Category Archives: Dissociation

childhood trauma and dissociation

What Is The Difference Between Repression And Dissociation?

what is the difference between repression and dissociation?

I have frequently referred to the concepts of DISSOCIATION and REPRESSION on this site as, of course, both are highly relevant to the subject of childhood trauma. But what is the difference between the two?

REPRESSION :

In terms of psychoanalytic theory (of which Sigmund Freud is considered to be the ‘father’) REPRESSION can be divided into two types :

  1. PRIMAL REPRESSION
  2. REPRESSION PROPER

I briefly explain these two types of repression below :

REPRESSION PROPER :

This refers to an unconscious process whereby the part of the mind that Freud referred to as the ego prevents distressing and threatening thoughts from ever permeating consciousness. Freud believed that often such thoughts were kept banished from conscious awareness as otherwise they would produce intolerable guilt (generated by the part of the mind that he referred to as the superego). 

Examples of types of thoughts that Freud believed are kept repressed by this process are those concerning certain types of sexual and aggressive impulses and instincts (generated by the part of the mind Freud referred to as the id) that we have learned from our environment (influence of culture, parents etc) are unacceptable.

PRIMAL REPRESSION :

the difference between repression and dissociation

The term primal repression refers to an unconscious process whereby the ego buries distressing and threatening thoughts, feelings and memories down below the level of consciousness into the id.

So, to summarize : in the case of repression proper, distressing and threatening thoughts are prevented from ever gaining access to conscious awareness whereas, in the case of primal repression, distressing and threatening thoughts, feelings and memories which have gained ephemeral access to consciousness are banished from it (buried in the id).

However, Freud also pointed out that there is a high price to pay for the unconscious process of repression in so far as this hidden, buried information that has been forced down into the id will create symptoms of anxiety.

DISSOCIATION :

In the case of dissociation (one of the core features of complex PTSD), thoughts / feelings / memories do NOT get pushed down into / buried in the id ; instead, they become separated / compartmentalized in a different part of the ego.

So, we can finally summarize in this way :

  • In the case of repression, mental information / content is split off into the id.
  • In the case of dissociation, mental information / content is split off into a separate part of the ego.

NB : This distinction relates to how the terms are used in psychoanalytic theory ; in other areas of psychology, the term ‘dissociation’ can take on other meanings (as the articles listed below will show).

To learn more about dissociation, you may like to read some of my other articles (listed below) :

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

 

 

 

 

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Types Of Dissociative Amnesia In Complex PTSD

types of dissociative amnesia

We have seen how the cumulative effect of repetitive and chronic, traumatic stress during childhood is associated with the later development of complex posttraumatic stress disorder (complex PTSD) and that many of those afflicted by complex PTSD experience symptoms of dissociation (e,g. Freyd, 1996 ; Peclovitz et al., 1997). [Click here to read my previously published post : SYMPTOMS OF DISSOCIATION : MILD AND SEVERE.]

We have also seen how dissociative symptoms may manifest themselves in different ways and that one such way is DISSOCIATIVE AMNESIA.

In this article, I intend to briefly recap on what is meant by the term DISSOCIATIVE AMNESIA, including a short outline of the DIFFERENT TYPES OF DISSOCIATIVE AMNESIA.

WHAT IS DISSOCIATIVE AMNESIA? :

If an individual is suffering from dissociative amnesia, it means that they are unable, for a period of time (usually relatively short periods of time such as minutes, hours or days, but, in mush less frequent cases, months or even years), to remember information about themselves / events in their past (sometimes referred to as autobiographical memory). And, perhaps more surprisingly, they may have periods of time during which they fail to remember a skill or talent that they have learnt (sometimes referred to as semantic memory).

For such memory loss to be diagnosed as dissociative amnesia the memory loss must be far more severe than in ‘normal forgetting’ and not accounted for by another medical condition.

dissociative amnesia

THE DIFFERENT TYPES OF DISSOCIATIVE AMNESIA :

According to the American Psychiatric Association (APA), dissociative amnesia can be subdivided into the following types :

  • localized
  • selective 
  • generalized
  • systematized

Let’s look at each of these in turn :

1. LOCALIZED :

This involves not being able to remember a specific period of time. Often, this period of time will be the first few hours after the traumatic event has occurred (including the traumatic event itself) and can occur as the result of an isolated traumatic episode.

