Dissociation PTSD Symptoms
Dissociation is a spectrum where one is not fully present in the moment. Examples include having an outer body experience, numbing, repression of feelings and/or sensations, depersonalization, spacing out, memory loss, or feeling as the world you’re in is not real.
Dissociation is often learned as a young person to cope with complex (childhood) trauma or adverse life events; it can even be helpful to survival and not having to feel the magnitude of stress or pain.
As a young person or a child, one does not have the mental efficacy to handle stressful events. This creates a split of self: the traumatized Emotional Part (EP) and the Apparently Normal Part (ANP). The EP is the part of the human psyche that experienced the trauma and is flooded with emotions from the past as if it was still happening. Meanwhile, the ANP is the part that appears “normal” to outsiders, performing daily tasks, going to school, work, etc. The ANP often subconsciously or consciously pushes the EPs away to not feel or fully acknowledge what has happened. There can be many different EPs carrying various emotions and triggers.
It can become a problem as an adult when dissociation aids avoidance and fosters unhealthy patterns. As a therapist, I don’t condemn dissociation. Instead, I work directly with clients’ dissociative parts to better understand and build their unique dissociation profiles. This invites more awareness and safety around when and how to dissociate and can help foster more agency in one’s body.
Symptoms of dissociation
Memory loss
Not hearing what the person in front of you is saying
Detachment or numbness of emotions
Outer body experience
Tunnel vision
Feeling little to no pain
Losing sense of time
Creating a dissociation profile
A dissociation profile aims to bring awareness and understanding to when a person dissociates. Awareness is important because with it comes more choice. You can create your own dissociation profile by listing your triggers and varying types of dissociation.
Triggers
A trigger is not a prerequisite for dissociation, but familiarizing yourself with triggers that are present can help give insight into where it feels too much. Triggers can include people, places or things.
How do you know you’re dissociating?
What does dissociation look like for you? Are you spaced out? Are you unable to feel parts of your body? Do you feel an absence of emotions? Did you forget what the person in front of you just said? Are you observing yourself from outside your body? Did you shut down or feel apathetic?
How intense is your dissociation?
Observe the types of dissociation, then identify and write down the symptoms’ type and intensity. It could be helpful to rank your sensations on a scale from 1-10, 1 being the least and 10 being the most intense.
What happened right before and right after dissociation?
Get descriptive in noticing what happens in the moments before dissociation and when you come back online. Describing your experience and the feelings or lack of feelings/sensations helps invite more awareness to that part of yourself. This question can also help identify patterns that start a cycle and what allows you to settle and feel present.
Safe vs. unsafe places to dissociation
People who dissociate may want to eliminate dissociation completely, which may be difficult. I invite a harm-reduction approach to dissociating — dissociating safely. Take note of any areas dissociation can be dangerous and have a negative impact on your life. Examples can consist of:
driving a car
crossing the street
any moments that require attention to stay out of harm’s way
Putting safeguards in place is necessary to ensure you mitigate risks to your health.
Dissociation Therapy for Complex PTSD
Ego State Therapy and Parts Work can support dissociation and fragmented parts. When working with dissociation, the goal is integration. Therefore, we want to connect and organize your system’s fragmented ANP and EPs. While the ANP may be primarily online, helping you accomplish daily tasks, it can also hold unhealthy behaviors or beliefs. Some examples are chronic worry, avoidance, fear of intimacy, fear of rejection, perfectionism, etc. Learning these different parts (the triggers, action systems, functions, and motives that come with dissociating) is critical in healing from the past and being more fully integrated with new adaptive behaviors in the present.
This article is not meant to be a substitute for seeking professional help, but as a resource to bring more attention and understanding to the dissociative parts of one’s personality. You are also welcome to contact me if you need more support on your journey.
