Dissociation: a protective mechanism of the psyche and a means of psychotherapy

Dissociation is a failure to integrate experiences that alter one's sense of self and personality. The ability to process experience can be severely damaged by trauma. Experience can also be repressed or limited when we are very tired, stressed or seriously ill, but in these cases the disruption is temporary.

Childhood trauma can profoundly interfere with our ability to integrate experiences into a coherent and coherent life story. Children's integrative potential (experience) is much more limited than that of adults. Of course, not all failures of integration lead to dissociation.

Dissociation is both the ownership of experience and the renunciation of it: while one part of you owns the experience, another part does not. Thus, people with dissociative disorders feel fragmented rather than whole. They have memories, thoughts, feelings and behaviors about things that they experience as out of character and foreign, as if they do not belong to them. Their sense of self and consistent response patterns change from situation to situation. They are not very effective in learning new ways of behavior, since dividing the personality into parts and maintaining this splitting takes a lot of energy.

What is dissociation

Dissociation is the breaking apart of something into its components. Derived from the Latin word dissociatiodissociatio, which means division.

In psychology

In psychology, the term was introduced by the French psychologist P. Janet (late 19th century). He managed to prove that individual thoughts can exist outside a person’s consciousness and can only be realized under hypnosis.

Dissociation in psychology is the primary defense mechanism of the psyche. Protects against shocks, injuries, negative emotions. In a state of dissociation, it seems to a person that the events did not happen to him. He takes the position of an outside observer, abstracts himself.

The specificity of the phenomenon is that a person can separate both negative and positive emotions from himself if they cause a state of distress. For example, strong love feelings interfere with working, thinking, and living. Sometimes a person tries to abstract himself from them.

There are two types of personality dissociation:

1. Positive. The individual abstracts himself from events in order to soberly assess the situation and protect himself from destructive feelings.
2. Negative. Due to excessive sensitivity, the individual perceives an ordinary situation as dangerous and withdraws through dissociation. This interferes with adaptation and spoils relationships with others.

People who have experienced dissociation describe it with the following phrases:

• “It’s like it’s not happening to me”;
• “The feeling that these feelings are not mine”;
• “My feelings seem to live separately from me.”

In cases where the norm borders on pathology, a person sees himself from the outside, feels dissociation as a way out of the body.

In psychiatry

In psychiatry, personality dissociation refers to the unconscious separation of thoughts and beliefs from awareness. For example, a person holds two contradictory views on the same problem. Without correction, the condition can trigger the development of dissociative identity disorder or the flight response. The phenomenon of dissociation and multiple personality syndrome develops in people who have suffered severe psychotrauma. The risk of developing abnormalities increases if we are talking about childhood psychological trauma, for example, violence.

Preface

In psychiatry there is a group of diseases called “dissociative disorders”. Compared to paranoia or schizophrenia, it probably doesn’t sound very scary, but it is a fairly serious diagnosis. What is it? Dissociation in Latin means “disintegration.” With this disease, mental functions such as memory, consciousness, and a sense of personal identity are impaired. These mental functions are separated from the holistic stream of consciousness and become independent. Thus, the integrity of the individual is violated.

Dissociation: examples

Every time we try to forget about some feelings and emotions, to stop feeling it, we use dissociation. We try not to think about what upsets, saddens, scares or hurts us.

Example of dissociation:

1. The person who survived the attack says that at that time he did not feel pain. Or he says that he saw himself as if from the outside.
2. A client in a session with a psychologist talks about rape as if it were the plot of a book. There are no emotions on his face, his pulse does not quicken, his blood pressure does not rise.

One of the most famous examples of pathological dissociation is Billy Milligan, a murderer and rapist with 24 personalities. They all have different gender, age and character. In this case, dissociation became the basis for the development of multiple personality disorder. By switching between personalities, Billy's subconscious protected him from suicide and old psychotrauma. Perhaps the impetus for the development of the mechanism of dissociation, and then the disorder, was the violence to which Billy was subjected in childhood.

Dissociative disorder

When people chronically dissociate and it disrupts their lives, they may be diagnosed with dissociative disorder. There are several dissociative disorders, and it is important to know that these classifications may not completely describe any person; in fact, dissociation still needs to be studied. There is general agreement, however, that major complex dissociative separations typically develop in childhood. They are the result of failures in the integration of the child’s personality, the consequences of which are present in adulthood.

