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Dissociation Disorder

Dissociation disorders are mental health conditions characterized by a sense of discontinuity and separation from one’s thoughts, memories, environment, activities, and identity. People with dissociative disorders unintentionally and unhealthily escape from reality, which makes it difficult for them to carry on with daily activities.

Dissociation disorders typically arise in response to trauma and serve to block out unpleasant memories. The dissociative disorder you have might influence your symptoms, ranging from forgetfulness to other identities. Stressful situations might momentarily exacerbate symptoms, making them more noticeable.

Searching for grounding techniques for dissociation? First, you must consider that medication and conversation therapy (psychotherapy) is best for treating dissociative disorders. Even though treating dissociation disorders can be challenging, many people find new coping mechanisms and go on to have happy, fulfilling lives.

Dissociation Anxiety

Dissociation is feeling detached from yourself, like in a dreamlike state, feeling weird or strange, and like everything is surreal. It is a common anxiety disorder symptom experienced by many anxious people.

Dissociative identity disorder (DID) is a rare psychiatric disorder diagnosed in about 1.5% of the global population. This disorder is often misdiagnosed and requires multiple assessments for an accurate diagnosis. Patients often present with self-injurious behavior and suicide attempts. [1]

Dissociation Common Symptoms

  • It feels like you are in a dreamlike state but fully awake.
  • It feels like your emotions have become disconnected.
  • It feels like you’ve had an “out-of-body” encounter.
  • It feels like you’ve encountered something “dreamlike.”
  • It feels like you’ve become disconnected from others and the physical environment.
  • You feel strange, weird, or that something is off.
  • You feel numb and euphoric but don’t know why.
  • You suddenly feel confused and as if you can’t think clearly.
  • You feel like things are unreal but can’t define exactly why.
  • It can also feel like your memory has been impaired or your recollection of events is missing.
  • It feels like your thinking is muted, muddled, or mixed up.
  • You suddenly feel “brain dead” – where your logical mind has switched off.
  • You feel like you are numb to the traumatic situation or events.
  • You can also have auditory, visual, olfactory, gustatory, tactile, somatic, or verbal hallucinations.
Grounding Techniques for Dissociation
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Dissociation PTSD

The WHO World Mental Health (WMH) Survey findings that dissociation is associated with elevated PTSD symptoms, high role impairment, and suicidality are consistent with clinical evidence that dissociation is related to the severity of PTSD. [2]

Posttraumatic Stress Disorder (PTSD) is associated with significant functional impairment in important areas, including interpersonal relationships and occupational or educational roles. Preliminary evidence suggests that the dissociative subtype of PTSD (PTSD+DS), characterized by marked symptoms of depersonalization and derealization, is associated with increased functional impairment and disease severity, including among military members and veterans diagnosed with PTSD. Similarly, first responders (e.g. police, fire, and paramedics) have also been found to experience dissociative symptoms. 

BPD Dissociation

Stress-related dissociation is a key symptom of BPD, closely linked to other core domains of the disorder (emotion dysregulation, identity disturbances, and interpersonal disturbances). Dissociation is a complex phenomenon that occurs in various clinical conditions, including dissociation disorders, (complex) post-traumatic stress disorder (CPTSD, PTSD), and borderline personality disorder (BPD). Traumatic stress is considered an important risk factor, while the cause or origin of dissociation is still debated. Next to traumatic experiences, temperamental and neurobiological vulnerabilities seem to contribute to the development of dissociation. Stress-related dissociation is a prevalent symptom of BPD, which may interfere with psychosocial functioning and treatment outcomes. [3]

Dissociation ADHD

While dissociation is not one of the ADHD symptoms, the two are closely related because they are often comorbid. People with dissociation disorders may also show symptoms of ADHD and vice versa. [4] The “checking out” might happen involuntarily, and you might have no idea what triggers it yet, but you can gradually regain control and prevent dissociative episodes with practice and treatment. How to stop dissociating? Whether ADHD or trauma came first, therapy will be crucial for recovery and symptom management. Even if you can’t identify any particular experience or event, dissociative symptoms are usually the result of your brain trying to protect you from emotional pain.

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Grounding Techniques for Dissociation

How to Stop Dissociating?

Patients diagnosed with dissociation disorder tend to possess extreme sensitivity to interpersonal trust and rejection issues, making brief treatment in a managed care setting difficult. Furthermore, Most dissociation disorder patients seek treatment because of affective, psychotic-like, or somatic symptoms. However, in an emergency with a new patient who does not know his or her name, it is important to consider that the patient may have a true psychosis because most “Jane and John Does” who present in psychiatric emergency settings have turned out to be psychotic, rather than in a dissociated state or to have an associated functional or organic psychosis.

