As part of my Complex PTSD due to severe childhood abuse spanning fourteen years, I suffer from dissociation and I don’t use the word suffer lightly. It is a scourge. One minute I am fully engaged in a conversation, writing a paper at work, cooking over a hot stove and suddenly I am totally cut off from all around me and disconnected from reality and it’s all beyond my control. It’s discombobulating and horrible. It’s embarrassing in company, can be dangerous, if for example driving or cooking as five minutes can go by and I don’t remember what I have done. When driving I can miss my Exit on the Freeway and have to drive extra kilometres to get to where I need to be.As a result, I haven’t driven for four years combined with the risk of sociality. I have burned many meals. Been had been late many times picking my children up from school.
Dissociation is an entirely normal response to overwhelming trauma. It is a way of us surviving something that otherwise would be unbearably painful, by narrowing down our consciousness, and failing to ‘join up’ the different strands of an experience, such as our actions, our memories, our feelings, our thoughts, our sensations and our perceptions. So we may have only an emotional memory (eg terror, disgust, shame) of what happened in a traumatic event, but no ‘visual’ record (‘seeing it’ in our mind’s eye). Or we may have a vivid mental picture of what happened, but it is disconnected from our feelings, so it is as if it didn’t affect us: we feel numb or nothing. The traumatic experience is ‘unintegrated’ and it takes on a life or identity of its own, separate from our main stream of consciousness. For the rest of our lives, we may have difficulty making a connection between what happened to us and how we felt about it at the time, or its impact on us in terms of how we feel or behave now. We may even struggle to connect with the fact that it happened to us at all.
I have asked my therapist if everyone who has been abused dissociates and she believes that everybody experiences dissociation to a degree and that dissociation exists on a continuum, ranging from mild to severe.
At the mild end of the spectrum, the mind ‘dissociates’ unimportant information so that we can concentrate on the task in hand. This is a narrowing of attention to focus only on what is essential. Getting lost in a book is a choice to ‘dissociate’ away from external distractions. Similarly, ‘highway hypnosis’ is the name often given to the kind of lost-in-thought state that people can fall into when driving a familiar route. Consumed with their thoughts, they are driving perfectly safely and are ready to respond immediately in an emergency, but while ‘on autopilot’ their attention is focused inwardly on what they are thinking about rather than on the scenery. As a result, they may miss their turning or arrive at their destination thinking, “How did I get here so soon?” I fit this description perfectly as I referred to earlier on.
In both of these examples, this is not a response to threat: in fact, it is the direct opposite, as it only occurs when the threat level is low and there is a relative sense of ‘safety’ in the environment. For that reason, some researchers do not think that this is the same kind of dissociation as is caused by trauma and which can lead to dissociative disorders. But many people do see it as existing on the same continuum as more problematic forms of dissociation and say that it is, therefore, a very normal, natural part of the way that our brain is designed to operate.
This kind of ‘alteration of consciousness’, where attention is directed to a specific task and away from other stimuli, can also be practised deliberately, for example in prayer or meditation.
Chronic, problematic, ‘pathological’ dissociation develops when there is repeated threat or trauma, especially when it starts at a young age, and when there is inadequate support or soothing from an attachment figure (usually a parent or primary caregiver).
This kind of trauma-based dissociation is an automatic, biologically-driven mechanism that is usually an involuntary response and which acts as “mental flight when physical flight is not possible”
Probably the greatest risk factor for developing a dissociative disorder in adulthood actually comes not from the degree of severity of the trauma, but from having a ‘disorganised attachment’ pattern. This comes from being cared for in infanthood by a caregiver who is persistently ‘frightened’ or ‘frightening’
Childhood trauma does not automatically lead to a dissociative disorder. The greatest resilience factor is a secure attachment pattern. Factors that increase the risk of developing a dissociative disorder include:
The severity of the abuse
The degree of coercion and pain
The younger the child at the onset of abuse. The longer the abuse goes on for. Abuse by an attachment figure — betrayal trauma. The need to reconcile the impossible: that the parent is both frightening and nurturing, both monster and rescuer.
The presence of alternative realities (for example, nightly abuse versus daily normality)
Social isolation during the abuse (no attachment figure with whom to process the experience, so it remains dissociated)
Society’s taboo on speaking about the abuse (“The child almost needs to push the experience outside of his consciousness in order to ensure that the CSA is not verbalised to others.”)
Reality-distorting statements from the abuser (such as “That didn’t happen; you were dreaming.”)
The perception of the abuse as trauma (eliciting fear, horror, pain)
Dissociative disorders develop as a result of dissociation being used as a survival strategy repeatedly during childhood. It is as if a ‘groove’ or ‘track’ in the mind is formed — in other words, certain neural networks are strengthened, and the mind develops with a propensity for dissociation as a coping mechanism for all kinds of stress, not just traumatic stress. Using dissociation repeatedly means that a child is unlikely to develop alternative coping strategies. This, therefore, affects their emotional and personality development.
The nature of dissociative identity disorder is that the trauma is hidden from view, ‘dissociated’ behind usually quite strong amnesic barriers in the mind. For this reason, people can be well into the middle or even late adulthood before these protective barriers disintegrate and clear evidence of a dissociative disorder is manifest. Their amnesic dissociative disorder is a protective mechanism that develops overtime and protects the brain and the person from further trauma. The only problem it and of itself obviously has it’s own problems as Matt Pappas writes in his Blog survivingmypast.net where he writes so well about a day coping with dissociation. He truly reflects the difficulties experienced and how hard it can be just to just simply get through a normal work day.