Dissociation: norm and pathology

It is customary to distinguish between normative and pathological dissociation. In the first case, we are talking about a natural defensive reaction to stress, shock, and unpleasant experiences. Dissociation normally occurs in difficult situations, where a person is required to maintain composure, restraint, and rationality, but he cannot consciously pull himself together. Then an unconscious process is activated - a protective mechanism of the psyche. As a result, a person gains an advantage over the situation, can soberly assess it and make a rational decision. In this case, dissociation can be seen as a means of adaptation rather than as a defense mechanism.

In the pathological form, a person dissociates in any emotional situations, and not just in difficult life circumstances. Such people are called thick-skinned, indifferent, cold, callous, unemotional. They exclude any negativity, refuse to resolve conflicts, and are not ready for productive social interaction. This behavior can lead to isolation.

ICD-10 position

In the International Classification of Diseases, Tenth Revision (ICD-10), multiple personality disorder is included in category F44. To make such a diagnosis, it is necessary to identify four signs in the patient:

• The presence of two or more personalities, and only one should be present at a given time.

• Each personality has its own memory, preferences and behavioral characteristics; at times one of them seizes control of consciousness.
• The patient cannot remember information important to the main personality. At the same time, memory lapses exceed ordinary forgetfulness in scale.
• Symptoms are not associated with organic mental disorders, such as epilepsy and substance use.

The number of individuals can exceed a hundred. Their number has been growing over the years. They arise unconsciously. Most likely, the brain creates them to make it easier to cope with various situations. So, at the very beginning of treatment, the doctor can identify 2-4 personalities in the patient, and as communication progresses, another 10-12. Each has its own mannerisms, gestures and even handwriting. Often they don't know that they are not the only ones in a person's head.

Each person can have a different IQ, and the spread can be quite significant - from 80 for one to 140 for another.

Such patients are very rare, which is why specialists have different attitudes towards this disease. But the world of art and commerce often exploits this topic, as it attracts the interest of the public.

Dissociation and Association

Association and dissociation are two opposing processes. With association, a person is involved in some situation, with dissociation, he is detached. Our memories can be either associated or dissociated. Moreover, we ourselves can choose what they will be. This technique is used by psychotherapists. The more involved in something (association), the more acutely you feel a certain situation, a specific emotional state. The less you are involved in some memories (dissociation), the easier it is for you to objectively analyze the situation and learn a lesson from it.

Dissociation and association are two forms of perception of external information. With association, we actively participate in the analysis of the situation, realize it, comprehend it, and experience it. For example, when watching films, many people are completely immersed in the picture and feel what is happening for themselves. With dissociation, a person analyzes the situation from the outside, look at it from the outside, and not from the inside.

In life, we regularly choose one or another type of perception. If a person becomes fixated on one type, then this is an alarming signal. This indicates rigidity of consciousness.

Getting stuck in a state of association leads to victimization of thinking. A person takes everything to heart and plays the role of a victim. Being stuck in a state of dissociation leads to emotional coldness. The individual becomes unable to enjoy life and his successes. He can't show empathy.

Being stuck in one of the states puts a person at risk for chemical dependency. Alcohol and drugs help you “switch.” The individual quickly recognizes this and uses this method as “treatment”.

Being stuck in a state of dissociation leads to emotional coldness. The individual becomes unable to enjoy life and his successes.

Reason for confusion

First, let's try to figure out why two different diseases began to be perceived as one. This is mainly due to the etymology of the word “schizophrenia”. From Greek it is literally translated as “to split” or “split” the “mind”, “thinking” or “thought”. This causes confusion among people who do not understand medicine and psychiatry.

But for an experienced doctor, differentiating these diagnoses is not so difficult. In short, with a split personality, it is as if a person has several people in one body. In schizophrenia there is no such split or split; the patient simply inadequately evaluates himself and the surrounding reality. The differences between these diseases will be more obvious if you look at their symptoms. Let's start with split personality.

Dissociation in psychotherapy (techniques)

Psychotherapy begins with the client's acceptance and awareness of the problem. Without this, healing is impossible. The client must realize that only he is responsible for any situations and changes in his life. And for this, a person needs to dissociate, separate the problem from his Self. So far, hypnosis has been recognized as the best way. The specialist helps the client realize what he has long separated from himself.

To learn how to switch from associations to dissociations, you need to identify personal triggers (external factors that turn on a defense mechanism). As soon as you feel a trigger approaching, begin to analyze your state and consciously direct it in the right direction.

Let's take a closer look at several dissociation techniques in psychology. They help to distance oneself from traumatic circumstances.

I see, I hear, I analyze

In order to move away from the situation and pacify emotions, you can use one of the following formats, but it is better to use all three at once.

