Dissociation and Trauma

By Tanya Ruckstuhl-Valenti LICSW, MSW

TV shows like the “United States of Tara” have made the public more interested in the phenomena of Dissociative Identity Disorder, formerly known as Multiple Personality Disorder. 

I recently had tea with my friend and colleague Jari Preston with whom I’m presenting  What Every Attorney Needs to Know About Trauma next month, and we got to talking about dissociation. 

In contrast to popular belief, dissociation is not a single, static condition but rather a continuum of behavior that essentially boils down to this:  not being present to your current experience.  This universal departure from the here-and-now ranges in frequency from typical, low-occurrence and low consequence in the general population to the problematic high-occurrence and high consequence frequency in untreated trauma survivors. 

What is a typical level of dissociation? 

For example, when wandering through the aisles of Target, entranced by the many attractive consumer goods, pondering the purchase of a world map shower curtain or a pretty striped outdoor cushion, I mentally depart the store, ignoring my children and everyone around me.  I am dissociating.  How is this dissociation if it is based on the current experience?  Because I am not really present at that moment:  I’m only dimly aware of the sales associates stocking shelves or the customer selecting dog sweaters, or my boys angling for Pokémon cards. 

What does trauma have to do with dissociation? 

Trauma survivors often use dissociation unconsciously during the time of their trauma to get away from overwhelming feelings of hopelessness and terror.  Dissociation provides an emotional departure which acts like the steam release valve on a pressure cooker. 

For instance, childhood sexual abuse victims may mentally project themselves out of the room while being violated in order to not feel the pain of the abuse.  A soldier who witnesses a buddy blown up by an IED may focus on the task of collecting his friend’s body parts, thinking to himself about how they—he and the dead friend—will laugh together about this event in the future, without allowing himself to acknowledge the fact of the death. 

What are the long term implications of dissociation?

We have all dissociated while driving home, thinking about a project at work, a conflict with a loved one, or an item on our to-do list.  So you know what it is like to suddenly arrive somewhere without any memory of how you have gotten there. 

Imagine living your entire life without consciously being able to show up.  At best, your experiences of life–your memories as well as your emotional responses to them–would be intermittent.  All the important, stressful events such as the birth of your child(ren), your wedding day(s), both the celebrations as well as conflicts, you would not remember, or you might remember as fleeting images or sensations. 

People with untreated trauma often report feeling they are living “behind a glass wall” and able to come out only under certain peaceful—or conversely, intensely conflicted—conditions.   

In contrast to the run-of-the-mill spacey Target shopping example, at the far extreme of dissociation people with D.I.D. (Dissociative Identity Disorder) are so fragmented they feel literally absent when under stress.  This is when their “alters” or other personalities show up and make choices.  People with D.I.D. lack the continuity of an internal connection with themselves and without that it is nearly impossible to nurture long term, stable connections with other people.

The good news is that if you are further along this continuum than the mild shopping/driving home dissociation, seeing a qualified therapist can help. 

If you are in the legal field and are interested in attending my upcoming workshop, “What Every Attorney Needs to Know about Trauma,” please visit my website, http://www.therapistseattle.net/.