A cognitive behavioral therapy (CBT) approach is often recommended that incorporates communicating effectively with the alters and helping the patient find more adaptive coping strategies than “switching” when distressed. This can be enhanced by teaching relaxation exercises, suggesting breaks from the setting for a few minutes, and helping the patient gain control over cognitive distortions of the self and world. The therapist tries to model an appropriate relationship and model appropriate, calm, and considered reactions to crises.

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Best Grounding Techniques for Dissociation

The essential tactic is the use of an “anchoring phrase.” Prepare a sentence you can say (out loud or internally) that will bring you back to the present. Include your name, age, and the address where you reside. Specifics like where you are, what you’re doing, what time it is, and so forth can be added as they apply. Here are some additional pointers to assist you in getting back to the present.

Mental Work

  • Give yourself relatively mundane tasks to accomplish. For example:
  • Perform some basic math
  • Create mental lists in broad categories like birds or sports teams, or colors
  • Look at something in your line of sight before looking away and challenging yourself to recall what you just saw
  • Recite song lyrics or movie lines, or a poem

Keeping a journal can help you understand and remember different parts of your experience. It could:

  • Include writing and the artwork you do at other times and, if you have a dissociation disorder, in different identity states
  • Help improve the connections and awareness between different parts of your identity by reading entries from them
  • Help you remember more about what happened in the gaps in your memory
Grounding Techniques for Dissociation
You may use grounding techniques for dissociation pdf or create a journal to help you understand and remember some of your experiences.

Engage Your Senses

Focus on the sensations you are feeling right now. You might find it helpful to keep a box of things with different textures and smells (for example, perfume, a blanket, and some smooth stones) ready when you need them.

  • Eat something spicy or sour
  • Eat or drink anything but take your time to experience its taste deeply
  • Put your hands in cold water or touch something very cold
  • Close your eyes and focus on all the scents, smells, and aromas you notice
  • Specifically, savor a scent you enjoy (cologne, perfume, food, etc.)
  • Listen to music, sing along, play air guitar, and try to hear something you never noticed before
  • Touch your bare feet onto the ground
  • Touch something that comforts you (perhaps it’s a pet!)
  • Create and carry around a sensory kit that contains items you can feel, touch, smell, etc.

Involve Your Body

Look after yourself.

  • Move your body
  • Take a walk
  • Exercise, dance, stretch, etc.
  • Practice deep breathing
  • Seek out a hug (even if it’s from your pet!)

Soothe Yourself

  • Create a list of calming affirmations you can say to yourself, e.g. “you’re doing your best”
  • Visualize a place that makes you feel safe and grounded
  • Think of someone you love, imagine their smile, hear their voice
  • Create a plan in your head to spend quality time with the person you’re thinking about
  • Whenever possible, find a safe space where you can ride out the dissociation as calmly as possible

Treat the Underlying Causes

Dissociation can be a hard challenge, even with grounding measures. You must address the underlying issue even when you’ve mastered self-soothing techniques. Typically, a trained trauma therapy specialist will provide supervision for this attempt. Finding a dissociative identity disorder specialist or a mental health professional with extensive training in addressing dissociation is crucial. The majority of therapists lack that.

One of the most effective ways to comprehend what is occurring is to speak with a skilled trauma therapist. From there, strategies and answers may be discovered.

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How Long Does Dissociation Last?

Dissociation is a way the mind copes with too much stress. Periods of dissociation can last relatively short (hours or days) or much longer (weeks or months). It can sometimes last for years, but usually, if a person has other dissociative disorders.

Signs and symptoms depend on the type of dissociative disorders you have but may include:

  • Memory loss (amnesia) of certain periods, events, people, and personal information
  • A sense of being detached from yourself and your emotions
  • A perception of the people and things around you as distorted and unreal
  • A blurred sense of identity
  • Significant stress or problems in your relationships, work, or other important areas of your life
  • Inability to cope well with emotional or professional stress
  • Mental health problems, such as depression, anxiety, and suicidal thoughts and behaviors

There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association:

  • Dissociative Amnesia. The main symptom is memory loss, that’s more severe than normal forgetfulness. You can’t recall information about yourself, events, or people in your life, especially from a traumatic time.
  • Dissociative Identity Disorder. Formerly known as multiple personality disorder, this disorder is characterized by “switching” to alternate identities. You may feel the presence of two or more people talking or living inside your head, and you may feel as though other identities possess you. Each identity may have a unique name, personal history, and characteristics, including obvious differences in voice, gender, mannerisms, and even such physical qualities as the need for eyeglasses.
  • Depersonalization-Derealization Disorder. This involves an ongoing or episodic sense of detachment or being outside yourself — observing your actions, feelings, thoughts, and self from a distance as though watching a movie (depersonalization). Other people and things around you may feel detached and foggy or dreamlike, time may be slowed down or sped up, and the world may seem unreal (derealization). You may experience depersonalization, derealization, or both. Symptoms, which can be profoundly distressing, may last only a few moments or come and go over many years.