View from the outside:

1. Stop mentally, get out of your body and look at yourself, other people and the situation from the outside. Avoid value judgments, state the facts.
2. Imagine the image in black and white.
3. Zoom out the picture and move it away from you, as if you were doing it on a smartphone display.
4. Move into the background those people who cause you negative emotions.
5. Imagine you are watching a movie. Play the “video” faster or slower.
6. Imagine what this situation, events, participants will look like in 20–30–40 years. Do you think it makes sense to worry the way you originally did?

Auditory format:

1. Imagine listening to other people and yourself through your phone or speaker.
2. Imagine how the volume of each voice, or just those that annoy you, decreases.
3. Change your annoying voice, for example, make it squeaky. Play with the speed of your voice.

Analytical format:

1. Imagine that you are watching what is happening from the outside. This time, not only study the facts, but also give your assessment of what is happening.
2. “Convey” your emotions to the one you are looking at.
3. Analyze the situation according to plan: who, what, why and why.
4. Imagine different scenarios for the development of the situation.
5. What should you do to turn the situation in your favor?

We don’t know how to experience and think at the same time, so while you imagine something and analyze the situation, emotions fade away. Practice the techniques regularly and switching will become easier each time.

X-ray (NLP)

Goal: to achieve a relaxed and calm state, humility, peace, slight sadness. Alternative names for the technique: Memento mori (remember death), Danse macabre (dance of death).

What to do: imagine yourself and those people who are involved in the traumatic event in the form of skeletons (as in an x-ray). NLP specialists believe that this will be enough to realize that all the difficulties, failures, and worldly vanity are trifles. At first you will feel slight sadness, then forgiveness, humility, peace.

Visual-kinesthetic dissociation

Using this method, you can work through psychotrauma. This is a complex technique that is best performed under the supervision of a psychologist.

What to do:

1. Imagine that you have stepped away from the situation and looked at it from the outside. You see yourself at the starting point of the development of traumatic circumstances. At the same time, you understand that you are in the present moment, and you see yourself at that point as on a slide.
2. Now once again separate your consciousness from your body and imagine that you are observing your younger self (at the beginning of the trauma) and your present self. Triple separation is necessary so that you stop feeling and seeing yourself as a direct participant in events.
3. Replay the trauma, maintain kinesthetic detachment. You observe your younger self, the reactions and feelings of that person.
4. Having looked and listened from the outside, first enter the image of yourself that we received in the first point (you are from the one who observed everyone, enter the body of the one who observed himself at the beginning of the injury).
5. In your thoughts, approach yourself in a traumatic situation. Say that you come from the future and are ready to help. Give your younger self what he needs at this moment.
6. As soon as you understand that the young you has calmed down, satisfied your desires, received the right amount of support, enter this image, and then transfer it to the image of your current self. This will help you accept the past, change your attitude towards it, and gain integrity.

In some cases, one point has to be performed 2-3 times. It is important that the person maintains a state of dissociation. To get rid of trauma, you need to maintain the position of an outside observer.

Where does it all begin?

When a child is born, he has no self-identity and does not separate himself from his mother. Gradually he begins to look around, see himself, raise his head and see the environment, grab objects and walk. By studying the world in this way and comparing himself with it, the child eventually realizes himself as something separate from the whole world. It is at this time that the first thoughts about death begin to arise in him, because the previous connections “I = mother” and “I = the world around” are destroyed, and he becomes an isolated being. At this age, the mother, when talking about the child, often still uses the pronoun “we” (“we walked,” “we ate,” “we pooped”) and this is normal. But around the age of 5, the moment comes when the mother must begin to stimulate and support the separation process, and this is first done through speech. When talking about a child, you should now say “he” or “she” (naturally, in the presence of the child or when addressing him, call him by name), thereby teaching the little person to understand that he is a separate person. Then you need to gradually delegate to him responsibility for his own actions and decision-making. You can start with the child mastering basic self-care skills (dressing, etc.). It is important to encourage his independence - this means praising him, even if he did not succeed. Your own example is also very important. Sometimes it seems that parents think their children are idiots, deaf or blind, when they are much smarter than they might seem. The child's psyche is very flexible, it instantly absorbs and integrates everything that happens around it, and this happens several times faster than in an adult. The child is more spontaneous, open to the world and trusting. So if you promise something, do it. If it doesn't work out, explain to your child why. Take responsibility for your actions and decisions. Don't deceive or manipulate: children understand very well if you explain to them and feel when they are being manipulated. Be honest yourself, and you won’t have to reap the fruits of your deception and manipulation when a child “behaves like this for someone who doesn’t understand” or in adolescence loses trust in his parents (in modern Soviet psychology the latter is considered natural, but, nevertheless, nothing it happens “suddenly”). Communicate more with your child, perceive him as an individual. This is how healthy upbringing will be built. I think you have heard more than once how the mother of a school-age child says to her friend: “We went to school.” It's still funny, but extremely harmful for the child. However, there are often cases when a mother says: “We went to college” - this is no longer funny or amusing. Unfortunately, this may continue - it’s not for me to tell you what conflicts arise when an adult decides to start his own family, but separation from his parents never happened. The examples given serve only as a verbal indicator of the lack of separation and self-identification. Of course, there are much more situations themselves, and they are more diverse, and many verbal examples can be given. I have cited here only the most frequent and striking ones. If separation has not occurred, then it turns out that the person is physically seemingly an adult, but mentally still infantile. This is a consequence of the fact that in childhood the parents, due to the peculiarities of their development, were unable to correctly separate the child, and he, in turn, did not learn to associate his decisions and actions with himself, which is reflected in his speech by the use of the pronouns “we” and “you” " instead of "I".

