Complex PTSD Symptoms:
Dissociation
Dissociation is one of the brain's strongest way to react as a defense mechanism.
Sections:
What Is Dissociation?
Symptoms, Causes, & Types of Dissociation
Healing Dissociative Disorders in C-PTSD
What Is Dissociation?
Dissociation is a mental process in which the mind's ability to automatically and fully integrate all aspects of identity, memory, and consciousness fails under the stress of trauma.
In many cases of Complex PTSD, the person experiences dissociation when confronted by stimuli that remind them of their traumatic experiences.
As a result, a person experiencing dissociation may feel disconnected from the self, and the surrounding environment may seem unreal. This process usually happens with no warning, no planning, and no awareness.
The survival mechanism of dissociation kicks in to protect the central organizing ego from breaking from reality and disintegrating into psychosis.
Hence, fragmented dissociated parts of the personality carry the traumatic experience and memory, while other dissociated parts function in daily life. Consequentially, profound symptoms of depersonalization and dissociation linked to C-PTSD manifest.
Dissociation, like all other symptoms of C-PTSD, is a learned behavior that initially helped you cope with a threatening environment. It is linked to a history of experiencing abusive or neglectful parenting and psychologic trauma.
When a child is neglected or abused they rely upon built-in, biological protection mechanisms for survival to "tune out" threatening experiences.
When we’re getting abused, insulted, or attacked verbally, or mentally, the brain seems to shutdown. It turns off feelings, emotions, and awareness, like a mental shield.
Literally our conscious self gets turned off. The brain may have had good intentions, but dissociation is not a good way to protect one's self.
In adulthood, this dissociation can be perpetuated as you push away the parts of you that hold emotions of fear, shame, or helplessness.
This dissociation becomes a well-maintained division between the part of you involved in keeping up with daily tasks of living and the part of you that is holding emotions of fear, shame, or anger.
You might feel that it's just too much to think about what happened. When emotions or body sensations come to the surface of your awareness, it is common to instinctively push the scary, yucky, painful, or confusing feelings far away by resorting to learned dissociative patterns.
Almost 15% of people with PTSD also experience depersonalization and derealization.
As a result, these people—
Experience PTSD symptoms more frequently
Have onset of PTSD in childhood
Have high exposure to trauma and more childhood adversities (for example, mental illness in a parent, divorce, and poverty)
Experience severe role impairment (for example, they have difficulties in performing job responsibilities and completing work around the house)
Have more suicidal thoughts and make more suicidal gestures, plans, and attempts
Healing dissociation asks you to accommodate the reality of your neglect or abuse. In doing so, you develop the capacity to realize that traumatic events influence your sense of self and your basic assumptions ablut the world.
By cultivating mindful awareness of the "here and now" you can differentiate the past from the present, which gives you access to choices now that were not available to you then. — This plays a crucial role in your ability to adapt to adversity.
Even though they are painful; traumatic patterns are familiar; letting go can actually feel more overwhelming. It can feel safer not to trust people. It can feel easier not to change. Relational psychotherapy with a clinician informed about complex trauma can help. Recommended modalities include EMDR Therapy and Somatic Therapy (body-centered).
The process of healing complex PTSD involves:
- Observing your patterns of dissociation.
- Accepting and loving yourself with all of your defenses.
- Compassionately recognizing the impact of dissociation on your life and relationships today.
- Recognizing that a traumatic event happened to you.
- Realizing that increased awareness brings increased choice.
- Increasing tolerance for rejection, loss, disappointment, shame, conflict, and uncertainty.
- Decreasing the reliance upon defenses that maintain dissociation from painful feelings.
- Recognizing that the frightening or dangerous events are over now.
- Distinguishing between the past and present more clearly.
- Reclaiming flexibility in your body and mind.
- Developing new, healthy expectations about relationships.
- Having a clear understanding of the impact of relational traumas experienced cultivates compassion.
Symptoms of Dissociation
This disconnection can occur as part of a dissociation disorder, or it may be a symptom of another mental health issue. For instance, people with borderline personality disorder, post-traumatic stress disorder, and schizophrenia sometimes experience dissociation.
Someone with dissociation might feel a sense of unreality and lose their connection to time, place, and identity. This is because dissociation disrupts four areas of personal functioning that usually operate together smoothly, automatically, and with few or no problems.
