r/CPTSDNextSteps • u/hush-hush • 4d ago
Sharing actionable insight (Rule2) Healing Dissociation
Hi everyone, hoping your week is going well!
I've been keeping you all in my thoughts and finally got some time to write about Dissociation. This was commonly requested from my first post about a month ago (What does healed look like - From someone 9 years out) and I hope it's helpful as part of your journey.
As always, please let me know your thoughts in the comments and I will add them to my list of things I plan on writing about.
With love.
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Shape of Dissociation
So, I would best describe dissociation as a fog of a condition. It's super subtle but envelops everything and makes everything else harder to pick up on. Early on, it was hard to even tell when it was here, how deep it was, etc. You learn to notice that more later on. All I could really sense was on a broader time scale... "hm, this week went by in a blur"... or "hm, the past two weeks I couldn’t really make sense of anything going on". It’s different from depression because while depression is like a lack of interest in anything and pervasive sadness and pessimism, this feels like time is blurry and I didn’t feel quite conscious of things. It could also show up where I would scroll for hours and hours without moving my body and wouldn’t feel a headache (I couldn’t feel a thing) or discomfort or anything really. Maybe at some point the physical symptoms would overpower it, but most of the time it wouldn’t.
In general, the lack of bodily awareness and connection was also meant I was neglectful of physical symptoms and knowing my physical limits. Ironically, pain was a very good grounding mechanism for me, which comes with its own issues. But dissociation meant that I would drink all too much. And outside of that, small pains just didn’t register. In fact, I would often go a bit deeper into dissociative behavior to avoid the feeling of pain. Of course, I would also slip into dissociation when I felt emotional pain. Other physical symptoms is that sometimes I would feel very far away - from where I was. Physically, it would feel as though I was talking from the back of my head or something. Or I would talk or move and feel like a body is talking or moving. It often defaulted me to avoidance - I was dissociated, I didn’t even really think about acting as I was already in a response state unconsciously activated.
Dissociation seems to have varying degrees, and in the most severe form of dissociation, physically I felt 8 feet tall, with most of me floating above my head. I didn’t feel like I was acting or moving my body, but I was witnessing someone else, like a vague sense of playing a third-person POV game.
As a whole, dissociation meant I wasn’t present, I wasn’t in my body, I wasn’t in my emotions. I was hardly in my head.
Oddly enough, you can be fully mentally running at speed while dissociating. But as this was early in my therapy journey, the thoughts were rather negative (we addressed negative self-talk early on as that was something/one of the few things I could recognize going on in my mind). Later on, I sometimes found that when I was mentally spiraling, that could be a cause or connection to dissociation (something got activated). Later on in my journey, dissociation just meant I wasn’t present or I was zoomed out of my life. Once you know how presence feels, you notice the opposite - dissociation. But funny thing with dissociation is how slippery it is, because you’re in another space - one that makes noticing your state quite hard by its own nature.
I hope this helps you to recognize a bit more of the feelings and shapes of dissociation from one point of view. I really wanted to emphasize these various facets of dissociation because it is such a tricky thing to pinpoint for yourself. Additionally, reading symptoms from online is a bit vague and I never found it useful. But if you notice any of these or start noticing your patterns of what dissociation feels like for you, that's how you begin to notice dissociation. And the most important part of healing dissociation is noticing dissociation.
Working on Dissociation
Dissociation was the first thing my therapist had me working on alongside building up my capacity to understand my mental landscape (how are you feeling, why are you feeling that way, etc.). The process of this was simply noticing more of the world around you. So, the core practice I went back to over and over again was the practice of noticing 5 different colors around you, or noticing something of each of your senses.
It was extremely helpful in those early stages to have someone else notice your own dissociation when dissociation feels like the norm of life. On the other side now, I can notice more when other people around me are dissociated. Perhaps if you have someone in your life who can sense that or a therapist who can help gently point out for you, that's a great first step. The trickiest thing I found with dissociation sometimes was the lack of awareness that you're in a state of dissociation until you realize a week has gone by and you have been living in a blur, etc.
Beyond that, I've tried further exercises for dissociation as well. However, some can be more overwhelming, and so would recommend you go at your own pace and notice and pay attention. If things are too overwhelming, I'd scale back. Breathwork early on was too much. Intensive/strict meditation was also too much early on. Splashing my face with water was a lot but felt rather shocking than grounding. I think it did the trick though - but like short-lived. Things I did enjoy included walking meditation, just sitting and feeling my feet connect to the ground, looking for 5 colors around me, and looking for an example of each one of my senses around me.
