Why Do I Dissociate During Therapy?
Have you ever been driving and then you realize you don’t remember all or part of your trip? Have you ever had a conversation with someone and then realize you didn’t hear anything or part of what they said? Have you ever daydreamed? Woken up from a dream and wasn’t sure if what you just dreamed really happened? Ever looked in the mirror and not recognized yourself?
What is Dissociation
If you answered yes to any of the questions above, then you my friend have experienced dissociation which is normal and natural for human beings to experience. It’s a regular function of the human brain to be able to detach from reality. Dissociation can happen on a spectrum from checking out during class all the way to to DID (Dissociative Identity Disorder). Milder forms are referred to as “normal dissociation” and extreme forms are “pathological dissociation”. For those who have experienced trauma, dissociation becomes the primary coping mechanism they use to deal with post-trauma related symptoms; it’s a type of coping that our body learns in order to help keep us safe.
Hyperarousal
Hyper-arousal can also be known as feeling too much, and is characterized by excessive activation/energy. When you’re in a state of hyperarousal your fight-flight-freeze response is activated and you are in a heightened state of activation. You may not feel in control of your actions when you are in this state. It can often be triggered by perceived threat, traumatic memories, or certain emotions.
Signs of hyperarousal:
Feeling sensitive and edgy
Feeling an urge to flee
Anger outbursts
Anxiety/panic
Emotional overwhelm
Tightness in muscles
Hypoarousal
Hypoarousal prompts the “freeze” or “shut down” response and it is the opposite of hyperarousal. When you are in hypoarousal you are feeling too little. Similar to hyperarousal, it is often triggered by feeling a threat, traumatic memories, or experiencing emotions related to past trauma.
Signs of hypoarousal:
Shutting down for brief periods of time, going to sleep or being unable to think
Becoming unresponsive, unable to hear or respond to someone speaking to you
Avoidance of thinking about anything painful or unpleasant
Feeling numb/detached
What Happens When You Dissociate
Dissociation is a mental process that causes a lack of connection in a person’s thoughts, memory and sense of identity. But moral judgments depend on conscious reasoning from explicitly understood principles and; thus, the condition could cause a dangerous lapse in judgment.
It is mysterious, person-specific, and complex. One of my favorite ways to describe dissociation is, “it feels like the lights are on and nobody’s home.” When you dissociate you feel disconnected from your thoughts, feelings, sensations and beliefs. Your brain is essentially trying to protect you from reliving traumatic memories or experiencing painful emotions including shame, anxiety, and or fear.
Think about an electric fence and what its function is--safety. It is consistent and predictable. Our primary need is safety and if we don’t have that electric fence then we need some other sense of protection. Therefore we put gloves on to touch it and not get hurt but it doesn't change the fact that the fence is electrified. Dissociation is the glove to help keep us unaware of our internal experiences.
Sarah Jenkins, MC, LPC, 2021
Signs of Dissociation in Therapy
When you...
Feel empty or nothing
Ask your therapist to repeat the same questions
Feel as though you are farther away from your therapist than you actually are
Can’t hear your therapist’s voice or it sounds faint
Can’t tell what is real
Feel like you’re in fog
Can’t remember your previous session
Some signs your therapist can sense if you’re dissociating:
They start to pull away
They feel disconnected
They feel confused
They feel numb
They feel like you’ve gone somewhere else
Things don’t add up
They feel a sense of chaos
They feel spacey
You might be wondering why on earth your therapist’s state would change when you’re dissociating. This is because there are reenactments taking place unconsciously in you and in your therapist. We refer to this as “the trance dance”.
Being present in life is a challenge if you struggle with dissociation. Nonetheless, it can also be a challenge to be present in your own therapy session. If you are coming to therapy to work on unresolved trauma from your past, learn how to manage your anxiety, depression, or other related problems; it’s going to be difficult to truly get to the root of the problem if you constantly find yourself dissociating. With the right treatment focus, therapist, and coping skills you can ultimately stop yourself from spacing out and eventually to overcome much of your dissociation.
