal world/life? Every time you choose (consciously or unconsciously) to dissociate, you’re saying no to achieving these things. And I say that with absolutely no judgement or criticism, I really do, because I relate so strongly to your predicament. I do feel though that by saying to yourself and saying here that you want to keep dissociating, that is quite a strong message repeatedly embedding that response in your brain. So, if you intellectually want to do the hard stuff (even if you feel you can’t do it yet) I would encourage you to say those things to yourself too, if you don’t already. Not in a way to give yourself a hard time about not being able to stop dissociating at the moment. More just to keep strengthening and embedding the thought and intention that you do want to ‘go there’ and that your brain doesn’t have to rely on this mechanism because you will be ok and safe without it (even though it might feel uncomfortable)

Sorry, I’m rambling on and I know you didn’t ask for advice around stopping dissociation. But as you went from ‘I don’t want to stop dissociating’ to ‘I do want to work on the hard stuff’ I thought I’d throw in some possible things to think about. If not helpful, please ignore, of course! But I recognise and identify with this dilemma very much.

Your advice as well as all the other advice I've been getting has been very helpful. It's given me a different perspective, something I will truly think about.

 

[Sideways]

I can see it's going to be a more difficult journey than I imagined

Yeah, I think a lot of folks here would agree with this statement. And it's shit and unfair.

But, worth it.

 

[Friday]

I do want to work on the hard stuff, that was the point of starting this. I can see it's going to be a more difficult journey than I imagined but in the long run, it will be worth it.

It’s one reason a LOT of people take meds in the short term, adding some chemical distance / chemical control, to get symptoms & coping mechanisms under control enough to START therapy… then peeling off & reducing meds as they’re able to remain more in control.

That’s not the only solution, of course, it’s just one of the fastest.