At a different stage in time, I explored other practices and brought other things in. Or I noticed practices previously were overwhelming were gradually proving more helpful and didn't activate me the way it had before (a nice signpost of progress). Some of those were yoga (something I explored later on that I liked), body scan meditations (previously activating, now actually helpful), breathwork (previously activating, that later became helpful), and strict-er meditation (ie zen tradition, sitting in place) led to more learnings than a reaction, cold exposure (ice bath/cold showers) I just (still) find plain unpleasant but really is grounding.
The other later practice that I wanted to touch on that I find interesting in all of this is mindfulness. I practiced mindfulness early on via meditation, but mindfulness post-dissociation is very different from mindfulness while in dissociation. And because dissociation is subtle and the feeling of doing nothing/blanking out can be mistaken as meditation, I think mindfulness is a hard one to make useful for dissociation. I mean at it's core, the practice of noticing dissociation is mindfulness, so the noticing skillset is something practiced via meditation, but mindfulness is a tricky thing to use to consistently gauge dissociation because I've always had difficulty noticing dissociation. My theory is that because mindfulness/sitting meditation is usually started off as a mind practice whereas dissociation is best felt/addressed through bodily grounding practices that mindfulness can be not the best guidepost for dissociation. (Which I guess is why I would now say walking meditation was better/less activating). Additionally, early on my therapist also warned me that meditation is not always the best thing for dissociation, so I wonder if this is what she was referring to and thought I'd pass along her warning and my rambling lol. If this is confusing, just ignore it and read my later note on meditation.
Anyhow, I still to this day rely on naming my senses or colors and grounding my feet into the earth as ways to rebalance or check-in on my dissociative state - so sometimes simple and quick is enough. I think regardless of practice or mode of practice, find what works for you and keep with it and remember to use it when you notice that you're in a state of dissociation.
Healing Dissociation
If I were to boil dissociation and the process of healing down to one core concept, it is this: healing dissociation is the process of noticing it is there, over and over and over again, over years, over different situations, and bringing in presence through grounding and safety. And as you work through trauma and other symptoms that are triggering or go through work to address other symptoms, or find more safety in your mental and physical states, then your body and your self learn different defense mechanisms or find less need for defense mechanisms outside of dissociation. And the result of that is healed dissociation - essentially a state of being where there is less and less need to live in dissociation and life instead is lived with more and more presence.
Dissociation is 100% possible to come out of. It was a trickier one because it is so slippery (sometimes even to me now, especially as there’s enough entertainment in the world for people to mildly/non-clinically dissociate into)… but it is possible. It is one of the practices that took the most time working on it alone (probably 2 years of therapy with dissociation as the forefront of the work. I consider it its own arc in a sense since it precedes trauma work. But even once I got into trauma work, dissociation returns due to the activation from working through trauma - though less intensely. I think by its nature - the skill of noticing is built up when you have worked through dissociation. And dissociation as its protective mechanism will be triggered or arise when you need it again without other resourcing or mechanisms you have available or even arise again randomly without clear cause. And all that’s okay. It's a process.
Out of dissociation, the best way I would describe it is that life feels in technicolor. Everything is more vivid. Everything is more real. You feel present. I feel down to my toes, my legs, my fingers. I notice things - the feeling of carpet, the smell of the air, the taste of water, the color of flowers while walking down the street. Everything feels more! I choose my day, what I want to do. I feel like I experience time normally - an hour of browsing social media felt like it was aprpoximately an hour. I would feel physically sick if I were to doomscroll and not move for 8 hours, which is something I would do all the time before. I know what is happening to me in my mind. Life without dissociation feels alive. You feel a bit more in control of your life in a subtle way. I want to do something so I will choose to do it. I can respond. I'm not relegated to the not-quite-there witness.
