Not all dissociation is pathological, and it happens more often than some of us might think. It is common in PTSD, as well as in everyday life.
To help us be more informed, we asked experts to describe what dissociation is and what it feels like.
Here are their insights:
Mark D. Rego, M.D.
Psychiatrist | Assistant Clinical Professor of Psychiatry, Yale University School of Medicine
Dissociation always has the quality of some aspect of missing consciousness
Sometimes it is hard to put your finger on this. People express things like being in a dream (some aspect of the world seems missing or unclear) or being personally unreal (here the always recognizable but hard to express the feeling of being yourself is not quite right).
Visual phenomena play a large role in things in the world seeming to not have their normal clarity or proportions (some things seem clear while others do not, usually the background).
Other normal aspects of experience are also distorted like time and the spatial arrangement of the outside world. Mostly things are as I have described. Further changes get into hallucinatory experiences and are not dissociation.
Linda Gantt, Ph.D., ATR-BC
Owner, Intensive Trauma Therapy | Art Therapist
Imagine seeing thousands of colored pixels like a malfunctioning television screen about two feet in front of your eyes
You go to the eye specialist and he can find nothing wrong with your vision. Yet, this occurs over and over especially when you are anxious or upset. As you process your early childhood traumas you come to understand that the television you watched was both soothing and trance-inducing.
You dissociated from the real world and connected to the screen as if it were another person. Even where the screen went to a test pattern or the images turn to “snow” that TV set was the most reliable thing in your world. In fact, it was the only thing you could count on since your parents were so wrapped up in their drug habit.
Imagine seeing yourself your own body from another vantage point
A coal miner trying to stabilize the roof of the mine was suddenly surprised when the ceiling of the mine chamber collapsed on him.
In a split second, he felt that he was at the top of the chamber looking down on his body covered in rubble. His first thought was “Wow, I bet that hurts!” After he was rescued and treated for his broken bones he began walking as part of his physical therapy.
He had the feeling that someone was walking behind him. He tried to catch that guy but never could until he processed his trauma. It turned out this was a phantom body he was experiencing.
A young woman was chronically out of her body after she had been pistol-whipped by her ex-boyfriend and held captive for 24 hours. For seven long years, she had the sense that her body and her consciousness were separated.
She drew a picture that showed what it was like to have her physical body in front of her consciousness, tethered by a cord. She then added another depiction of her consciousness even farther away from her actual body to represent being under extreme stress.
In a hypnosis session, she had a spontaneous reversal of the out-of-body experience when the therapist helped her merge the actual and the imagined bodies.
A middle-aged man had a cerebral aneurysm (a brain bleed) for which he needed brain surgery. The surgery was successful but he suffered transient symptoms of an organic personality disorder with rage attacks and persistent memory problems.
Most distressing of all, he experienced himself as a phantom hovering above and behind his body. However, his intelligence was unchanged and somehow he was able to function. He even returned to his job as a psychotherapist. He constantly felt out of his body but kept it a secret.
He struggled for another four years before seeking help. His therapy began with a hypnotic reconstruction of the surgery. He watch the operation as a hidden observer in the operating room when the scene shifted to his postoperative hospital room. He visualized two of himself side-by-side in the bed.
The therapist guided him to look at a specific object, first from the eyes of one body and then the other, ultimately merging the two together. When he reoriented himself to the present he described feeling like he was now in his body. He was himself again.
Imagine looking in the mirror and couldn’t recognize yourself
What if you had a conviction that you were of another gender with blond hair and blue eyes when you are actually a brunette with brown eyes.
One woman told me of the extreme distress she experienced one day when she saw a hand reaching in front of her to grab a knife from the kitchen drawer. She reached for the knife and then was aware that it was her own hand.
The two hands battled for control of the knife. I had a suspicion that she was describing a dissociative episode so I asked: “Who I am talking to?” The reply came in a voice an octave lower than her normal voice and said: “Wouldn’t you like to know!”
Board Certified Adult Psychiatrist
Dissociation can feel somewhat different for different people but there are generally some common threads in their experiences.
Some people feel as though they have completely “blacked out”
They are unclear on how the day has gone by so quickly or don’t understand how they ended up in their current location. Sometimes it’s hard for people actually “feel” dissociation or to identify dissociation as an event because the experience inherently includes losing touch with reality and not having an ability to be aware.
Clues often come as stories of noticing others have told them they did or said something, and others showing them proof of this, while the person with dissociation has no recollection even when most others would have some recollection after someone may “jog their memory.”
This often includes more than just a simple text that is easily forgotten if anyone’s attention is suddenly and dramatically shifted to something else far more important. (For example, it’s natural for many people to not remember what happened right before a traumatic event.)
In the case of dissociation, there may be gaps of memory and recollection of whole conversations
There can be minutes to hours of lost time. Another clue presents itself when the pattern of stressful events, news, discussions seem to trigger these dissociations.
Many of my patients describe less severe dissociation as feeling in a fog, feeling disconnected from their body, or feeling small or large compared to their actual size. Again these feelings are usually after something uncomfortable has happened or they are reminded of something stressful.
Traci W. Pirri, MSW, LCSW-S
Owner & Director, Hope of the Journey
Dissociation can feel all kinds of ways. Each person experiences it a little differently, which is why it can be easy for people (and therapists and doctors) to mislabel or even misdiagnose as something else. Here’s a quick list of some common descriptors:
This might feel like a brain fog where time moves slowly or feels frozen. You might feel a shift in colors and vision as if a literal fog is swarming around you.
You feel separated from others and from what is going on. You might have an awareness that you have feelings about something, but can’t actually feel them at the moment.