2. SELECTIVE :

This involves not being able to remember some (but NOT all) of the events that occurred during a specific (traumatizing) period of time (often, this may be the most traumatic aspects of the events which occurred during this time period),

3. GENERALIZED :

This particularly alarming and devastating form of dissociative amnesia occurs when the individual afflicted by it is unable to remember their ENTIRE LIFE including, remarkably, who they are and where they are from. Fortunately, this extreme form of dissociative amnesia is very rare.

4. SYSTEMATIZED :

This type of dissociative amnesia involves being unable to recall information associated with a particular category such as being unable to recall any memories associated with one’s abusive parent or associated with a particular location where one was traumatized. For example, I have virtually no memory of living in my first or second house which incorporated the years between my birth and my being about eight years old when my parents divorced.

 

To learn more about DISSOCIATION, you may wish to read one or more of my other posts on the topic (shown below):

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

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Overcoming Feelings Of Dissociation

 bpd and hallucinations

What Is Dissociation?

I have already discussed the phenomenon of dissociation in the article : Always Zoning Out? Dissociation Explained to recap very briefly, dissociation is a biopychological process that operates as a defense mechanism to prevent disturbing thoughts/memories/experiences from penetrating consciousness due to the unbearable burden of stress they would bring about were this mechanism not in place.

In so doing, dissociation can function to protect us from potentially highly potent emotions such as helplessness, fear and shame.

What Does Being In A State Of Dissociation Feel Like?

Feelings of dissociation can be seen as lying on a continuum : relatively mild dissociation involves feeling mentally ‘hazy’,’foggy’ ‘ numb’ and somehow ‘not fully present’ nor fully engaged with reality ; at the other end of the continuum, dissociation can involve complete loss of conscious memory of a highly traumatizing event / series of events / periods of one’s life (I describe my own experiences of dissociation in the article linked to above).

Depersonalization And Derealization :

Two important types of dissociation are :
a) DEPERSONALIZATION : this state involves cutting off from one’s own thoughts and feelings so that they do not feel like one’s own but those of somebody else. Individuals in this state can feel like an ‘observer of themselves’, as if they were watching themselves on a film screen.

b) DEREALIZATION : as the word implies, this refers to a feeling of ‘unreality’ – as if what is going on around one is unreal, surreal or dreamlike even when it is, objectively, ordinary and quotidian.

Overcoming Feelings Of Dissociation :

According to Dr Harold Kushner, author of Healing Dissociation, in order to overcome feelings of dissociation / dissociative disorders it is necessary to :

– gradually, as part of a therapeutic process, to come to terms with, and accept, the reality of one’s traumatic childhood experiences (as opposed to being in denial about this, repressing it or suppressing it)

– firmly recognize the traumatic experiences are now over and in the past

– firmly recognize that because the traumatic experiences are over and in the past, how one feels, behaves, thinks and acts no longer has to be constricted by these experiences – one is free to start making fresh choices and take on a new, more positive approach to life

– come to an acceptance that injustice, pain and suffering are inevitable parts of life and that what is of greatest importance is how one responds adapts to this inescapable fact.

– find meaning in one’s experiences of suffering, such as how it has developed one as a person and how it can lead to posttraumatic growth.

David Hosier BSc Hons; MSc; PGDE(FAHE).

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Structural Dissociation Theory

structural dissociation theory

Structural dissociation theory was developed by Van der Hart, Nijenhuis and Steele (2006).

Essentially, this theory relates to the idea that many of the behaviors that you may feel uncomfortable about, ashamed of, guilty about, or hate are likely to be the behaviors you unconsciously learned as a child to survive in an environment which was hostile, unpredictable, threatening and unsafe. In the present, these behaviors are likely to be triggered by any occurrences or events which, even remotely, resemble the events which once threatened your safety (psychological or physical) as a child.

In other words, the vulnerable, frightened child continues to live within you, trapped in the past, and responding to events now as if they (or, rather, what these events symbolize) were happening then (during your traumatic childhood).