How Can I Help Myself?

Dissociate definition is “to disconnect or to separate.” Many people may experience dissociation (dissociate) during their life. If you dissociate, you may feel disconnected from yourself and the world around you.  Some individuals trigger dissociation during sex, and some encounter dissociation while driving. Dissociation can cause great anxiety, so driving is unsafe when diagnosed with the illness. Some people with dissociative disorders present in a crisis with traumatic flashbacks that are overwhelming or associated with unsafe behavior. People with these symptoms should be seen in an emergency room. Call your doctor if you have less urgent signs indicating dissociative disorder.

If you have thoughts of hurting yourself or someone else, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend.

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Treatment Dissociative Identity Disorder

The primary treatment for dissociative disorders is psychotherapy. Also known as talk therapy or psychosocial therapy, psychotherapy is focused on talking with a mental health professional about your mental health. Psychotherapy aims to learn how to cope with your disorder and understand its cause.

Psychotherapy can be an alternative to medication or can be used with other treatment options, such as medications. Choosing the right treatment plan should be based on a person’s needs and medical situation and under a mental health professional’s care. [5]

Even when medications relieve symptoms, psychotherapy and other interventions can help a person address specific issues. These might include self-defeating thinking, fears, problems interacting with others, or dealing with situations at home, school, or work.

Some also consider hypnosis to be a useful tool for dissociative disorders treatment.

Medication is sometimes used in the treatment of dissociative disorders, as well. Although no medications are specifically recommended for treating dissociative disorders, your doctor might use them for associated mental health symptoms.

Grounding Techniques for Dissociation
Coping with trauma related dissociation can be done safely and effectively with the help of a mental health professional.

Some commonly used medications are:

  • Anti-anxiety medications
  • Antipsychotic drugs
  • Antidepressants

The We Level Up FL primary mental health center stands ready to help. We Level Up FL can inspire a support system through our mental health treatments to make you feel valuable. You can trust the treatment backed by leading recovery specialists practicing evidence-based therapy. We Level Up FL Treatment Center offers therapy under one roof. Get comprehensive therapy for mind, body & spirit.

Call us now for a free mental health assessment! In addition, for the substance abuse or dual diagnosis approach, our inpatient treatment, inpatient medical detox, and residential primary addiction treatment may be available at our affiliated facility. For more treatment resources and grounding techniques for dissociation, call us about your symptoms, and we can help you determine the cause and develop a treatment plan.

Search Grounding Techniques for Dissociation & Other Resources
Sources:

[1] Mitra P, Jain A. Dissociative Identity Disorder. [Updated 2022 May 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568768/

[2] Stein DJ, Koenen KC, Friedman MJ, Hill E, McLaughlin KA, Petukhova M, Ruscio AM, Shahly V, Spiegel D, Borges G, Bunting B, Caldas-de-Almeida JM, de Girolamo G, Demyttenaere K, Florescu S, Haro JM, Karam EG, Kovess-Masfety V, Lee S, Matschinger H, Mladenova M, Posada-Villa J, Tachimori H, Viana MC, Kessler RC. Dissociation in posttraumatic stress disorder: evidence from the world mental health surveys. Biol Psychiatry. 2013 Feb 15;73(4):302-12. DOI: 10.1016/j.biopsych.2012.08.022. Epub 2012 Oct 9. PMID: 23059051; PMCID: PMC3589990.

[3] Krause-Utz A. Dissociation, trauma, and borderline personality disorder. Borderline Personal Disord Emot Dysregul. 2022 Apr 19;9(1):14. DOI: 10.1186/s40479-022-00184-y. PMID: 35440020; PMCID: PMC9020027.

[4] Matsumoto, Toshihiko, and Fumi Imamura. Association between childhood attention-deficit-hyperactivity symptoms and adulthood dissociation in male inmates: a preliminary reportPsychiatry and Clinical Neurosciences vol. 61,4 (2007). doi:10.1111/j.1440-1819.2007.01683.x

[5] Psychotherapies – https://www.nimh.nih.gov/health/topics/psychotherapies – National Institute of Mental Health