[ WHAT IS DISSOCIATION? ]
Dissociation is generally known as a disconnect between oneself and what is actually going on. This is different from psychosis which is known from a break in reality. (Psychosis causes hallucinations, delusions, and stuff seen in things like schizophrenia.) There are many forms of dissociation and among them, some considered normal and some considered chronic and can be qualified as a disorder and some that are symptoms that are part of other disorders. The prime core idea of dissociation and the behavior associated with it is where the mind does not necessarily connect everything in the way that it should be and almost like there is a break in a circuit. [ WHAT IS “NORMAL” DISSOCIATION?]
When talking about dissociation, it is important to address that not all dissociation is abnormal, worthy of concern and alarm, hoặc a disorder. In fact, dissociation is actually considered something that the good majority of the population will experience in a mild degree and a good chunk of people in the world, especially those who are mentally ill with a different disorder, will experience at least one notable ‘dissociative episode’ in their life.
Some common forms of ‘normal’ dissociation that almost everyone encounters a few times in their life is automatic driving, getting ‘lost’ in a book, hoặc getting really Mất tích off in thought. In these cases, the mind is not entirely present hoặc grounded into the world around it and instead are off thinking about something else hoặc completely distracted bởi whatever is going on in their head. As a result, when driving, one might not remember the entire drive when they arrive - normal dissociation. As a result of getting too far into a book, one might lose track of time hoặc be unaware of their roommate coming in and turning on the ti vi since their mind disconnected from the surroundings and stopped picking up / registering any of the stimuli in the actual world which is very similar to zoning out. To experience this occasionally is entirely normal and to get Mất tích in plans is also normal as even the most ‘neurotypical’ person can experience these types. ((Small detail, but its noted that a lot of people who dissociate also tend to be rather creative; however correlation is not causation and the relationship between the two of them is not proven to my current knowledge of that.))
In addition, experiencing a moderate episode one hoặc twice in your life can also be considered somewhat normal as well; however that in its own often is due to a different disorder, depression, hoặc anxiety getting out of hand.
As for a ‘normal - abnormal’ moment of dissociation is in the short period after a traumatic event. After a traumatic event hoặc accident (sudden death, car accidents, etc) it is normal to actually have mild to moderate dissociation for a certain length of time (I believe its a month), however if it continues, it (along with PTSD) might be considered rather abnormal. Still, if the dissociation fades as the trauma is processed, that dissociation is considered to be expected and normal to a degree. [ MALADAPTIVE Daydreaming ]
So a quick disclaimer. Maladaptive Daydreaming has not been shown to necessarily be dissociative in nature and is rather thêm so a thảo luận on its correlation. This section is thêm so a personal commentary as a recovered severe maladaptive daydreamer and someone who experiences severe dissociation.
Maladaptive Daydreaming, for those that do not know, is the excessive and vivid ability, tendency, and practical addiction to daydreams that some people have and can develop. Often these daydreams consist of things that they themselves wish could be their life (such as marrying a celebrity they love, being rich and famous, having their ideal dream life) to which they put themselves into and live out in their head hoặc could be extensive storylines with characters that they may hoặc may not self insert them into. Often, in both cases, the person gets so invested into their Daydreaming that they may take preference to and replace actual human interaction with their daydreamed interaction, lose the ability to control the daydreaming, and lose hours of their ngày to the daydreams that they have created.
Personally, I decided to put this into this bài viết since I personally believe that Maladaptive Daydreaming has roots in dissociation and is often something that many strongly dissociative people are also prone to doing. No, I am not saying that if bạn are a Maladaptive Daydreamer that bạn are dissociative nor am I saying the opposite, but I do believe there is a strong section of comorbidity and shared characteristics between Maladaptive Daydreaming and Mild/Moderate Dissociation. ((To also put a disclaimer, this could also be accounted to be a compulsive behavior and thus be equally related to mild forms of OCD and research says that there is also a high comorbidity between maladaptive Daydreaming and schizophernia and depression as well.))