These behaviors, then, can be seen as adaptations : behaviors that allowed you, as a child, to survive; I repeat : they are the legacy of the child within you that, under extreme circumstances, managed to survive and, as such, should cause neither guilt nor shame. THE BEHAVIORS WERE ESSENTIAL AS A MEANS OF PSYCHOLOGICAL SELF-PROTECTION.

 

Structural Dissociation Theory In Terms Of Neurobiology :

In terms of neurobiology (the physical/biological workings of the brain) the theory states that when events occur that we find threatening (on either a conscious or unconscious level) because they trigger implicit memories of our traumatic childhood :

the right half (hemisphere) of the brain and the left half (hemisphere) of the brain become disconnected to a degree that they no longer communicate with one another in an effective manner.

What Are The Functions Of The Left And Right Hemispheres Of The Brain ?

For the sake of simplicity,we can confine ourselves to the functions most pertinent to the theory :

  • The brain’s left hemisphere is involved with day-to-day functioning and is relatively logical, permitting us to struggle on despite internal, mental conflict.
  • The brain’s right hemisphere ‘contains’ the responses that you were forced, by extreme and hostile circumstance, to learn as a child in order to ensure psychological survival, including hypervigilance for imminent danger and perpetual readiness for fight/flight/freezing/fawning – whatever was necessary to avert danger (real or perceived).

structural dissociation theory

Splitting / Fragmentation :

The personality of the individual who has experienced severe childhood trauma can become split / fragmented so that when events occur that cause stress / fear / make the individual feel threatened / remind the individual, however tenuously (on a conscious or unconscious level), of their childhood trauma the responses stored in the brain’s right hemisphere are triggered (fight/flight/freeze/fawn responses) whereas the brain’s left hemisphere guides ‘normal’ everyday behavior, allowing the person, to some degree at least, to function. To simplify :

  • Stress, threat, fear etc / implicit reminders of childhood trauma = right hemisphere dominant
  • Everyday functioning = left hemisphere dominant

Compartmentalization and Self-Alienation :

Whilst such compartmentalization may allow our day-to-day functioning to continue under one guise or another, there is, however, a price to be paid : the individual can suffer from intense feelings of self-alienation, self-loathing, shame (that s/he is ‘concealing’ a ‘bad,’ ‘secret’ self) and a sense of being a ‘fake’ and ‘fraudulent’ person.

My next article (Part Two) will look at how we might best overcome this problem.

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David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

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Symptoms Of Dissociation : Mild And Severe

 

dissociation

If we have suffered significant childhood trauma, we may, as adults, frequently find ourselves in various states of dissociation, ranging from mild to severe. Indeed, dissociation is a key feature of complex posttraumatic stress disorder (Cptsd).

What Is Meant By The Term ‘Dissociation’?

Dissociation is a symptom of the effects of childhood trauma which we developed as a defense mechanism in order to better equip us to cope with the emotionally painful and destructive environment in which we grew up. It is a way of mentally escaping and psychologically cutting off from reality; it is sometimes colloquially referred to as ‘zoning out’ or ‘tuning out’.

Dissociation And Flooding :

We are particularly likely to dissociate when we feel overwhelmed, or ‘flooded’, by stress and psychological threat. Symptoms of dissociation can range from mild to severe. I outline examples of such symptoms below:

symptoms of dissociation

Mild symptoms include:

– feeling in a daze (sometimes referred to as ‘mind fog’),

– feeling utterly exhausted, numb and soporific for no obvious reason,

– finding oneself tongue-tied when trying to talk about difficult experiences (as if experiencing a kind of mental block).

 

More severe symptoms include:

– amnesia for certain events, or large periods of time, in one’s life (for example, I have no memory whatsoever of large chunks of my childhood) – such ‘dissociative amnesia’ far exceeds normal forgetfulness.

time loss : an individual may suddenly find him/herself in a particular place, with no memory of how s/he got there, unable to remember anything that has occurred in the recent past (eg the last few hours or days)

feeling very out of control (eg uncontrollably angry)

– periods of apparent deafness (at my first school, when things were at their worst at home between my parents, at times I did not respond to my name being called out in class – the school thought I was suffering from deafness; in fact, though, the cause was deep psychological trauma. This is certain as it became apparent this ‘deafness’ only occurred when the class was discussing parents/family matters or associated topics).

symptoms of association

 

Dissociation And Switching:

Some people dissociate when under extreme stress (ie when ‘flooded’, see above) in a way that almost resembles ‘changing personality’; this is referred to as ‘switching’.