These areas are:
- Consciousness
- Identity
- Memory
- Self-awareness and awareness of surroundings
Breaks in this system of automatic functions can cause dissociation symptoms. Dissociation can range from feeling a mild sense of detachment (daydreaming) to experiencing a more severe disconnection from reality (feeling as if the world is unreal).
If you have a dissociation disorder or a mental health condition involving dissociation, you may sometimes have felt "disconnected" from yourself. Examples of dissociation include:
- "Blanking out" or being unable to remember anything for a period of time
- Experiencing a distorted or blurred sense of reality
- Feeling disconnected or detached from your emotions
- Feeling like you're briefly losing touch with events going on around you, similar to daydreaming
- Feeling numb or distant from yourself and your surroundings
- Feeling that the world around you is unreal and distorted
- Having an altered sense of time and place
- Having flashbacks of traumatic events
- Memory loss about certain events, people, information, or timeframes
It is possible to experience dissociation without being aware of it. Sudden mood changes, difficulty remembering personal details about yourself or your life, and feeling disconnected are all symptoms of dissociation.
Some people with dissociation may experience additional symptoms of depersonalization (feeling as if the self is not real) and derealization (feeling as if the world is not real). Both of these are serious mental health issues.
Depersonalization and derealization are often responses to overwhelming traumatic events that cannot be escaped, such as child abuse and the trauma of war. They help the person to keep functioning at the moment of being severely traumatized.
An example of depersonalization is an out-of-body experience, where people see themselves from above. This lets them feel that whatever is occurring "is not happening to me." In states of derealization, people are detached from their surroundings. This lets them feel that their situation isn't real, or that it is "just a dream."
Causes of Dissociation
Several factors can play a role in the development of dissociation. Among the potential causes are trauma, drug use, and other mental conditions.
TRAUMA
The main cause of dissociative disorders is trauma. In cases such as this, dissociation occurs as a way to keep memories of the traumatic event from feeling overwhelming or too massive to handle.
Dissociation also helps the person distance themselves from the situation. Assault, abuse, accidents, natural disasters, and military combat are all sources of trauma that can cause dissociation.
DRUG USE
Substance use can also cause dissociation. Experiences with dissociation and trauma can even predict the potential for addiction. There are relatively high levels of dissociation among women with both substance use disorder and PTSD.
OTHER MENTAL CONDITIONS
Certain mental health disorders can also cause symptoms of dissociation. PTSD, for example, is often characterized by symptoms of dissociation and detachment.
Types of Dissociation
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), a handbook published by the APA to help mental health professionals diagnose mental illnesses, identifies three types of dissociative disorders:
- Depersonalization-derealization disorder:
This dissociative condition involves feeling detached from one's own body and thoughts. People with DPDR may feel like they are observing their own life as an outsider, or they might feel disconnected from their surroundings.
- Dissociative identity disorder:
This dissociation disorder was previously known as multiple personality disorder. It is characterized by having two or more persistent personality states, sometimes referred to as "split personalities."
- Dissociative amnesia:
This type of dissociation is characterized by forgetting one's personal information. This includes not being able to recall or "losing" memories of past events.
Related Conditions
In addition to these dissociative disorders, dissociation may also occur as a symptom of another condition. Conditions in which someone may experience dissociation include:
- Acute stress disorder
- Affective disorders, also known as mood disorders
- Anxiety
- Attention-deficit/hyperactivity disorder(ADHD)
- Borderline personality disorder (BPD)
- Depression
- Epilepsy
- Migraines
- Obsessive-compulsive disorder (OCD)
- Phobias
- Post-traumatic stress disorder (PTSD)
- Schizophrenia
- Substance use disorders
Healing Dissociative Disorders in C-PTSD
Dissociative disorders are conditions that involve disruptions or breakdowns of memory, awareness, identity, or perception.
In the context of severe chronic abuse, the reliance on disassociation is adaptive, as it succeeds in reducing unbearable distress, and warding off the threat of psychological annihilation.
The dissociative disorders a survivor of chronic trauma presents with vary and are inclusive of dissociative identity disorder, dissociative amnesia, dissociative fugue, and depersonalization disorder.
Identity confusion is also deemed a by-product of dissociation and is linked to fugue states when the traumatized person loses memory of their past and concomitantly, a tangible sense of their personal identity.
The treatment process for those afflicted with C-PTSD and attendant dissociative disorders is extensive and comprehensive. Depending on the severity of the repetitious traumas, even in progressed stages of recovery a client may find himself grappling with persistent feelings of detachment and derealization.
