Have you ever been driving and suddenly realized you didn’t remember the last ten minutes of your drive? Have you ever been in a conversation and recognize you haven’t heard a word the other person just said? Ever daydreamed through a lecture at school? Almost everyone has had their “autopilot” activated at some point in their life. It is a regular function of the human brain to be able to detach from reality and cling to something reassuring to avoid anxieties.
Dissociation may be a normal phenomenon, but like everything in life, all in moderation.
For some, dissociation becomes the main coping mechanism they use to deal with the effects of a trauma response in anxiety disorders, such as PTSD, or other disorders, such as depression. It can present itself unconsciously and feel out of the person’s control. When dissociation becomes the go-to is when it becomes a problem.
There are a few textbook varieties of chronic and disabling dissociation that may call for an official diagnosis. However, not everyone who experiences dissociation fits into an exact category and may therefore be labeled “dissociative disorder not otherwise specified (DDNOS). Dissociation can also be a side effect of other mental illnesses rather than its own unique condition.
As nice as it may seem to “check out” of difficult situations, chronic dissociation comes with a plethora of undesirable side effects, the worst of which being that you are no longer in the driver’s seat of your reality. Your brain ultimately learns how effective it is as keeping you “safe” from a trauma response by detaching from your surroundings, so it keeps doing it — often whether you like it or not.
So what do family and friends need to know when a loved one is dealing with chronic dissociation? While every person is different — and every experience of dissociation is different — here are the top five things to keep in mind based on my personal experience with DDNOS.
The person dissociating is not dangerous
Dissociative disorders, such as dissociative identity disorder (formerly known as multiple personality disorder), often get a bad reputation in the media. We see movies and read books about people who dissociate and commit horrible crimes under the control of a villainous personality. The truth is, when people dissociate, they are doing it not because theyare dangerous, but because they perceive danger toward themselves.
A person experiencing dissociation is typically closed off from others, possibly catatonic. When someone detaches so deeply from reality, it may result in an inability to break out of this shell. In such a state, most people couldn’t hurt a fly, even if they wanted to. Dissociative identity disorder may be the exception, since their alters often are able to act while the person has dissociated, but this does not make them dangerous.
Reality is not an option
Trying to reason with someone who has dissociated is not going to be effective. Reality is exactly what their brain is trying toescape. Bringing it to their attention may only cause them to retreat more.
Anger is not helpful
Anger is another experience that may cause the person dissociating to furtherretreat. They are already reacting to a perceived threat, and anger will only build on that threat. If you must speak with them, use a calm voice and don’t be surprised if they do notrespond.
Additionally, do not attempt to argue. If someone has dissociated, they are not available for this type of interaction. You are talking to a person who cannot reason with you. The person might be able to hear you, but regardless, they may be unable to respond. And if you try to argue long enough, you could rouse their inner child — this is especially likely if the dissociation began when they were young. This will not help anyone, so stay with being supportive.
Acceptance is key
Accept them. Try to understand them. Ask kind questions about what they think would help. Make them comfortable. Tell them they are safe. Protect them.
Grounding techniques can help
“Grounding” refers to the process of physically and mentally connecting with the world around you — the ground you can feel beneath your feet, the scents you can smell in the air, etc. — which can re-establish a sense of reality. Grounding can be beneficial for people experiencing panic attacks and other forms of anxiety, as well as dissociation.
If someone you know experiences dissociation, you can help them learn grounding techniques and be there to facilitate the steps during an episode. Even though people can usually feel the onset of dissociation, it can be difficult to “ground” without help. Having a friend or family member there can make the process more effective, as they can offer support by remembering or reading the necessary steps. There are many techniques to try, so it’s important to find what works for a specific person.
As with any mental illness, people need patience and kindness. They need a break from the stigma of their disorder or symptoms. They need to know they aren't alone.
And now, here is the good news: dissociative disorders can often be treated, given the appropriate mental health care, a safe environment and support of friends and family. As a person who no longer uses dissociation as her main coping mechanism, I can vouch for that.
Allie Cotterman is a mental health advocate, who has been herself dealing with the effects of mental illness her whole life. She has degrees in psychology and teaching, and loves to help inform others on ways to drop the stigma of mental illness. She specifically likes to write about bipolar disorder, dissociative disorders, anxiety disorders, anorexia and borderline personality disorder, as those are her own personal experiences. Educating the public on the difficulties of these diseases will forever be a passion of hers.