In fact, it is NOT a literal switch of personality, but a switch of ego states/states of consciousness sometimes referred to by psychologists as ‘parts’ or ‘alters.’

Studies suggest that nearly all people who suffer such switching have experienced severe early life trauma. It is NOT a genetic disorder.

When a person switches due to stress, they switch from the ego state/state of consciousness/part/alter that s/he relies on for his/her day-to-day functioning to the ego state/state of consciousness/part/alter that is normally dissociated/’kept in a separate compartment’ in mind (it is this separation that allows the individual to function daily, by preventing the feelings in the dissociated part from interfering in it).

This dissociated part contains profoundly painful trauma related feelings such as fear, shame and anger.

 

Can dissociation be treated?

The short answer is, YES.

Individuals can be helped by becoming aware of the link between their childhood trauma and the dissociated part of their mind that they switch to when under severe stress.

As well as this, individuals suffering from dissociation can be enormously helped by learning the skills of mindfulness. Mindfulness, essentially, helps a person to live in the present/the ‘here and now’, rather than staying trapped in the past.

RESOURCES :

Excellent site about MINDFULNESS – mindfulness.org

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childhood trauma and homosexuality

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David Hosier BSc Hons; MSc; PGDE(FAHE).

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2 Opposite Ways The Child Responds To Stress : Hyperarousal And Dissociation

hyperarousal and dissociation in children

When, as children, we are subjected to trauma, stress, fear and even terror, our nervous systems may respond in two, diametrically, opposed ways. Both these responses, however, have evolved to serve the same purposes : THOSE OF SELF – PROTECTION AND SELF – PRESERVATION.

Both, too, involve biochemical changes in the brain (in particular the regions of the AMYGDALA, the HYPOTHALAMUS and the BRAIN STEM) and physiological changes in the body that, in turn, alter how we think, feel and behave (or, to put it in more psychological terms, they affect us on a cognitive, emotional and behavioural level).

To what degree the child responds to stress will depend upon the severity of the stress and its duration – the more severe and long-lasting, the more extreme the child’s hyperaroused or dissociatiated reaction is likely to be.

The psychological researcher, Sperry, has put forward an ascending scale showing different symptoms of HYPERAROUSAL and DISSOCIATION. I represent this scale below :

SYMPTOMS OF DISSOCIATION IN ASCENDING ORDER OF INTENSITY :

  • a sense of detachment
  • a sense of being numb (shut down of feelings/emotions)
  • compliance
  • lowering of rate of heart beat
  • distorted perception of time  (time may be perceived as ‘standing still).
  • a sense of being ‘detached from reality’ (the psychological term for this is ‘derealization’)
  • transient, discrete and ephemeral periods of psychosis (Sperry uses the term ‘mini-psychoses’)
  • fainting

SYMPTOMS OF HYPERAROUSAL IN ASCENDING ORDER OF INTENSITY :

  • constant feelings of being under threat and continuously being on the lookout for threats (unconsciously and consciously) ; the psychological term for this is hypervigilence
  • anxiety
  • reactivity
  • alarm
  • speeding up of heart beat, increased blood pressure, shallower / increased rate of breathing (the psychological term for this is hyperventilation), increase in amount of glucose released into blood stream and consequently delivered to the muscles (collectively, this group of physiological responses is frequently referred to as the fight/flight response).
  • fear
  • panic
  • terror

Significant stress giving rise to neurological changes that is repeated throughout childhood can, sadly, lead to long-term damage being done to the brain’s physical development (which can be learned about by clicking here).

hyperarousal and dissociation in children

 

Dissociation can be seen as avoidance strategy (although the ‘strategy’ forms automatically and on an unconscious level), involving a withdrawal from the ‘real world’ (as this ‘real world’ generates intolerable mental pain) into an ‘inner world’ (perhaps a ‘fantasy world’ of considerable complexity in which the child makes-believe s/he is ‘all-powerful’ or in which s/he is completely protected and safe : the short – term gains for the child, won by withdrawing into such a phantastical place of psychological refuge, hardly necessitates further elucidation.

