Dissociation

**Dissociation** is the state of disconnected from one's thoughts, surroundings, identity, consciousness, or memory. It often functions as a coping mechanism to protect the individual from overwhelming experiences, but can become maladaptive. Dissociation exists on a broad spectrum, encompassing common occurances like "highway hypnosis" to Dissociative Identity Disorder and Otherwise Specified Dissociative Disorder, and can last minutes or days. It can be found in other disorders like ADHD, anxiety, eating disorders, and borderline personality disorder, or during substance use.

## Symptoms

There are five main categories of dissociative symptoms:

* *Depersonalization*, or disconnection from the self, appearance, body, or thoughts; can also present as "out-of-body" experiences
* *Derealization*, or the dissconnection from one's surroundings or life
* *Identity Alteration*, or the feeling of being an entirely different person than oneself
* *Identity Confusion*, or the feeling of not having internal consistency or acting outside of one's character
* *Dissociative Amnesia*, or forgetting critical personal information, chunks of time that can range from seconds to decades, or past emotions

## Plurality

Plural people often experience dissociation (notably in DID or OSDD-1, but not exclusively to these types). In DID, all five forms of dissociation are present (but not necessarily equally), while in OSDD-1, four forms are present. Alters are typically holders of dissociated memories, traits, or ideas that other alters could not integrate; work towards integration can minimize day-to-day dissociative symptoms, though. Trauma may be hidden behind amnesic barriers, only to be uncovered later when the individual or system feels safer.

## Grounding

A dissociative state is often unpleasant and can last for any amount of time. Not knowing how long a dissociative episode may continue could cause further distress to the dissociative person(s). A common recommendation for persisting through the event is to attempt grounding exercises.

Popularly effective grounding techniques include:

* Engaging the body's sensory abilities, such as describing objects around oneself, smelling a comforting scent, and massaging limbs or the scalp
* Pacing, especially while also listening to lyrical music through headphones
* Using ice or another cold substance on the body's surfaces, such as rubbing an ice pack over the skin
* Counting backward from a high number
* Reading a written work, such as a poem or short story, out loud
* Narrating one's situation and the things around oneself
* Petting and talking to a docile, nearby animal

Asking for another person to help coach them through their actions and do grounding techniques along with them may help dissociative individuals to better ground themselves.

## Related Terms

There are three major dissociative disorders in the DSM-V: Dissociative Amnesia, Depersonalization/Derealization Disorder, and Dissociative Identity Disorder. Additionally, Unspecified Dissociative Disorder or UDD and Otherwise Specified Dissociative Disorder are used for cases where the symptoms do not fit in the earlier three, or it cannot be determined.

Integration can be considered the opposite of dissociation. It is the process of bringing together memories & feelings across dissociative barriers.

## References

1. ↑ https://archive.ph/xck8y
2. ↑ https://www.verywellmind.com/adhd-symptom-spotlight-dissociation-5270278
3. ↑ https://www.verywellmind.com/dissociation-anxiety-4692760
4. ↑ http://estd.org/eating-disorders-and-dissociation
5. ↑ https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml
6. ↑ https://www.isst-d.org/resources/dissociation-faqs/
7. ↑ https://www.youtube.com/watch?v=-Mhr0pCB5us
8. ↑ https://www.healthline.com/health/grounding-techniques