Dissociation can range from normal dissociation, (a common and temporary response to trauma) to increasing degrees of dissociative disorders. DID is considered on the extreme end of this spectrum (Van Der Kolk, The Body Keeps the Score, 2015).
Defining Dissociation
Dissociation may be defined as the failure of integration. Ingetration is what we do as we process any information. Normally, facts and experiences are incorporated into our understanding of self and personal history. Dissociation occurs when one struggles with derealization or depersonalization. In other words, sense of self or events take on a feeling of being unreal. Sometimes this may cause amnesia for the traumatic event that can later manifest itself in dissociative flashbacks. In DID the psyche actually stores information in separate dissociated parts called alter egos. Those with dissociative disorders use dissociaton for coping or may have different aspects of personality that manifest in different environments, but the personality aspects are not so separated or even walled off as in DID.
Whenever we experience trauma, some extent of integration is needed in order to heal. This means accepting the reality of the trauma and making it part of one’s personal story, so that can be retrieved without re-experiencing the trauma in a PTSD manner. This may mean being able to recall the trauma history without feeling signifiant betrayal, fear, anger, and/or helplessness.( http://did-research.org , on the home page click on treatment and then click on Integration).
PTSD and Dissociation in Childhood
DID has its beginnings in childhood, typically with trauma and/or abuse as young child. However, someone who has “split” and become DID as a young child will likely use this same mechanism to process trauma later in life. DID allows young children to emotionally distance themselves from unbearable, confusing experiences. Here the mind is required to distance itself from the experience and keep it out of conscious memory. This is made more difficult when the abuse comes from parental figures whom children need for protection and safety. It is hard to say at what point childhood trauma requires the young mind to create an alter ego. Perhaps there is a threshold of accumulated factors that reach a threshold and require a “split.” There are likely both internal and external variables.
Coping with Dissociation
Since DID is a dissociative disorder, having some techniques to deal with dissociation is very helpful. Dissociation is the “go to” coping mechanism for those with DID. Even after integration, I was aware that dissociation in stressful situations was common.
For me, “mindfulness” was a helpful technique. There is much literature on this subject if you just google it. The Science of Mindfulness: A Research-Based Path to Well-Being from The Great Courses was helpful. I also used a number of meditation videos found on the internet. Learning to meditate was a way for me to decrease stress and dissociation.
The internet site mentioned above http://did-research.org has a sizable list of grounding techniques. Grounding techniques are ways to get oriented in the present rather than being overwhelmmed by or being cutoff from emotions. It lists multiple ideas in the following areas:
1. Mental distracion techniques that engage the intellectual mind 2. Reorienting techniques with ways to focus and interct with your present physical world. A script that you can say to yourself to help your mimd feel more safe and present is also described. 3. Sensory-based grounding techniques where you use your senses to explore you present environment 4. Movement-based grounding techniques that include breathing techniques and doing things to connect you with your immediate environment. 5. Imagery techniques that includes picturing yourself in ways that create relaxation.
Lastly they desribe how to make a “grounding box” with items and written ideas that you can go to whenever you are feeling dissociated or depersonalized.
It also give you ideas to prepare ahead of time for when you have a flashback or panic attack.
Coming Up
For the next few blogs, I would like to write about integration. I integrated about 9 years ago. In was a process and when my alter egos integrated, I no longer had parts that talked to me in my head. The internal quiet was different. I had worked so many years on integration that I thought that when this happened I would be “all better.” I was so much better in many ways, but there was still some healing to do with how my self system worked in present real life when major stresses came up. The studies that have been done in the last nine years and the website I have mentioned in this blog would have really been helpful for me. I wish that I had known what to expect after integration. More to come…..