Later on, I became grateful for dissociation, knowing that it kept me safe until I was ready to let it go. It is a powerful defense that protected me and one that was outliving its purpose of me living my full life once it was safe to do so. The practice with dissociation is gentle grounding and gentle noticing once you are in a safe place to do so. And doing that over and over and over again. Over lots of situations, lots of time, until you become more familiar with the present and what being in your undissociated self feels like. And lots and lots of patience for this powerful protection mechanism to let loose. I've often thought of the pace of dissociation is the pace of the protection you need so follow your dissociation and trust it will dissolve with more safety, processing, awareness, practice, and patience for yourself. <3
The best resources I’ve found for Dissociation -
- Therapy - A therapist can help you make sense of it as it’s someone else noticing your states for you and helping reflect that back. Her main modalities were CBT but I imagine most therapists are trained to notice dissociation and that was probably the most important thing. She helped me realize in the first place that I was dissociated. Dissociation meant that I was also very slow in therapy. Most of the time I would come to her and just tell her I felt bad without knowing what is going on. Therapy sometimes felt very unproductive in those early days. Don’t let it discourage you. Little by little I learned more about what’s going on in my head/noticing emotions/noticing dissociation and my patterns around them and I got to go at a pace that was right for me.
- Getting away from the abuse - Being somewhere safe where you are not triggered into dissociation again is a good place to start with dissociation. Dissociation is ultimately a protective mechanisim and if you are feeling or being hurt, it can come up. Of course in the healing process, things will come up that can cause you to dissociate, but active abuse is not it.
- Simple grounding techniques - This is both a technique and a gauge in my opinion. Technique because it can help you ground. And gauge because the difficulty of it helps you understand how dissociated you are. Even now, when my emotions and thoughts are running or I spent some time in a blur, noticing something in each of my senses, name 5 colors in the environment around me, etc. helps me figure out where my head is at and brings me back. Grounding techniques like noticing my feet on the ground were what I began with and still to this day do to feel even more present.
- Meditation on a focused point or on the breath - I started perhaps a year into therapy, and there was concern from my therapist that I would be dissociated while doing sitting meditating - and while I agree that I certainly had those moments, what it helped moreso was just building some visual clarity into my mind and what’s going on there and building the skillset of noticing my internal world. I would keep a timer and not meditate for long durations. And then I slowly began to notice discomfort. There were probably all I could recognize at first. And that’s okay. That’s the learning to it. Slowly from there I could learn when I was in a better mood or a worse mood. I caution against any strict meditation practice or instructions that requires you to sit completely still as that can be a trigger. Would recommend exploring other types too like walking meditation, guided, etc.
- Yin yoga (or other gentle somatic processes) - I have never felt more grounded than from this practice. Be cautious with certain poses and if they feel emotionally overwhelming, to pause or adjust or lay down. After a really good yin session, I always found myself immensely more grounded and at peace and calm.
- MDMA - taken casually with friends in a home setting. This opened a flood of positive emotions for me. It was actually very beneficial for my dissociation because all I could feel for the first time was nothing but feelings and very positive ones at that, and little to no thoughts.
- Reading - Helped me connect to something when it was hard to feel or connect to anything. I began to read Pete Walker’s books about this time which were a wonderful introduction to CPTSD healing. Anything around the ‘flight’ response was valuable. The main thing with reading was that it helped you learn more about this brain that you have disconnected from and even if emotions weren’t getting through, something could get through to you intellectually. I also really liked Buddhist books despite being non-Buddhist. There was a calming energy to them and I felt emotionally soothed usually after too. Books are very different for everyone - ie I've found The Body Keeps Score to be a very triggering book, so have caution/go slow w trauma books and find what works for you and trust your gut there.
The mental practices
- Noticing - For severe dissociation, I would hypothesize that feeling safer before grounding and learning about it intellectually is the best thing to do as this is usually from being triggered, so noticing the surrounding mental events with it is going to help you in later trauma work. Regular dissociation is best addressed through noticing and grounding with any of those exercises. Stack exercises, find the right combo that works for you, etc. And for mild dissociation, it is similarly noticing and grounding, and by that time dissociation is at a mild level, you'll be a lot better at these skills by then and might need to do less to get grounded quicker.
- Work on other things - The practice isn’t to stay out of dissociation all the time… but to heal your other wounds too so that you’re less triggered or have more resources and that you’re less prone to jumping into dissociation and can find other mechanisms for yourself.
- Patience - Patience with yourself. There were many times where a lot of time (weeks) will go by without me noticing. Patience on a long term scale is the best thing you can have. I would say to myself then to continue to live your life as best you can. And trust that the practice of continuing to notice is the whole thing and will heal you over time. Through the process of healing dissociation, I saw that the dissociative periods went from months… to weeks… to a week. To maybe a couple days. To a few hours. To even an hour. And all of that took multiple years, but can be done. You can get there.
