What is dissociation? Is it always a problem? Does it always require psychotherapy? I understand dissociation as existing on a continuum. The Sidran Institute describes dissociation as
a disconnection between a person’s thoughts, memories, feelings, actions, or sense of who he or she is. This is a normal process that everyone has experienced. Examples of mild, common dissociation include daydreaming, highway hypnosis, or “getting lost” in a book or movie, all of which involve “losing touch” with awareness of one’s immediate surroundings.
Some people describe it as feeling “spacey”, “numb” or “checked out”. Dissociation is a common reaction to traumatic events. In fact, many trauma survivors dissociate to some extent. Maybe you dissociate from your body or bodily sensations. Maybe you have no access to forbidden feelings like anger, sadness, fear. Maybe you are missing pieces of information about events from the past. Maybe during stress you feel like you are watching yourself from a distance.
For those who experience ongoing, severe trauma from early childhood on, dissociation occurs so frequently that it interferes with other aspects of life or functioning. When this is the case, you may develop a dissociative disorder and psychotherapy can help.
Dissociative Identity Disorder (previously known as Multiple Personality Disorder) is characterized by
the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior
an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
is the most severe and chronic manifestation of dissociation, characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior, accompanied by an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. It is now recognized that these dissociated states are not fully-formed personalities, but rather represent a fragmented sense of identity. The amnesia typically associated with Dissociative Identity Disorder is asymmetrical, with different identity states remembering different aspects of autobiographical information. There is usually a host personality who identifies with the client’s real name. Typically, the host personality is not aware of the presence of other alters (American Psychiatric Association, 2000; Fine, 1999; Frey, 2001; Kluft, 1999; Kluft, Steinberg & Spitzer, 1988; Maldonado et al., 2002; Spiegel & Cardeña, 1991; Steinberg et al., 1993). The different personalities may serve distinct roles in coping with problem areas. An average of 2 to 4 personalities/alters are present at diagnosis, with an average of 13 to 15 personalities emerging over the course of treatment (Coons, Bowman & Milstein, 1988; Maldonado et al., 2002). Environmental events usually trigger a sudden shifting from one personality to another (Maldonado et al., 2002).