Trauma-related dissociation and its treatment

Although dissociation is a defense mechanism that allows us to escape the memory of adverse events, in the long run it causes problems and suffering. Find out more here.

Last update: 03 July 2023

Trauma-related dissociation is a concept that raises many questions and some misconceptions. First, we must understand that it does not imply weakness nor is it a pathological mechanism. It is an adaptive psychological reaction that helps people cope with a painful event.

The human mind uses dissociation to separate the individual from the adverse experience and thereby silence their emotional pain. However, this sophisticated survival resource comes at a psychological cost. In fact, it can fragment the individual’s memory and identity. It is a complex mental reality that we will explore in this article.

Early diagnosis of the presence of a dissociative disorder prevents the individual from developing serious behaviors such as self-harm or suicide attempts.

Trauma-related dissociation is a neuropsychological defense mechanism that seeks to separate the individual from external and internal experiences in order to reduce pain. It dulls their memory and drives them away from certain thoughts and emotions. After all, if the memory of a dramatic event were permanently in the foreground of their minds, they would feel completely overwhelmed.

A study conducted by the University of Maryland (USA) suggests that the impact of this dimension has been overlooked. They suggest it greater awareness of dissociative processes is neededbecause they correlate significantly with self-destructive and suicidal behaviors.

While it is true that this response seeks to protect the individual from suffering, in the long run a fragmented mind has enormous consequences on all levels.

Symptoms related to dissociation

Traumatic dissociation works by mobilizing different neurological areas, to regulate the imprint of painful memory and the consequent suffering. The cerebral amygdala activates the production of cortisol and centers such as the prefrontal cortex stop functioning normally. The hippocampus, the emotional memory center, also becomes dysregulated.

This results in an emotional numbness, lack of memory and a reduced capacity for reflection and reasoning.

An article written by the University of Leiden (The Netherlands) points out that this mechanism is an extremely complex process present in conditions such as post-traumatic stress disorder, dissociative identity disorder and borderline personality disorder (BPD). It’s helpful to know how your symptoms progress:

Anxiety.
Suicidal thoughts.
Isolation of emotions.
Doubts about identity.
Persistent feelings of anxiety.
Sleep disturbances, such as nightmares.
Anhedonia or the inability to experience pleasure.
Self-destructive behaviors such as self-harm.
Not being able to remember certain periods.
Disconnect from themselves and the world around them.
Going somewhere and not knowing how they got there.
Having flashbacks (brief memories of traumatic events).
Experiencing the feeling that many stimuli and experiences around them are not real.

This type of dissociation falls on a spectrum. As a result, some people experience only minor ailments, while others experience a truly dysfunctional and painful quality of life.

According to Diagnostic and Statistical Manual of Mental Disorders ( DSM-V), Trauma-related dissociation can manifest itself in the following three ways:

dissociative amnesia. After one or more traumatic experiences, the individual develops gaps in memory and forgets some fragments before or after the adverse experience.
Depersonalization/derealization disorder. This causes the individual to feel that they are outside their body. They also believe that what is happening or around them is not real.
Dissociative identity disorder. This condition used to be called multiple personality disorder. Patients who suffer from it adopt different identities in response to the trauma. An article published in The Journal of Mental Science states that this condition is a severe form of post-traumatic stress. Furthermore, it is a complex reality to diagnose and treat.

Trauma-related dissociation usually appears after several overlapping traumatic events. It doesn’t always occur after a specific event, such as the loss of a loved one. However, people who have been abused since childhood are at a higher risk of developing this psychological defense mechanism.

The University of Turin (Italy) conducted a study which supports multiple traumatic experiences threaten mental functioning and dissociation appears. The types of events that can trigger these harsh realities are as follows:

Living in a war zone.
Growing up in a dysfunctional family.
Being mistreated or abused for several years.
Living in a disadvantaged or adverse social context.
Witnessing violent events that have continued over time.
Working for years in a threatening and highly stressful environment.

Dissociation can give the individual the feeling that they are going crazy and that everything is out of their control. The first step is for them to understand that this reaction is a normal mechanism of their brain in the face of suffering and that it can be treated.

When it comes to trauma-related dissociation, the therapist always starts from the particular needs and reality of each patient. As pointed out in an article published in the Indian Journal of Psychiatryan adequate diagnosis must be established, excluding other causes, any comorbidities and traumatic and personality predisposing factors.

Let’s take a look at the strategies used to deal with this reality and useful therapeutic models.

strategies and treatments

Promote a healthy self-concept.
Change harmful thought patterns.
Develop healthy coping skills.
Promote physical and emotional self-regulation capacity.
Reduce the constant hyperactivation of the central nervous system.
Encourage the individual to come up with new goals and meanings.
Facilitate a connection with the physical sensations of the body as a way to deal with emotional pain.
Guide them to accept the emotional pain associated with dissociation and gradually integrate their identity.
Make it easier for them to gradually process the traumatic experience.
There is no need for them to revisit their traumatic memories. It is more appropriate to treat their dysfunctional emotions and thoughts and generate healthier behaviors.

Appropriate therapies for dissociation

One of the most widely used therapeutic approaches in dissociation is EMDR therapy or eye movement desensitization and reprocessing. Research published in The Permanent Journal emphasizes that EMDR is one of the most effective treatments for all traumatic processes. Other useful therapeutic techniques are as follows:

Cognitive Processing Therapy (CPT). This is a convenient model for addressing cases of sexual abuse and maltreatment.
Psychoactive drugs. These are an alternative popular with doctors and psychiatrists in continued treatment for emotional dissociation.
Trauma-focused cognitive behavioral therapy. Thanks to techniques such as cognitive restructuring, emotional regulation and exposure to adverse stimuli, the patient integrates his painful experiences.
Somatic therapies. These work on the idea that dissociation leaves a deep imprint of suffering in the physical sphere. Dealing with sensations and somatic discomfort gradually reduces the patient’s emotional pain.

Final recommendations

While dissociation is a useful mechanism of the mind, it hinders our quality of life in the long run. Indeed, it is true that there are certain memories, experiences and images that should never return to our consciousness. But, traumatic experiences must always be elaborated and integrated into the identity of the traumatized, thus reducing his burden of suffering.

This is the purpose of psychological therapy. So, don’t hesitate to ask for specialized help if you need it.