However, when looking at Maladaptive Daydreaming we can see forms of dissociation that border between normal and abnormal dissociation. In the cases of this, we see similar things to the aforementioned “lost in the story” and “loses ability to be conscious of the world around them” traits in the “Normal Dissociation” section, but when we bring together the fact that this is frequently done, chronic, and a bit out of control, we have to consider that it might not necessarily be entirely normal but rather to a degree abnormal.
From personal experience, Maladaptive Daydreaming can easily
mix with dissociation as dissociation calls for an escape and retreat from the world, and Maladaptive Daydreaming provides it. In this case, it becomes a very dangerous cycle that makes both problems worse. In addition, another similarity between the two is the common reasons why they occur. ((Another disclaimer: Maladaptive Daydreaming is a rather under researched, under discussed, and unrecognized psychological condition / phenomenon and there is a lot I am actually missing in here. Cause of Maladaptive Daydreaming is actually unknown and I do know some people are like this from a young age despite a lack of any of the reasons mentioned in the tiếp theo section. This section just explains my current knowledge of it.)) [ CAUSES OF CHRONIC DISSOCIATION AND DISSOCIATIVE TENDENCIES ]
Back onto actual defined dissociative topics, dissociation is actually one of the few mental disorders and conditions where a cause is considerably well known and agreed on my professionals and that cause is the one and only…. trauma.
To be thêm specific with that, dissociation is often caused bởi childhood trauma with a positive correlation and trend between the severity of the dissociation and the severity and how frequently one was exposed to trauma and abuse as a child. This is not to say that dissociation is exclusive to those abused as a child as some may develop it due to long term trauma in adulthood along with PTSD and many other situations; however with that being said, dissociation is much thêm common and much thêm severe in those with repeated childhood exposure to trauma and abuse.
This is essentially because at a young age, children are actually very dependent on the adults around them to take care of them and due to their developing minds, lack of identity, and inability to flee, they are extremely skilled and capable at dissociating. When faced with a traumatic situation at a young age, children are known to escape internally (since they can’t run away from the adults they depend on nor could they fight them; thus bringing on the “freeze” part of fight hoặc flight). When this is done repetitively in childhood, it can easily become one of the strongest and fastest, if not THE strongest and fastest, coping mechanism that they use and unlike most children that loose the ability to dissociation, they maintain it into teenage years and then adulthood to which the coping mechanism becomes a problematic dissociative disorder. What kept them surviving in a traumatic environment at a child essentially becomes an outdated, problematic disorder that is not actually applicable to the real world that is not demanding such excessive defenses.
For general trauma as well, dissociation is a process done when the brain can not make sense of the world, can not handle the world, and/or is overwhelmed bởi what is going on around and thus is essentially overwhelmed and overloaded to the point the brain disconnects from what is going on in order to maintain itself. Therefore, when extremely depressed hoặc faced with a traumatic event, the brain goes through a stage of denial to which is will fall into a dissociative state in order to protect itself from actually feeling hoặc experiencing what is going on at the time.
In the end, the core cause of dissociation is known to be an overwhelming amount of anxiety, fear, threats, and negative emotion that the psyche can not handle and in order to shield itself, it disconnects in some way hoặc form so it “does not have to” experience what is overwhelming it. When thinking in the core of people who dissociate, this concept remains sturdy. For those with dissociative disorders, dissociation occurs when they are threatened hoặc overwhelmed and for some, depending on how much of a primary coping mechanism that it became in their childhood, it may have a higher hoặc lower threshold for when they whip out the dissociative defense card. [ WHAT IS THE DISSOCIATIVE SPECTRUM? ]
So then we have to address the dissociative spectrum. The “Dissociative Spectrum” is used to describe the different types and severity of dissociative disorders and symptoms. I actually could not find enough consistent “spectrums” that rated the level of dissociation, but I felt this one was pretty good so if bạn want to see a suggested one, link
Within the spectrum, there are four core types if chronic / dissociative disorders: Depersonalization and/or Derealization Disorder, Dissociative Amnesia, Dissociative Fugue, and Dissociative Identity Disorder. In addition to that there is an extra disorder called “Dissociative Disorder Not Otherwise Specified” which has four sub-categories to describe which it falls best into. That diagnosis is often được trao either due to time constraints in clinical evaluations hoặc due to an individual being slightly off the mark for one of the main disorders / types of dissociation. [ DEPERSONALIZATION / DEREALIZATION ]
Depersonalization / Derealization is one of the most common forms of dissociation that occurs and, much like previously mentioned, there is a degree to which these are both considered relatively normal.
