Disclaimer: if you experience any of these symptoms and have not spoken to a medical professional about them I would encourage you to do so, they should check if you are experiencing any kind of underlying physical cause and refer you for a diagnosis. I am not a medical professional and this information is written based on my own experiences and research. However, medical help for mental health is complicated and depending on your location can be financially prohibitive. There is a list of sources, resources and helplines at the end of this article should you wish to understand more or feel the need for some immediate support.
Dissociation is at the most fundamental level, feeling of detachment, it can range in strength and has a variety of causes. It’s also something a lot of us do naturally to a lesser degree, like falling into a deep daydream if you’re bored on the bus or switching off part of your brain to get through something monotonous at work, but it can also be more severe and have a serious negative impact on your quality of life. Dissociation has a range of causes. It is common in people who have experienced trauma or have PTSD, as well as depression and anxiety but it can also happen for other reasons, and it may not even feel linked to direct a cause.
The concept of the window of tolerance is very useful for understanding and dealing with dissociation. This concept explains how we all have a window in which our brains function best and can process stimuli. If you are operating within that window you will be able to make decisions calmly and rationally and reflect on consequences. Extreme stress can cause you to move out of that window into either hyper-arousal or hypo-arousal (or, as I like to think of it, overstimulation and under-stimulation). Outside of that window of tolerance, your brain cannot process input properly, this can cause panic attacks and dissociation. If you have experienced a traumatic event or are struggling with mental illness, or extreme stress it is likely your window of tolerance will be smaller, and that in the past as a way to cope you brain may have used dissociation as a way to escape and now uses it as a reflex when you’re struggling.
Dissociation during trauma or extreme stress can make you feel like the event is happening to someone else, as if you are viewing the situation externally from a distance. This makes sense as a natural reflex and way to cope, if you are in a situation of danger your instinct will be to find a way to survive, contrary to popular opinion, the body does not just have ‘fight or flight’ to choose from, there is also the subconscious option to freeze and wait for the danger to pass. This can be a cause of dissociation, but particularly for survivors of trauma, once a traumatic event has passed your body may still reach for this coping mechanism in situations of stress. It is also likely that your tolerance for stressful situations is smaller because of the traumatic event and how that impacts your body’s ability to respond appropriately to stress. Panic attacks are usually characterised as an outward expression of emotions, but they can also feel like a kind of freezing, where you feel unable to move or talk or interact with the world around you.
Dissociation and dissociative disorders do not just occur because of trauma, but regardless of the cause they can be very disruptive, it can feel impossible to maintain interpersonal relationships while you are dissociated, you may not be aware of the world around you which can be dangerous (for example when crossing the road. Ultimately it can just be very frustrating not to feel in control of your life and not to feel able to choose whether or not you are fully present and aware. They can affect your memory and make you feel like you’re ‘losing time’ or find it hard to recall important information, for example if you dissociate in a meeting at work or when spending time with friends, you may then not be able to recall precisely those events at a later date, You may feel like you do not have a sense of self, or that you are watching yourself from the outside as if in a film, as if you are floating or as if other people are not real.
Tips for managing dissociation when it’s happening:
· Describe out loud 3 things you can hear, see, smell and feel. Repeat this several times, if there is someone with you who can spot when you are dissociating this is a good thing they can ask you to do to ground you.
· Run your wrists under cold water, this will remind you that your body is yours on a physical level and it’s also very refreshing and calming.
· Feel your body: this could be in a very small way, like rubbing your hands together or massaging the base of your thumb, or you can gently touch your arms and legs to remind yourself they are there and are part of you.
· Remember this feeling will pass and understand that it is your body trying to keep you safe
· Accept the feeling for the moment, fighting it may make you feel more distressed and make you feel more frozen, but try to remember you are not going to feel like this forever, it will pass.
· Take 3 deep breaths in and 3 deep breaths out, with each breath lasting three seconds.
· Apply moisturiser to your hands, this can be a good one for public situations as it won’t attract attention but is very grounding.
· Use a lip plumping or menthol lip balm, the tingling feeling can be very grounding and again won’t attract attention
· Text someone, it may feel impossible to talk so why not send the person you are with a text if they are someone who can understand, or tell someone who isn’t nearby what’s going on. Describing it can help you feel more in control.
· Do a meditation that focuses on grounding you, it may feel uncomfortable as dissociation is your body’s way of ‘detaching’ from your physical form as it is trying to avoid a perceived danger, so making you aware of your body may feel stressful or scary. Don’t force yourself if it feels too much, but if you can this is sometimes a useful option.
Remember that this a defensive mechanism, your brain and body are trying to protect you from a perceived danger. Try and treat yourself with patience and kindness and know that you do have control of what’s happening, it may just take time for you to find a way to manage what’s happening to you that works, and to understand what is setting you off.
‘The Body Keeps the Score’ an interesting read if you want to understand more about living with trauma - https://www.amazon.co.uk/Body-Keeps-Score-Transformation-Trauma/dp/0141978619
Contact details for the Samaritans support service - https://www.samaritans.org/how-we-can-help-you/contact-us?gclid=EAIaIQobChMI1OzA-eOd2QIVAhwbCh1dFwJkEAAYASABEgIcovD_BwE