During a period of significant trauma the child may (unconsciously) adopt one or both forms of psychological protection. In the case of the latter, when the biological and emotional demands of the hyperaroused response cease to be sustainable, s/he may switch to the dissociatiated form of self-protection (again, this entire process is unconsciously orchestrated).

 

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David Hosier BSc Hons; MSc; PGDE(FAHE).

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Childhood Trauma, Borderline Personality Disorder (BPD) and Dissociation.

childhood trauma

I have already written posts explaining the connection between childhood trauma and BPD. An important symptom of BPD is DISSOCIATION, which this post will examine in greater detail.

Dissociation is generally considered to be a COPING MECHANISM in response to severe trauma or stress. The phenomenon of dissociation can involve feeling disconnected from one’s emotions, one’s memories, one’s thoughts or even from reality itself. It is common in those suffering from BPD; BPD frequently occurs in individuals who have experienced childhood trauma.

Dissociation is, essentially, a way of ‘escaping’ from the stressful situation, or memory of the stressful situation, by changing one’s state of consciousness (this often occurs automatically and without intention); sometimes people report feeling ‘numb’. In situations of terror, one may dissociate, and, paradoxically, feel a detached state of calm. It may feel, too, that the traumatic event is not happening to oneself, but that one is ‘observing the traumatic event from outside of the body’, leading to passivity and emotional detachment.

Dissociative feelings of ‘being outside of oneself’ are described as DEPERSONALIZATION and dissociative feelings of being disconnected from reality are described as DEREALIZATION.

Some experts have described dissociation as working a bit like morphine – dampening down emotional and physical pain. However, it is yet to be properly explained what the exact biological mechanisms are that underpin the dissociative experience.

images

The four main types of dissociation are:

1) DISSOCIATIVE AMNESIA
2) DISSOCIATIVE IDENTITY DISORDER
3) DISSOCIATIVE FUGUE
4) DEPERSONALIZATION DISORDER

Let’s look at each of these in a little more detail:

1) Dissociative Amnesia: here, large parts of, or all, the traumatic event/s cannot be remembered.

2) Dissociative Identity Disorder: this is also known as MULTIPLE PERSONALITY DISORDER. Here, the person adopts two or more distinct, utterly different personas. The different personas talk in different voices, use different vocabularies etc (they can also actually differ in handedness). The different personas do not have access to ‘each others” memories, studies have shown, so they have distinct ‘personal histories’. It is likely that each persona represents a different strategy for coping with stress.

3) Dissociative Fugue: in this state, individuals can disconnect from their previous personalities, and, then, often, travel far from home to take on, and live under, a completely new persona. They may appear normal to others who have never met them before, even though they are living under a completely new identity, having left a whole life and set of memories behind.

4) Depersonalization Disorder: in this state, individuals can feel detached from their bodies or experiences. A phrase I read in a novel recently may aptly illustrate the sensation: ‘it’s like living in a dream underwater.’

A large number of people who have suffered extreme childhood trauma report experiencing such automatic dissociative states. Furthermore, they may often seek to induce dissociative states, deliberately and artificially, as a way of escaping the constant psychological pain resulting from the initial trauma by, for example, USING ALCOHOL TO EXCESS, USING NARCOTICS, SELF-HARMING or GAMBLING. The kinds of psychological state from which the individual is seeking to escape through dissociation include INSOMNIA, NIGHTMARES, FEELINGS OF RAGE and INTENSE ANXIETY.

LONG-TERM PROBLEMS OF DISSOCIATION:

Dissociation may be helpful (adaptive) in the short-term but problems develop when the state persists long after it has served any beneficial purpose. The psychologist ,Lifton, described prolonged states of ‘psychic numbing’ and ‘mental paralysis’ often resulting from a dissociative response to severe trauma. This can make even basic day-to-day functioning extremely problematic and requires professional intervention.

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David Hosier BSc (Hons); MSc; PGDE(FAHE).

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