Depersonalization is where the body and mind disconnect themselves from one another and the reality of the situation going on internally. This can come in the form of feeling like bạn aren’t in your body, not being able to feel your emotions, and/or feeling like your body isn’t real. This can actually extend all the way outwards to feeling like a full on out of body experience for some. The core thing about depersonalization is a detatchment from one’s self and it is often a form of coping mechanism as to lessen the extreme emotions and experiences going on. This can even detatch one from people they otherwise had strong attachments to otherwise as their emotions would be disconnected. “It isn’t me going through this.” “I don’t feel like this is really my issue even though I know that it is.” This can sometimes also come with sensory distortions such as sound being muffled, words being blurry, etc but nothing to the level of psychosis. Generally, when this becomes repetitive and chronic, it may actually result in the diagnosis of Depersonalization Disorder. Often, like other dissociative symptoms, they often only get to the point of a disorder if the coping mechanism of depersonalizing is something that was established at a young age.
I would put a personal anecdote of my depersonalization, but I have trouble remembering them and often they overlap with my Dissociative Identity Disorder experiences and Dissociative Fugue.
Derealization is similar to depersonalization but instead of the body and the mind, it is the world and the mind. This is essentially where bạn mind pulls itself back from reality and disconnects itself in a way that makes the world feel unreal, fake, distant, hoặc empty. This can come with some perspective issues similar to depersonalization where some might feel / see the world as being unrealistic looking and the feeling of touch being off. This can be in retrospect as well where the event itself that bạn experienced might not feel real at all when bạn look back on it. This is pretty much just as common as depersonalization and together they make up the two main types of dissociative symptoms.
From personal experience, derealization is a rather unsettling experience, but due to the fact it is also often paired with the emotional detatchment of derealization, I am both very unsettled, and too detatched / apathetic to really be unsettled. I do remember a lot of the time though when I went through several months of being in a constant state of dissociation that I would sometimes just touch leaves and objects in hope that I could find that ‘spark’ hoặc ‘connection’ I used to have that made the object feel real but never finding it. It is a sense of connection bạn don’t really notice until it is gone. It felt like literally everything, no matter how close they were to me hoặc even if I was physically touching it, they were all a mile away and I just was walking independent of the world.
While those both explain the thêm disorder-like version of the symptoms, depersonalization is considered relatively normal as a normal level occurs when bạn get really into a book, watch a movie, do repetitive boring tasks, travel from work and back, and so on. It is also a bit of a thing that happens within normal daydreaming. Of course, these can extend further into thêm abnormal areas without being a full on disorder because - as mentioned above - dissociation is a massive spectrum. [ DISSOCIATIVE AMNESIA ]
Dissociative Amnesia is one of the thêm higher end forms of dissociative symptoms that some might experience and this is a common trait within Complex PTSD. Dissociative Amnesia, is as bạn would imagine it to be from what it is called. It is the disconnect of some to all of the memory one experiences of an event as to disconnect itself from the event and protect oneself. When the pain, stress, and/or trauma of event becomes too severe for the body and brain to properly handle it, the mind tries to escape the stress bởi essentially forgetting about it and removing it from the consciousness. Unlike some other forms of Amnesia, Dissociative Amnesia isn’t full on destruction of the memory. Often times, the memory still remains somewhere in the mind and can be dug up. What changes though is how severely repressed and buried the memory is. In extreme cases, the memory may be entirely separated off from an identity state and only accessible bởi an alternate identity state in cases like Dissociative Identity Disorder. Within Dissociative Amnesia there are a few specific patterns that are the most common.