Diagnosis of mental illness

This behavioral personality disorder is quite difficult to diagnose, especially in its initial stages.

Common points that psychologists and psychiatrists pay attention to are:

• not the individual behavior of the patient - manifestation in the actions and speech of different personalities (2 or more). It is quite difficult to understand at an early stage whether there really are disturbances or whether the person is simply not in the mood. At later stages, it is easier to identify diverse behavior - individuals can consider themselves to be of the opposite sex, express extreme and previously uncharacteristic views on life;
• changeable behavior - occurs due to the fact that one personality replaces another. Most often this happens by a conditioned signal (in each specific case this signal will be individual);
• partial amnesia - it is useless to explain to a person with a dissociative disorder that just a couple of days ago he perceived this or that situation differently, simply because it was not him, but another person;
• the influence of synthetic substances - alcohol, drugs, nicotine in people suffering from this disorder causes a dramatic change in mood. We can say that existing bad habits in people with dissociative disorder serve as the same signal for activation of the disease as severe stress or pleasure.

In addition to these signs, with this deviation there may be other purely individual manifestations of the disorder, which are more likely to be noticeable to loved ones of a person suffering from a dissociative disorder. This condition can often be confused with a form of schizophrenia, which is also characterized by personality disorder, but with schizophrenia, patients do not experience memory loss.

Symptoms

This mental disorder is manifested by the following symptoms:

1. The dissociative flight reaction is a dissociative fugue. The person behaves quite normally, but acquires character traits that are unusual for him and moves away from his place of residence. Unconscious memory loss (partial or complete) occurs. A person may suddenly leave work, behave differently than usual, respond to different names and not understand what is happening. This abnormal condition passes quickly, and the return to normal is rapid.
2. Dissociative amnesia - under the influence of stress or a traumatic event, the memory suddenly disappears, but the individual understands this. His consciousness “works” normally and he is able to perceive any new information.
3. Dissociative identity disorder. A personality is split into several, each having its own name, character, thinking, psychological properties, behavior, and nationality. Each of them periodically “commands” a person, personalities change each other without any reason or systematicity. The individual does not realize or feel such replacements, does not remember what happened to him in one form or another.
4. Depersonalization disorder - a person seems to observe his body and mental processes in it from the outside. The surrounding world seems colorless, unreal (derealization), and parts of the body are of incomprehensible sizes, the sense of time is lost. The individual feels like he is a robot and is tormented by anxiety and depression.
5. Derealization without depersonalization.
6. Trance is a violation of consciousness, there is no reaction to external stimuli. This is how children react to trauma or violence. Common to trans mediums during a seance and to pilots during a long flight. It is also observed in a number of cultures, such as excitement and rage, memory lapses, and strange actions, for example, among the Malays and Eskimos (Amok, Piblokto).
7. Ganser syndrome - deliberately incorrect answers to the simplest questions (faint speech), simulation of a severe mental illness. Sometimes accompanied by amnesia, loss of orientation, and perception disorders. Common among male prisoners.

If you notice such signs in yourself or in your relatives, you should contact a psychiatrist or psychologist. Treatment must be carried out in a timely manner, as complications are possible:

• prolonged depression;
• suicide attempts;
• severe headaches;
• self-harm;
• problems with eating;
• sexual dysfunction;
• anxiety disorders;
• drug addiction or alcoholism;
• nightmares, sleepwalking, insomnia.