What is dissociation?

Your sense of reality and who you are depend on your feelings, thoughts, sensations, perceptions and
memories.
If these become disconnected from each other, or dont register in your conscious mind, your
sense of identity, your memories, and the way you see yourself and the world around you will change.
This is what happens when you dissociate.
Its as if your mind is not in your body; as if you are looking at yourself from a distance; like looking at a
stranger.
Everyone has periods when we feel disconnected. Sometimes this happens naturally and unconsciously.
For example, we often drive a familiar route, and arrive with no memory of the journey or of what we
were thinking about. Some people even train themselves to use dissociation (i.e. to disconnect) to calm
themselves, or for cultural or spiritual reasons. Sometimes we dissociate as a defence mechanism to
help us deal with and survive traumatic experiences.
Dissociation can also be a side effect of some drugs, medication and alcohol.
Many mental health problems, such as schizophrenia, bipolar disorder and borderline
personality disorder, have dissociative features.
Some people will experience having limited ability to regulate their bodily functions and may feel like
they are going crazy or are out of my body during dissociative events. Other people may lose control
of their emotions or actions during a dissociative event and can do things that are otherwise quite
uncharacteristic. Some people will have limited memory of the dissociative event and may feel surprised
or disoriented when it ends. Many people may later recall what happened during their dissociation, but
others may not be able to remember significant parts of what occurred, sometimes for even for a time
before they dissociated. All of these combined make dissociation a very disturbing and frightening thing
for the people who experience it.
There is an association between traumatic events and the process of dissociation. It may be that
dissociation is a way the mind/brain contends with overwhelming stimuli. There is much more to be
learned about the process of dissociation and the best strategies to address it. Dissociation can be part of
a symptom of an existing mental illness. For example, many people who have experienced a traumatic
event, such as physical or sexual abuse, may have some aspect of dissociation during the event itself
and will be unable to recall details regarding their victimization. For many people diagnosed with
posttraumatic stress disorder (PTSD- , dissociative episodes may be a very troubling symptom of their
illness. Dissociation can also be a symptom associated with certain anxiety disorders, includingpanic
disorder and obsessive-compulsive disorder.

What are dissociative disorders
Dissociative disorders (DD) are conditions that involve disruptions or breakdowns of
memory, awareness, identity or perception. People with dissociative disorders
use dissociation, a defense mechanism, pathologically and involuntarily. Dissociative
disorders are thought to primarily be caused by psychological trauma.
Dissociative disorders are a controversial sub-group of mental illnesses. The most dramatic condition in
this area is called dissociative identity disorder, formerly called multiple personality disorder. The media
has a history of sensational portrayals of dissociative illnesses (e.g., the film The Three Faces of
Eve (1957) and the book Sybil (1974)) and of persons who have pretended to have dissociative illnesses
in order to avoid criminal charges (e.g., the 1996 film Primal Fear). Researchers, clinicians, and the public
alike find the topic compelling and challenging to understand.
The different types of dissociation
There are five types of dissociation:
Amnesia
This is when you cant remember incidents or experiences that happened at a particular time, or
when you cant remember important personal information.
This is perhaps the most common of the dissociative disorders andlike all other dissociative illnesses
is associated with traumatic events. This amnesia can be limited to specific details or events but can
also encompass entire aspects of a persons life.
Dissociative amnesia is a disorder in which the distinctive feature is the patient's inability to
remember important personal information to a degree that cannot be explained by normal
forgetfulness. In many cases, it is a reaction to a traumatic accident or witnessing a violent
crime. Patients with dissociative amnesia may developdepersonalization or trance states as
part of the disorder, but they do not experience a change in identity.

Depersonalisation
A feeling that your body is unreal, changing or dissolving. It also includes out-of-body experiences, such
as seeing yourself as if watching a movie.
marked by recurrent feelings of detachment or distance from one's own experiences and can be
associated with the experience that the world is unreal. While many people experience these sensations
at one point in their lives, an individual with depersonalization disorder has this experience so
frequently or severely that it interrupts his or her functioning.
It is often associated with sleep deprivation or "recreational" drug use. It may be accompanied
by "derealization" (where objects in an environment appear altered). Patients sometimes
describe depersonalization as feeling like a robot or watching themselves from the
outside. Depersonalization disorder may also involve feelings ofnumbness or loss of emotional
"aliveness."
Derealization
The world around you seems unreal. You may see objects changing in shape, size or colour, or you may
feel that other people are robots.
Identity confusion or Dissociative fugue
Feeling uncertain about who you are. You may feel as if there is a struggle within to define
yourself.
A massive disorientation of self that leads to confusion about ones personal
identity and potentially the assumption of a new identity
Again, this condition usually follows a major stressor or trauma. Apart from inability to
recall their past or personal information, patients with dissociative fugue do not behave
strangely or appear disturbed to others. Cases of dissociative fugue are more common in
wartime or in communities disrupted by a natural disaster.