Firstly, we have Localized Amnesia. This is where people struggle to remember a limited and estimated amount of time surrounding the time before, during, and after a traumatic event. One that I saw while researching this was survivors of the attacks on 9/11 couldn’t remember how they got out.
Secondly, we have Selective Amnesia. This is where people can not remember some but not all of what have happened over a certain length of time. This often creates holes in memory and/or parts of an tổng thể memory that is missing. An example of this is remembering that they ate and were shot and went to the hospital, but pieces in the middle were missing. Additionally, it could be the entire loss of the emotional / visual aspects to the memory while still maintaining the general idea of what had gone on.
Thirdly, we have Generalized Amneisa. This is completely forgetting / being unable to recall any parts of your life. This often results in them being found bởi the police hoặc taken to the emergency room due to the level of confusion this can cause.
Fourthly, we have Continuous Amnesia. This is where the memory is consistently gone without any interruptions from the traumatic event up to until the present. I can’t think of any specific good examples of this off the hàng đầu, đầu trang of my head.
And lastly, we have Systemized Amnesia. This is where only memories and events related to a specific topic, event, location, hoặc person are lost. This can be memories relating to the place trauma occured hoặc memories relating to a person that had inflicted the trauma / had been around the trauma.
From personal experience with this, my Dissociative Amnesia is a mix between Selective and Systemized; however it is better suited to being labeled under Dissociative Identity Disorder with how the memories function for me. When it comes to Dissociative Amnesia, it can be quite problematic depending on how severe it is and which pattern it falls into. For some it might be a blessing to not remember, but others it can be quite distressing. On the front of Generalized and Continuous Amnesia, it can cause major dysfunction in life as memory is being Mất tích quite frequently. Often journals, notes, and reliable Những người bạn can often do good to help with thêm long term and frequent memory issues.
Like mentioned above however, Dissociative Amnesia can applie to all parts and forms of memory which can go from Implicit Memory, Explicit Memory, Episodic, Procedural, etc and the components that make up memory.
Often Dissociative Amnesia results as to cope with a traumatic event hoặc a moment of extreme emotional stress / distress and as of such can occur in a variety of different disorders. [ DISSOCIATIVE FUGUE ]
Dissociative Fugue is thêm of a tiêu đề for a type of episode than it is necessarily a symptom. In an episode of Dissociative Fugue, one where the person experiencing it can not recall some hoặc part of their past / self and may hoặc may not travel away from trang chủ in an abnormal manner. In these states, there is a considerably large amount of dissociation going on at the time, but instead of it being notably debilitating, the body functions regularly and such a state can often be completely unnoticed bởi onlookers. People experiencing a fugue state may be confused as to their identity and / hoặc take on a partial hoặc complete new identity that they believe to be their own. Often, while in a fugue state, the person experiencing it will not be aware of it hoặc have low awareness of it and it is often considered bởi onlookers when the person is confused about their past, identity, hoặc lack thereof. Usually the fugue state isn’t noticed until the person experiencing ‘comes to’ and suddenly find them in a place they don’t recognize and having gotten to a place they don’t remember traveling to hoặc doing things they themselves don’t remembering doing since it was done in a fugue state. These states can last for just a few phút up to months to years at a time.
In the case that this isn’t part of Dissociative Identity Disorder (to which if someone has frequent states of dissociative fugue, it often is) it is often due to an extreme stressor being placed on someone who already was dissociative, experiences of trauma of some sort, hoặc extreme emotional distress that causes the original identity to be temporarily abandoned.