This is commonly described as if your body is on autopilot. You are aware of yourself doing things and saying things, but you feel disconnected from it. You may even disagree with what you are doing/saying, but you are no longer in control of yourself.
This is when you feel like you are floating outside of your body watching what is happening but not truly experiencing it.
The Time Warp
For this type of dissociation, people have little or no memory of blocks of time. If asked about it, some details may or may not come back to you, but big blocks are just wiped clean. You might find receipts in your pockets that you don’t remember.
People might start talking to you as if they know you, but you don’t know who they are. You might suddenly find yourself somewhere without any knowledge of how you got there or what day/time it is.
Dissociation happens to some extent to all of us. For instance, if you’ve ever driven home and suddenly arrive without remembering the trip, you were dissociative for the ride. This would be a pretty common example of The Robot (see above).
When it happens more frequently, leaves you with big blanks in your memory, and begins to impact relationships and functioning, it’s time to look for some professional help. Often significant dissociation is associated with a history of trauma.
But beware: not every therapist is trained in working with dissociation, so make sure to find someone who is. Generally, asking about their training and experience working with dissociation will lead you in the right direction.
Caroline Gebhardt, NCC, APC, RYT
Psychotherapist, Body-Based Psychotherapy | Nationally Certified-Counselor | Registered Yoga Teacher
Dissociation can feel like a spectrum of “checking out”
From daydreaming during a meeting to driving somewhere on autopilot and arriving without remembering stoplights, to feeling separate from the body but still being “in the room” (depersonalization), to having bouts of amnesia making it impossible to remember certain events.
Keeping in mind the spectrum-perspective for dissociation, we all participate when we are a little tired or overwhelmed (like daydreaming during a long meeting), but we don’t all necessarily suffer from amnesia during events where our nervous system senses too much threat to stay present and engaged (like in traumatic situations).
The important thing to remember is that when dissociation becomes serious enough that we disengage from bodily experiences at the moment and perhaps cause harm to ourselves, or when we suffer from amnesia or behave strikingly different from the usual personality, there are deeper traumatic roots that need tending and support.
What does dissociation feel like in disordered eating?
As a therapist specializing in disordered eating, I’ve experienced my clients’ dissociative behaviors show up as automatically engaging in disordered eating behaviors or compulsive exercise.
While modern diet culture influences some of these coping mechanisms and certainly overvalues exercise and dieting as socially acceptable endeavors, the emotional eating or rigid food/exercise rituals become ways for people to cope with deeper feelings and triggers of overwhelm and threat.
Whether these stem from chronic, developmental trauma and/or acute trauma, the nervous system becomes too overwhelmed to cope in a more connected, grounded, biologically healthy way.
Instead of being able to attune to one’s emotional, mental and physical needs in a healthy, sustainable way, food or exercise behaviors become the outlet or focus to help control and soothe deep feelings and sensations of being overwhelmed.
While food and exercise indeed can be used to entertain and even soothe in small doses — our taste buds need pleasure and our body loves to move! — When we restrict or overindulge our food intake and manipulate our body to the point that we ignore or shut down our own interoceptive (internal biological) signals, we risk falling into a slippery slope of disordered eating and fail to recognize and work through the bigger emotional picture at play.
When we have tools and support to stay with the body and mind as we cope with emotional distress or heal from trauma, we no longer need to “check out” or dissociate through food and exercise behaviors and instead are able to engage in a more present, grounded, conscious and fulfilling way.
Certified Mental Health Consultant, Enlightened Reality | Relationship Expert, Maple Holistics
Dissociation allows you to perceive your surroundings without actually being there
In essence, it’s like watching your own life on TV without feelings or really sensing your surroundings. You see them and perceive them, but there is a gap between the environment and your senses.
This gap in perception is difficult to really verbalize and is not always clear to people experiencing dissociation. It is similar to perceiving everything through a cloud.
Often this dissociation is an internal defense mechanism to a traumatic event or intense situation. Your mind disconnects itself in order to protect your consciousness.
Katie Ziskind, LMFT
Owner, Wisdom Within Counseling
Disassociating may feel like dreaming
Disassociating is what happens when someone experiences a severely traumatic event. Their mind goes to a happier place. It’s a survival mechanism for getting through an emotionally shocking or overwhelming event.
For instance, when someone is being sexually abused, for survival, their mind will disassociate. Their brain moved outside of their body. Disassociating may feel like dreaming. It’s unreal. Later on, looking back, usually through therapy for PTSD, a person can reflect and realize they disassociated.
Often, once the trauma is over, the person will disassociate as a protective mechanism, so it needs to be released through therapy. Disassociating is a normal response to PTSD.
Dan Blair, LMFT, LCPC, NCPC, CAMS
Working with dissociation is like someone shut out the light.
It is reported that dissociation is like being pulled through a door, or the part of the brain that can speak and move is stepped on.
Sometimes it’s like being hypnotized or like falling asleep or passing out. It depends on who is coming and why.
Returning to awareness is like waking up; sometimes it’s sudden. Like being in the dark and then the lights unexpectedly go on. It is startling. Most of the time it’s slower. One can gradually hear and see the present. It is like standing in the doorway before you come in the room. Although maybe embarrassing, it is nice to be there. You don’t feel as out of control.
Sometimes, there’s nothing at all. You’re not even conscious. It’s only dark when transitioning, just for that moment. Returning to awareness may be scary if you are not with someone you know and trust. Being alone at that time is okay.
Usually, you are not sure what has happened and there is no clue what you looks like. You may wonder, “Where am I? What happened? Am I dressed properly?”
It’s scary, sometimes relieving, and you can feel crazy and sometimes out of control. But you can also learn to be grateful.