{"id":29974,"date":"2015-12-03T08:00:34","date_gmt":"2015-12-03T16:00:34","guid":{"rendered":"http:\/\/www.goodtherapy.org\/blog\/?p=29974"},"modified":"2017-08-18T12:59:53","modified_gmt":"2017-08-18T19:59:53","slug":"understanding-dissociation-and-when-it-becomes-problematic","status":"publish","type":"post","link":"https:\/\/www.goodtherapy.org\/blog\/understanding-dissociation-when-it-becomes-problematic-1203155","title":{"rendered":"Understanding Dissociation and When It Becomes Problematic"},"content":{"rendered":"

\"Blank-facedWe\u2019ve all had moments where we felt\u00a0completely spaced out. What is normal, and when do instances of mental escape become a cause for concern? Dissociation<\/a>, or the feeling of being disconnected or separated from oneself, is a common experience, especially as a means for coping with or escaping from stressful situations<\/a>.<\/p>\n

I like to explain dissociation on a continuum. At one end there is \u201cnormal\u201d dissociation, the kind we all do at times. A popular example to describe simple and typical dissociation is driving your car on autopilot and not really paying attention to the road ahead, yet managing to safely make it to your destination. Another example is when you are completely absorbed in a movie until the person next to you reaches for the popcorn and your awareness snaps back to the present moment. These moments of \u201cescape\u201d happen occasionally and are a normal part of the human experience.<\/p>\n

A little further down the spectrum is the type of dissociation used as a defense mechanism<\/a> to cope with stressful situations or feelings of being completely overwhelmed<\/a>. People will sometimes describe themselves as detached, \u201cout of it,\u201d or even as if they are watching themselves from an out-of-body perspective.<\/p>\n

At the other end of the spectrum is a mental health diagnosis<\/a> called dissociative identity disorder (DID). Previously known as multiple personality disorder, this condition involves dissociation so extensive that it results in a complete split, or compartmentalization, of memories<\/a> and experiences that ultimately become separate and distinct personalities<\/a>. Different personalities are often referred to as \u201calters,\u201d while the main identity is typically called the \u201chost\u201d personality. Together, the various personalities make up a system that initially served to help an individual cope with experiences of extreme and repeated trauma<\/a>, often including severe sexual or physical abuse<\/a> at a young age.<\/p>\n

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‘Alters’ and Dissociative Identity<\/strong><\/h2>\n

DID is often difficult to comprehend, and the multiple personalities within a person with this diagnosis are sometimes hard to recognize or believe until a personality shift is witnessed within the person. Each personality serves some type of purpose for the host person. For example, one alter may be the \u201cplayful one,\u201d while another is the \u201cprotector\u201d or \u201chelper.\u201d Each alter has his or her own interpretation of events and, often, only certain alters will remember the details of the trauma that occurred.<\/p>\n

Different alters typically have their own names and distinct traits. They may speak in different accents and tones, display different mannerisms and body postures, and dress differently from one another. They each have their own idea of how they look, and sometimes it\u2019s vastly different from the host person\u2019s actual appearance.<\/p>\n

A person with DID often has alters of\u00a0different genders<\/a> than the host person\u2019s true gender, and they may have personalities who are \u201cstuck\u201d at younger ages than the host personality\u2019s actual age. For example, an adult experiencing DID might\u00a0have an alter personality who is\u00a05\u00a0years old and is interested in coloring or playing with dolls. Each alter may have\u00a0a unique\u00a0set of talents and hobbies, and some may even speak different languages.<\/p>\n

DID After Surviving Trauma<\/strong><\/h2>\n

While DID is initially a coping mechanism the brain employs to allow a person to survive extreme trauma, it can lead to difficulties as the host person grows up and tries to interact in a world where this level of dissociation is not widely understood. Individuals with DID are often misperceived and sometimes called liars because the stories or actions of different alters don\u2019t add up.<\/p>\n

Although the trauma may have ended, the barriers in the mind remain and can lead to confusion for the individual, who may also experience co-occurring symptoms of depression<\/a>, anxiety<\/a>, and posttraumatic stress. Sometimes, certain alters may develop self-destructive patterns, such as drinking excessively, behaving recklessly, and engaging in actions to sabotage the host personality\u2019s efforts to stay healthy. Some alters may have suicidal thoughts or attempts<\/a>.<\/p>\n

A\u00a0person experiencing DID who ends up in the hospital\u00a0may\u00a0often be misdiagnosed since hospital staff may only see a snapshot of the system and issues. Incorrect diagnoses often include major depressive episode, bipolar<\/a>, substance abuse<\/a>, and schizophrenia<\/a>.<\/p>\n

The following indicators are often displayed by individuals who experience DID:<\/p>\n