I actually didn’t know that I did this a lot
until I started seeing a therapist that specialized in dissociation and he straight out noted that most people do not do as complex activities hoặc function as thoroughly and without memory as much as I do while being severely dissociated like I do. In retrospect, it does make a lot of since. In my fugue states, while I don’t go into full on identity alteration hoặc any severely notable loss of memory (unless bạn count the times when my alters front 100%), I do disconnect strongly from myself. This actually doesn’t often come to have major disruptions in my life as I don’t tend to stray too far off from what I generally originally do on a ngày when I am in a fugue state, but I tend to get a lot of work done and do a lot of duties and just shrug it off. [ DISSOCIATIVE IDENTITY DISORDER ]
And now we have reached the reason I actually went back to this bài viết and went to go finish and complete it. Dissociative Identity Disorder is pretty much the most severe form of dissociation that experiences pretty much all forms of dissociation of the types previously mentioned. There are different severities of Dissociative Identity Disorder relating to if they are polyfragmented hoặc not (where alters have alters) and how many alters they have and how severe the memory blocks are / how poor the communication is between the alters, but DID is pretty much the largest form of dissociation the DSM-V currently has.
Dissociative Identity Disorder (previously known as Multiple Personality Disorder prior to the 1990s) is where an individual has two hoặc thêm distinct personality states / identities. With these personality states / identities, each one has its own way with interacting, perceiving, interpreting, relating to, and understanding the world around them. They often have different core beliefs, different outlooks on the world and people as a whole, different memories, different behaviors, different consciousness, and can even have different skills. With having these distinct personality states / identities, people with DID almost always have experiences of depersonalization, derealization, dissociative amnesia, and dissociative fugue as all of those play a key role in how DID functions.
DID, unlike the trước đó disorders, are almost exclusively formed due to repeated trauma that happened in childhood before the age of 9-12 (the exact age is under debate) since it is formed bởi the trauma causing issues integrating a child into a singular identity / hole. The most common forms of trauma that result in this is repetitive physical abuse, sexual abuse, and emotional neglect.
To keep the large theory of structural dissociation and childhood personality development in relation to DID short, essentially when a child is born they do not have a experience and basis to create a strong sense of singular personality, identity, core beliefs, and sense of self. In order to function, they multiple ‘personality states’ to handle various needs and tasks and over time they slowly combine and integrate those states into a general single sense of “I” which occurs around the age of 9-12 years old. After that point in time, if a single sense of self is established, it is near impossible to chẻ, phân chia, split up as a severely as to form something like DID. However, in the case of DID, the severe and repetitive trauma forms the personality states to have very conflicting attachments, ideas, beliefs, and emotional responses to the world that makes it very difficult to integrate and/or amnesiac “walls” (Dissociative Amnesia) has made it so that the personality states can not properly merge into one. Some states will merge with others, while some that are incompatible hoặc blocked bởi amnesiac “walls” will not integrate and will instead become the alters / personalities that make up DID. One personality might have learned that their father is an toàn, két an toàn and loving and have an attachment to him having not experienced any of the abuse that another personality state did experience that causes that personality state to fear their father. Due to the separated memory and dramatically different emotions related to their father, the personality states are unable to merge.
Often, when they form, alters are chẻ, phân chia, split into one of two categories. “Apparently Normal Parts” which are alters that have no memory of the trauma that they underwent hoặc they do have memory of the trauma but are extremely detatched from it and have no emotions tied to it. Due to having none of this, they are generally capable of handling their normal life and appearing outwards like any other normal person. The other category are the “Emotional Parts.” This is not to say that the ANPs do not have emotions, but rather that unlike ANPs, EPs have memories of the trauma and are strongly connected to đã đưa ý kiến trauma both emotionally and not.
Essentially, that is the current theory to how DID is formed kept short, but I strongly recommend bạn looking into the theory of structural dissociation as it goes into how PTSD is formed, how BPD is formed, and how lesser dissociative disorders are formed. It is also the most up to ngày theory on all of this.