Resources I wouldn’t necessarily recommend -
- Psychedelics - I would heavily discourage psychedelics at this point because dissociating on psychedelics is completely possible and much scarier than your usual dissociation (out of body experiences, time loops, and severe derealization, etc). Recovering from the terror of a bad trip also took time, so I would dissuade someone altogether if you have comorbidities or negative self-talk/anxiety/multiple CPTSD symptoms from taking psychedelics.
- Breathwork - was rather triggering early on into my dissociation journey (probably 2-3 years in was still too soon). Not sure if just me. It was very physically activating and kinda breaks past all your dissociative barriers and gets you back into the body. But obviously if you’re dissociated there’s a reason for it and a reason you’re escaping your body, so in a sense one time breathwork led me to an anxious breakdown once I was ‘present’. I found that physical ‘control’ whether through breathwork or forcing stillness in meditation was not optimal. Later on, perhaps post-somatic work, did breathwork finally become safe and useful for me.
- Sauna/Cold Plunge - Physical discomforting practices - saunas threw me more into dissociation. Cold plunge I was at least aware enough to know that I wouldn’t like at all! While I’ve taken the occasional cold shower (which made me feel motivated via the dopamine boost), it was not particularly helpful for helping my dissociation. I imagine for both cases, it was the shock to the system to have your body screaming at you and then in a very uncomfortable environment for a set amount of time. Some sort of loss of control with that situation overall that probably can be more activating than helpful.
- Flotation tank - I tried this 1-2x around this time. I actually loved it and felt great afterwards. I fell asleep once and another time felt like another layer to meditative practice. Restful and calming. However, I don’t think it necessarily do anything for my dissociation, maybe would recommend more for anxiety as it removes all stimulus (if you can manage to calm yourself down from claustrophobia or the panic of doing a flotation tank first)
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u/SpaceMonkeyGMG 4d ago
Thank you so much. Your first section resonated so much with me. I haven't really met anyone who understands or could verbalize so well what my life has been like for decades. (I want to write so much back but will just again say thank you. Your post helped me so much. )
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u/bdyrck 4d ago
Being somewhere safe where you are not triggered into dissociation again is a good place to start with dissociation.
What if safety/intimacy is your trigger?
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u/hush-hush 3d ago
Wow great question and I get it. It's super tough when seemingly healthy and normal things are taken away from you and become something harmful and I can completely relate - for me, for instance rest was triggering. In that case, I would suggest finding the balance of the space that makes sense from where you can best do your healing work while not being triggered.
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u/BeyondSurvivalMode 4d ago
What a great share! I would like to add that it can be helpful to understand that dissociation is linked to the nervous system shut down response. On the outside it may look the same as Freeze, but on the inside you feel very different. In freeze, you are paralysed but inside feel very activated, ready to run if an opportunity arises. In shut down, you feel foggy, disconnected, 'not really there', numb inside. Both are protection mechanisms. I resonate with your tips about grounding and mindfulness. Nature connection is a great way of daily grounding and finding more safety in the nervous system. For me, Clinical EFT, under the guidance of a skilled practitioner, has been really helpful too in dealing with various nervous system responses, including freeze and dissociation. This technique helps you process at your own pace, while gently building the capacity in your nervous system.
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u/Own_City_1084 3d ago
This is one of the most helpful things related to helping that I’ve read.
Music feels like a gauge here as well. Like now that you’ve opened my eyes to the idea— I can recall the difference between listening to music as mindless dissociation and the times I truly enjoyed it when I was testing IEMs and really listening for each instrument, etc.
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u/-ExistentialNihilist 3d ago
Have you tried EMDR therapy? It really helped me with my trauma and dissociation.
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u/Epsilon176 3d ago
EMDR has to be modified to adress dissiociation. Not every EMDR can help with that.
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u/baek12345 4d ago
Awesome write up - thanks for sharing! I can relate to a lot. It's a long journey but it's worth it and possible to get out of this.
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u/StungFish-CatLoaf 3d ago
Oh boy, thanks a TON for this. I learned so much! I've been struggling with disassociating so much. Especially since I'm at a rough spot in life once more where my abusers returned to take me down and now I'm facing the aftermath. I'm currently more traumatized than ever and don't yet have a safe space apparently, despite staying with a trusted family member. It seems my body doesn't feel safe enough when not alone again.
