I am sorry to hear you are going through a difficult time with your health at the moment and you are struggling to find the help that fits you. So, I am glad you reached out for some support on the Better Help platform. I will share some information and some tips on some things you might want to try on your own while you decide about seeking some further guidance with your situation.
Dissociation most often develops as a way for people to deal with trauma but there are several reasons people might dissociate aside from PTSD. Dissociation doesn't just happen after a traumatic event. Non-trauma-related panic attacks with dissociation.
So why, exactly, does it happen in the first place, and is there any way to stop it from happening? I will share some tips for how to navigate a dissociative episode.
What's happening in someone's brain when they dissociate?
You've probably heard of the "fight-or-flight" response before—you know, when you're under extreme stress and your heart rate increases, you start breathing faster, and your body releases a burst of adrenaline. Well, dissociation is a step beyond that - If the [fight-or-flight] attempt fails, the person can’t get away, or the aggressor is a loved one, then the body tries to preserve itself by shutting down, expending as little energy as possible. It can be the last-ditch emergency response system of the body in which the brain prepares the body for injury.
Researcher have explained this phenomenon from an evolutionary perspective.
While fight-or-flight prepares us to flee from danger, this shut-down "fright" state essentially allows us to play dead—it's harder (if impossible) to move or speak, our emotions are numbed, and our body's resources are conserved for impending shock.
Psychiatric/medical studies have shown almost every area of the brain has a decrease in activation during dissociation. Psychiatrist’s work around dissociation has shown abnormal activity in the temporal lobes, in particular—the ones associated with speech and hearing—and in the limbic system, which controls emotion and memory.
It also is researched that there is also a chemical component to dissociation.
The body releases its own opioids and cannabinoids which reduce perceptions of physical and emotional pain and produce calm and a sense of detachment from what is happening," she notes.
Dissociation can happen during a traumatic event, but it can also continue to recur afterwards. For those who have developed PTSD and related disorders, their brain remains on high alert for potential danger. The brain responds to things that are even slightly emotionally or physically threatening as though it were a life-or-death situation and reacts accordingly. And, as I previously mentioned, this can also happen independently of a specific trauma. (More on that in a sec.)
What does dissociation feel like?
While dissociation can happen to anyone, regardless of age, gender, or ethnicity, it doesn't look the same from person to person. As people have different brain patterns, their symptoms can vary from periods of spaciness, to panic, to rage outbursts. For some can also enter a trance state and have no awareness at all of what's happening around them.
That said, there are a few distinct categories of dissociation that mental health experts recognize. Depersonalization is a form of dissociation where you feel like you're outside of yourself and you don't have conscious control of your identity. Derealization is another form, which is feeling like things aren't real in some way.
Many people with PTSD have flashbacks to the traumatic event they experienced during dissociative episodes. Those intrusive flashbacks are like a daydream you can't stop having, and you're unaware of what's going on now.
In other cases, a person experiencing dissociation can feel like they're someone else entirely. For some who were abused as kids, they might get triggered and experience themselves as a small child in how they are reacting and feeling. The person knows that they are an adult but has a very strong feeling of being a child. The most extreme form of this phenomenon is dissociative identity disorder which used to be called multiple personality disorder. In this experience, the person’s self-states have identities and response patterns and have developed a sense of individual autonomy. These different parts may not know about or remember what other parts do when they come out.
What triggers dissociation?
Just like there are lots of different forms of dissociation, there are a ton of things that could kick off an episode if you're prone to them. Stressful situations, a lack of sleep, low blood sugar, and an emotional memory that reminds one of the initial traumas are common triggers.
The prospect of being alone can also lead to dissociation in some people. One of the primary ways that we as social beings handle threat is to seek social support. So, someone who has survived an armed robbery might dissociate when faced with their partner going on a trip for work and leaving them alone, because it feels unsafe, and unsafe is interpreted by their brain as life or death.
But for other people dissociation can happen without a clear cause. There isn’t necessarily a trigger at all, and that’s the problem. It's rare, but anyone can experience it, whether it is linked to a specific trauma.
Is there anything you can do to stop dissociation in its tracks?
Experts agree that there are lots of things you can do to reduce the severity of dissociative episodes and even eradicate them altogether. The first step, no matter what the cause of your dissociation, is to seek health from a mental health professional From a prevention perspective, getting into good therapy to address and work through the trauma is often essential. Once the traumas have been fully ‘digested,’ the likelihood of dissociation greatly decreases and may resolve. Your therapist may also recommend medication like antidepressants to help manage mental health issues often associated with dissociation. Therapy and medication are also the usual course of treatment for people with dissociative disorders. In the longer-term activities that require rhythm and engagement, like dancing or singing, can also be helpful for trauma survivors, as they help connect you with your body and other people.
Experts agree that it's also important to have an arsenal of grounding techniques at hand, which can be helpful when you feel a dissociative episode coming on. Taking advantage of every sense you have and rooting your mind in something very concrete can be helpful. So, for example, starting at 100 and counting back in your mind or out loud by threes. Holding something cold, like an ice cube, or smelling something like peppermint oil can help derail or shrink a dissociative episode. Listening to upbeat music or eating something can also help change your state quickly, for others the go-to techniques involves The Rubber Band Snap - snapping an elastic band on your wrist, you pull up the elastic band and let it go. Another focus technique is is count all the green things you can see.
What you don't want to do is to just avoid whatever triggers your dissociative episodes. Basically, what that does is reinforce [dissociation] as a coping mechanism. You are more likely to help it dissipate if you are able to recreate those triggers in a therapeutic setting. If you learn to manage the symptoms, you become desensitized to the trigger.
A therapist can help to route yourself in the present.
I absolutely get that it can be more difficult to seek and accept help when you 'are in the trade' but for many of us it is proven to be most valuable.
Consider this acknowledging and accepting help can assist you in becoming more empathetic towards your clients' emotional suffering. Therapists sometimes need therapy, too, and it is my opinion there should be no shame or stigma in that.
No matter how much dissociation affects your life, just know help is available. I am sure you know - Recovery is possible.
I wish you much luck in your journey and I hope you are able to find the help you are looking for Shanshan!