Looking into that just a bit further, there are common ‘archtypes’ hoặc general roles that different alters play that tend to appear in a lot of systems. The most common ones are “Protectors” which are alters that are there in order to handle emotional / physical danger and pain, “Persecutors” which often behave and act similarly to that of where the trauma came from and thus are often quite harmful to the body from time to time, “Inner Self Helpers” which tend to take the roll as mediators and middle men for issues, and so on. If bạn are futher interested in there, bạn could also look into them online as there are too many for me to address right now.
Within my personal system (a term use to describe all the alters as a whole), we have five members including myself. I am what bạn would call a “host” since I am the one that is out the most and responsible for life. Outside of that, I have Lucille who is an ANP and serves many
different roles / archetypes both as a protector, inner self helper, gatekeeper and caretaker. Additionally, he is in fact male. In the inner world, he is cismale, but like anyone who is male on the inside and female on the outside, when he fronts he actually experiences a lot of gender dysphoria along with body dysmorphia since my body is nothing like the one he should have. The other three in my system are all female, but I don’t have permission from them to share too much about them, so I will hold off from them.
From personal experience of having this disorder its… something. Personally, I am considerably high functioning in the sense that my memory gaps are not horrible and no one in the system is hurting the body / self sabotaging, that I have a fiance that understands and works with all of us, and that no one gets in the way of getting important things done. That is not to say that there isn’t dysfunction and that managing and living like this is easy, but I do have it a bit easier than others with the disorder. I would like to say that probably one of the hardest things is communication within the alters. I have five that I am sure I have, but I only really can communicate with one rather regularly and that would be - as bạn guessed - Lucille. Even then, I struggle to reach him a lot of the time. The memory issues is another major issue that we are trying to find our ways around. Honestly, there is a lot that could be discussed about this so I will just leave this open for anyone to ask specific questions. bạn may ask about the other alters, but I can not promise that I will respond. For now, I will continue on with this bài viết as I will leave all the intricacies to a possible DID focused article. [ OTHER SPECIFIED DISSOCIATIVE DISORDER ]
Finally the last dissociative disorder / symptom is OSDD which is the shortened version for “Other Specificed Dissociative Disorder.” This is the overarching term for a dissociative disorder that does not necessarily fit well into any of the previously mentioned disorder. Within OSDD there are essentially five subtypes which are often added at the end of OSDD.
OSDD-1 is pretty much “almost matches DID but is lacking a few details / major diagnositic factors to get the diagnosis.” This diagnosis splits into OSDD-1A where one experiences almost all of the DID symptoms but their alters are not clear and distinct hoặc alters are not present. OSDD-1B, the other split, is where one has distinct alters but does not have the dissociative amnesia that comes with the alters existing.
The other OSDDs are various forms of dissociation either due to brainwashing, acute dissociative reaction, being in a dissociative trance, and Ganser Syndrome and each of which are independent on their own. With that being said, I do not feel like I am familiar enough with the specifics of those to be able to add them on this danh sách and go any further in depth with it than I am currently going right now. [ OTHER DISORDERS THAT HAVE DISSOCIATION AS A SYMPTOM ]
Additionally, I would like to add a last note that Dissociation is a SYMPTOM in many cases. While there are dissociative disorders, abnormal dissociation does not autoamtically mean bạn have a dissociative disorder. Dissociation also comes up frequently in cases of Borderline Personality Disorder as well as Post Traumatic Stress Disorder as it is one of the common symptoms that make up those with the disorder. It may also come up in bad and long term cases of depression and anxiety to which the brain my be overwhelmed hoặc extremely pushed bởi one of those factors as well. Feel free to ask any questions. I wrote this with a tháng hoặc two in between the first half and một giây half so I likely missed a lot of details. All các câu hỏi will tried to be answered as best as possible.