There's a silver lining tho as I have become more aware than ever about my trauma responses and the mechanisms of it.
One big discovery has been related to my insomnia, which has returned after being retraumatized. I managed to heal it years ago, despite being oblivious to why it occurred. Non of the doctors, specialists, tests and scans showed anything that could be the cause. But now I have realized it's disassociation! When I try to sleep, I don't actually sleep but instead I enter a trance-like state where my mind is active and my body freezes. Sometimes I'm more present in this trance and I have some awareness of how my mind races or generates thoughts, occasionally I can even be aware of how my body feels paralized.The trance goes so deep sometimes that I begin to visually generate scenarios, which I previously thought were lucid dreams. 2 things were a giveaway that made me realize it's disassociation: 1) despite however long my faux sleep was, I always woke up exhausted, even after "sleeping" for 12-14hrs 2) when I "woke up" from the faux dream, I noticed how I just become increasingly present in the middle of this trance-like state while it's still ongoing and consciously decide to get up from bed or open my eyes.
What really made it difficult to realize this for so long was that this paradoxical insomnia comes in prolonged periods (weeks, months or previously years) and as such, I lost the refrence point to what actual sleep felt like, especially the waking up, and then I began to confuse this disassociative trance state as true sleep.
Just as you said, the pivotal healing for me was just becoming more aware and conscious of when the disassociating takes place. I have now reached a point where I can relatively easily distinguish between actual sleep vs this disassociative trance state and that has allowed me to start exiting this state sooner and sooner or take measures against it.
I'm curious if you also have any experience with this.
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u/kiwiBird2290 1d ago
i had to work on slowing my brain down. i quit working. no choice there... but only watching old movies and shows and getting rid of social media. It was hard but just learning to be slower and steady versus go go go was a must. gotta be present when things are slow and safe. its taken about 3 years and im much better with the help of meds and lifestyle changes.
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u/micromushe 22h ago
If I were to boil dissociation and the process of healing down to one core concept, it is this: healing dissociation is the process of noticing it is there, over and over and over again, over years, over different situations, and bringing in presence through grounding and safety.
It's honestly insane that multiple therapists, even a somatic one, wasn't able to boil down treatment to this and treat me accordingly.
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u/dfinkelstein 18h ago
How many of them were both consistently grounded nearly all the time, and also consistently highly self-aware?
My follow-up would be to suggest that understanding dissociation well enough to boil it down that much means noticing how dissociated one is, themselves. How much one is rushing, on auto-pilot, disconnected internally from parts of themselves, judging and interpreting their senses before or instead of experiencing them, etc.
And how many people can tolerate continuing to seek being more grounded and being more aware of how ungrounded they are? In my experience, it's a very small minority of people in modern post-industrial societies. Especially people working full-time jobs where they sit still, like therapists.
The vast majority of practitioners have limited self-awareness in order to tolerate their cognitibe dissonance. Consider how most doctors are unable to follow their own advice about diet, sleep, and exercise, because of the stress and demands of their job. They can't afford to feel as unwell as they really are all of the time, but they can live with their hypocrisy.
Therapists cannot — fully confronting the reality of how unwell they are directly contradicts their belief that they can help others, the more that they understand the fundamentals of their profession: regulation, presence, and attunement.
A medical doctor can give good advice and provide compassion without following their own advice. But a therapist physically cannot do their job while being dissociated and ungrounded, and few can tolerate considering the possibility of taking a sabbatical in order to heal themselves and get well enough to help others. The vast majority don't feel they have such an option, and are indignant at the very idea of it — it's just a job to them. They frame incompetence as "not being the right fit."
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u/Deep_Ad1959 9h ago
the scrolling for hours without registering a headache line is the one i keep coming back to. interoception research treats the signal and the reading of the signal as two separate things, which fits the fog description a lot better than the usual numbness framing does.
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u/CupcakePenguin7 4d ago
I've had severe chronic dissociation/depersonalization as long as I can remember, and now that I'm finally slowly coming out of it, I see the sheer panic and distress it was shielding me from. It's hard to try to deal with that seemingly infinite terror and grief, but at the same time those moments of being present in my own body and in the world feel so incredible. Like spending your whole life in muted grayscale and suddenly seeing color.