Identity alteration or Dissociative Identity disorder (DID)
This is when there is a shift in your role or identity that changes your behaviour in ways that
others could notice. For instance, you may be very different at work from when you are at home.
Previously called multiple personality disorder, DID is the most famous and controversial of
the dissociative disorders. This is characterized by having multiple alters (personal identities) that
control an individuals behavior and actions at different times.
Dissociative identity disorder (DID) is considered the most severe dissociative disorder and
involves all of the major dissociative symptoms. People with this disorder have more than one
personality state, and the personality state controlling the person's behavior changes from time
to time. Often, a stressor will cause the change in personality state. The various personality
states have separate names, temperaments, gestures, and vocabularies. This disorder is often
associated with severe physical or sexual abuse, especially abuse suffered during childhood.



Dissociation can affect your perception, thinking, feeling, behaviour, body and memory. If you
experience a dissociative disorder you may have to cope with many challenges in life. The impact of
dissociation varies from person to person and may change over time. How well a person appears to be
coping is not a good way of telling how severely affected they are.
The effects of dissociative disorder may include:
gaps in your memory
finding yourself in a strange place without knowing how you got there
out-of-body experiences
loss of feeling in parts of your body
distorted views of your body
forgetting important personal information
being unable to recognize your image in a mirror
a sense of detachment from your emotions
the impression of watching a movie of yourself
feelings of being unreal
internal voices and dialogue
feeling detached from the world
forgetting appointments
feeling that a customary environment is unfamiliar
a sense that what is happening is unreal
forgetting a talent or learned skill
a sense that people you know are strangers
a perception of objects changing shape, color or size
feeling you dont know who you are
acting like different people, including child-like behavior
being unsure of the boundaries between yourself and others
feeling like a stranger to yourself
being confused about your sexuality or gender
feeling like there are different people inside you
referring to yourself as we
being told by others that you have behaved out of character
finding items in your possession that you dont remember buying or receiving
writing in different handwriting
having knowledge of a subject you dont recall studying.
Causes:
Dissociative disorders usually develop as a way to cope with trauma. The disorders most often
form in children subjected to long-term physical, sexual or emotional abuse or, less often, a
home environment that's frightening or highly unpredictable. The stress of war or natural
disasters also can bring on dissociative disorders.
Personal identity is still forming during childhood. So a child is more able than an adult is to step
outside of himself or herself and observe trauma as though it's happening to a different person.
A child who learns to dissociate in order to endure an extended period of youth may use this
coping mechanism in response to stressful situations throughout life.
Complications:
Without treatment, possible complications for a person with a dissociative disorder may
include:Life difficulties such as broken relationships and job loss
Sleep problems such as insomnia
Sexual problems
Severe depression
Anxiety disorders
Eating disorders such as anorexia or bulimia
Problematic drug use including alcoholism
Self-harm, including suicide.

Treatment:
The effectiveness of treatments for dissociative disorders has not been studied. Treatment
options are based on case studies, not research. Generally speaking, treatment may take many
years. Options may include:
A safe environment doctors will try to get the person to feel safe and relaxed, which is enough
to trigger memory recall in some people with dissociative disorders.
Psychiatric drugs such as barbiturates.
Hypnosis may help to recover repressed memories, although this form of treatment for
dissociative disorders is considered controversial.
Psychotherapy also known as talk therapy or counselling, which is usually needed for the
long term. Examples include cognitive therapy and psychoanalysis.
Stress management since stress can trigger symptoms.
Treatment for other disorders typically, a person with a dissociative disorder may have other
mental health problems such as depression or anxiety. Treatment may include antidepressants
or anti-anxiety medications to try to improve the symptoms of the dissociative disorder