What Does Your Therapist Do When You Dissociate
When you being to dissociate your therapist can help you ground back to present, this can be done a few different ways:
Ask you silly questions. Did you drive here to session today? How long did it take you to get here? What kind of car do you drive? How much gas do you have left in your gas tank? Where did you get that shirt? Did you eat breakfast? What did you eat for breakfast? The point here is to get your prefrontal cortex back online and help reorient you back to present. Basically, it can help your brain feel safe again! Whatever you may need to help you remember that you are an adult with a life today.
Concentrate on an anchor. Anchors are items that remind us when and where we are. When we see, touch, smell, hear, taste them, we know. This can be literally anything, as long as it is neutral and pleasant for you. It can be helpful to have an anchor in your therapist’s office so that you (or with help from your therapist) can focus on that anchor when you begin to dissociate.
Use of movement. Light movement like standing up, stretching, walking around can help you ground. For some, some brief vigorous activity to get the heart pumping and the energy levels up (ex: jumping jacks, push-ups, or running in place).
Activating your senses of taste/smell. Peppermints or minty gum bring attention to taste and smell. Aromatherapy scents are another option, you can find a scent that you like and keep a small bottle of it with you when you go to your therapy sessions if your therapist doesn’t have essential oils in their office.
Treating Dissociation in Therapy
Treating dissociation is delicate work and in order for treatment to be effective it is essential for you to work with a therapist who is knowledgeable in this area. Orientation and grounding is key for this. When you are dissociating your system is still reacting to the past, therefore to overcome this you first must realize that you are safe and in the present.
The idea is to remember the adult things you are doing today as opposed to a part or parts being stuck in trauma time or how you were in past circumstances. Use what makes sense to you and reflect on what makes you the most aware that you are an adult and are in different circumstances (ex: your age, the age of your children and when they were born, the last time you paid bills, how often you have gotten your tax returns, how long you’ve had your wedding ring, etc.)
Your therapist can help you get more oriented in space and time. If you have a difficult time, orienting in space (being present in the room) then your therapist can help you explore potential triggers that are contributing to this. It can be helpful to compare the differences to the situation in the past and the current situation and name the differences. You can say to yourself, ‘In past circumstances things were like this ______, but now things are like this _____’. Pay close attention to how your body feels after you name these differences. You may notice your body experiencing some settling or the opposite. How your system responds to adaptive information is helpful for your therapist to know to then direct the treatment to help you and parts of you heal.
How to Cope with Dissociation in Therapy
Participate in some grounding movements. In order to stay present, we need to be present in our bodies. Yin Yoga, or a restorative yoga practice, allows the body to access the parasympathetic nervous system, which is the "rest and relax" response. Activating this response prompts your mind and body to be calm so that it may heal. Finding classes or even doing some poses outside of your sessions can help you elicit that feeling of calm and help all parts of you learn to tolerate it (difficulty experiencing and/or tolerating calm is common in traumatized individuals). Read this article to read more about poses that can help heal trauma.
Find anchors in your home. You have already read that having an anchor in your therapist's office can help you manage your dissociation, furthermore it’s important you to be able to continue to do this outside of your sessions. To do this, you can walk around your home and in each room concentrate on the various things you can see, the sounds you hear, the smells you can smell, the things you might taste in the kitchen, the things you can touch or hold. What is important is that you find things that are neutral or pleasing to experience, that is, to see, hear, touch, and they connect you to the present. It’s important that you are intentional when choosing items to be your anchor because the last thing you want is to go to use your anchor and that anchor triggers you or parts of you that then make you feel more dissociated. Consider whether you might want to make a written list of these anchors to have available when you need them, because people often forget to use their anchors when they are under stress.
Be kind to yourself. Learn to appreciate your brain for developing a coping mechanism to help keep you safe and recognize that recovery takes time. Progress isn’t linear, so be sure to give yourself grace throughout this process.
Dissociation Treatment
If you experience dissociation, we can help you understand what you’re going through and provide you with treatment options. Fill out this form or call us at (480) 382-9460 today to learn how we can help you.
Disclaimer for Blog: The content of this blog is meant solely for educational and informational purposes only, and does not constitute mental health or medical advice. It also specifies that use of the blog content does not establish any therapist-client relationships.
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