Given that the brains mediation of psychological functions is dramatically compromised by the impact of chronic trauma, this neurobiological impact may be a strong contributing factor regarding lingering dissociative symptoms in survivors of C-PTSD.
When a child’s brain is habitually set to a fear response system so as to survive daily threat, brain cells are killed, and the inordinate production of stress hormones interferes with returning to a state of homeostasis.
Turning to dissociative states to relieve the pain of hyperarousal further exacerbates the effective use of ones executive functions, such as emotional regulation and socialization.
Accordingly, neuroimaging findings reveal that cortical processing of emotional material is reduced in those presenting with C-PTSD and an increase in amygdala activity, where anxiety and fear responses persists.
In spite of the harrowing repercussions of prolonged traumatic abuse and neglect, those suffering from C-PTSD and dissociative disorders profit from working through overwhelming material with a caring, seasoned professional.
Treating the sequelae of complex trauma means establishing stabilization, resolving traumatic memory, and achieving personality (re)integration and rehabilitation.
Integrating and reclaiming dissociated and disowned aspects of the personality is largely dependent on constructing a cohesive narrative, which allows for the assimilation of emotional, cognitive, and physiological realities.
And finally, when fight/flight responses diminish and an enhanced sense of hope and love for self and others results from years of courageous, painstaking hard work, the survivor reaps the rewards of this capricious and harrowing journey; ones True Self.
SOURCES:
CPTSD
Workbook, Arielle Schwartz PhD/ CPTSD Treatment Manual__CPTSD: From Surviving
to Thriving, Pete
Walker__www.verywellmind.com/what-is-complex-ptsd__psychcentral.com/ptsd/complex-posttraumatic-stress-disorder-symptoms#common-triggers__goodtherapy.org/dissociation-c-ptsd-role-of-detachment-in-complex-trauma___crappychilhoodfairy.com/cptsd-behaviors-like-narcissism__Crittenden,
P. M., Heller, M. B. (2017). The roots of chronic posttraumatic stress
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D. M. Treating adults with complex trauma: An evidence-based case study.
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Behavior, Written by Silvi Saxena MBA, MSW, LSW, CCTP, OSW-C/Reviewed by Raiy Abulhosn
MD__ https://psychcentral.com/pro/complex-ptsd-and-the-realm-of-dissociation
SOURCES:
CPTSD
Workbook, Arielle Schwartz PhD/ CPTSD Treatment Manual__CPTSD: From Surviving
to Thriving, Pete
Walker__www.verywellmind.com/what-is-complex-ptsd__psychcentral.com/ptsd/complex-posttraumatic-stress-disorder-symptoms#common-triggers__goodtherapy.org/dissociation-c-ptsd-role-of-detachment-in-complex-trauma___crappychilhoodfairy.com/cptsd-behaviors-like-narcissism__Crittenden,
P. M., Heller, M. B. (2017). The roots of chronic posttraumatic stress
disorder: Childhood trauma, information processing, and self-protective
strategies. Chronic Stress, 1, 1-13
https://journals.sagepub.com/doi/10.1177/2470547016682965__Kessler, R. C.,
& Bromet, E. J. (2013). The epidemiology of depression across cultures.
Annual Review of Public Health, 34, 119–138. https://www.annualreviews.org/doi/10.1146/annurev-publhealth-031912-114409__Lawson,
D. M. Treating adults with complex trauma: An evidence-based case study.
Journal of Counseling and Development,
https://onlinelibrary.wiley.com/doi/abs/10.1002/jcad.12143 Sar, V. (2011, March
7)__Developmental trauma, complex PTSD, and the current proposal of
DSM-5__European Journal of Psychotraumatology,
https://www.tandfonline.com/doi/full/10.3402/ejpt.v2i0.5622__Tarocchi, A.,
Aschieri, F., Fantini, F., & Smith, J. D. Therapeutic assessment of complex
trauma: A single-case time-series study. Clinical Case Studies, 12, 228–245. https://journals.sagepub.com/doi/10.1177/1534650113479442__https://www.verywellmind.com/agoraphobia-101-2584235__Avoidance
Behavior, Written by Silvi Saxena MBA, MSW, LSW, CCTP, OSW-C/Reviewed by Raiy Abulhosn
MD__ https://psychcentral.com/pro/complex-ptsd-and-the-realm-of-dissociation