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Dissociation is when you feel disconnected from the world around you. A dissociative episode can last anywhere from a few minutes to months at a time, and often comes and goes.
Mild dissociation is very normal, such as when you get lost in your thoughts and aren’t aware of what’s going on around you – you ‘zone out’.
More severe forms of dissociation are often part of a dissociative mental disorder but can be a part of other mental health or neurological conditions, such as bipolar disorder, amnesia, post-traumatic stress disorder, dissociative identity disorder, emotionally unstable personality disorder, schizophrenia, anxiety, depression or a brain injury.
It can also be stress-induced or a defence mechanism caused by trauma. People can experience it or even use it as a way to detach themselves from their situation.
Types of dissociation
Dissociation can often be categorised by the symptoms presented. However, everybody experiences dissociation differently so many people’s experience does not align with one type, or can fall into more than one category.
The two main types of dissociation are:
Derealisation
Derealisation is when the world around you feels strange and unfamiliar, like you are in a dream. The world can feel off and a bit sinister at times. It’s like you are going around in this strange bubble that you can’t break out of, you can interact with the environment but you aren’t fully there. It can feel as if there’s a barrier between you and the world.
Depersonalisation
Depersonalisation is when you feel detached from your own body. It can feel like you are watching your movements and emotions from outside your body, as if they are happening to somebody else. An example might be that you are walking with a friend and experience a dissociative episode; you can feel your legs walking and see that your friend is talking to you, but you don’t feel like it is you that is consciously moving your legs and your brain is not forming any meaning from what your friend is saying, even though you can hear them.
Other types of dissociation include:
Dissociative identity
This goes by a few different names, but dissociation around identity is when you feel uncertain about who you are. People with dissociative identity can often feel like they have more than one personality, even having a name for their other identity and feeling like they cannot control it. This can be a form of denial to escape themselves, especially if their other identity is a child or an idealised version of themselves.
Dissociative amnesia
This is when you temporarily or permanently forget events as a response to trauma. For example, someone who was abused may not recall it happening or how they felt. It can be less severe than this, such as remembering very little about a job you were very unhappy in, as if your mind is ‘blocking it out’. A 1999 study published in the Australian and New Zealand Journal of Psychiatry found that many combat soldiers who served in the First World War experienced dissociative amnesia.
Intentional dissociation
Sometimes people can dissociate intentionally to remove themselves emotionally or consciously from a situation. This could be as harmless as choosing to slip into a vivid daydream in a boring class to something more serious, such as an abuser attributing their actions and anger to a separate identity in them that they tell themselves they can’t control.
Signs and symptoms of dissociation
Signs and symptoms that you are experiencing dissociation can include:
- Feeling like you’ve snapped back to reality or woken from being asleep when you’ve been awake the whole time
- When travelling, not remembering how you got somewhere. You may worry that you didn’t drive/walk/cycle safely, but usually you did
- Forgetting unhappy or traumatic events or periods of your life
- Feeling like you are in a dream and nothing around you is real
- Feeling out of synch with the world around you. For example you may feel like you are walking very quickly and that everything around you is moving very slowly
- Looking in the mirror and not really recognising the reflection as yourself, even though you know it is
- Not being able to recognise or understand information being picked up by your senses, as if your brain isn’t connected with them
- Losing control of your body movements
- Feeling apathetic in emotional or distressing situations.
If you know someone who experiences moderate to intense dissociation, signs that they are having an episode could include:
- They may look like they are not listening to you
- Staring blankly at you
- Forgetting something you just told them
- They may say strange things about how they are feeling.
What to do if you are dissociating
If you feel yourself slipping into a dissociative episode, one technique taught by psychotherapists is the grounding technique. This is when you use your senses to bring your mind back to reality.
To do it, keep calm and try to find:
- 5 things you can see, and name them out loud or mentally note them
- 4 things you can touch; textures like tree bark or water are really helpful here
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste
Some people keep a box containing things that can help them with this technique. It could contain items such as a stress ball, a music box, nice-smelling hand cream or essential oils, photos etc.
Also, try not to worry about it too much. Stress and anxiety can trigger a dissociative episode, so stressing about the dissociation itself can make it worse.
You should see your GP if you dissociate often or even have one experience of it that scares you, it may be a sign of a bigger underlying issue.
Treatments for dissociation
Your GP can refer you for treatment for dissociation and dissociative disorders.
These treatments could include:
Psychotherapy
Psychotherapy is the main treatment for dissociative disorders. A psychotherapist can help you to address underlying trauma and explore alternative coping strategies with you through talking therapy. They can help you to identify situations where you dissociate, such as in certain places or situations that you find stressful, and discuss how to manage them. You can find psychotherapists that specialise in the particular type of trauma you have experienced, such as abuse, bereavement, an accident, addiction or depression.
Medication
Antidepressants or antipsychotics can help with the cause of your dissociative episodes, but there is no medication specifically for dissociation.
How to support someone who is experiencing disassociation
If somebody you know is experiencing dissociation, they may be unusually tired or struggle to hold long conversations.
You may find it frustrating that they zone out while you are talking to them, but remember to be patient, it’s not their fault or that they’re intentionally not listening. Encourage them to leave the room or go outside for a minute as a change of scenery can really help. If they have a dissociation box nearby, you could fetch it for them.
If they become distressed, try to calm them in ways that help to ground them, such as by holding their hand or lighting a candle.
Helplines
If you are experiencing a dissociative episode or frequent episodes that you feel need urgent medical attention, call NHS 111 or make an urgent appointment with your GP. If you are feeling suicidal or at serious risk of harming yourself, go to A&E.
Helplines that you can use to discuss your dissociation or the trauma/emotions behind it include:
| Samaritans | 116 123 Open at all times | jo@samaritans.org |
| SANEline | 0300 304 7000 4:30 pm – 10:30pm, Monday – Sunday | |
| Rethink Mental Illness | 0300 5000 937 Open 9:30am – 4pm, Monday – Friday | advice@rethink.org |
| C.A.L.L. | 0800 132 737 Open at all times, available in Wales |