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Dissociation occurs when your mind separates itself from the physical world. The experience feels like you're not mentally present in your environment. At one end of the spectrum, you may simply space out, while on the other end, you may feel totally detached from your physical self and surroundings. People often dissociate as a way to cope with trauma and psychological stress. When your mind becomes overwhelmed, dissociation acts as a coping mechanism, but it can leave you feeling disconnected and lost. We've put together a guide to help you deal with dissociation and stay grounded to work through dissociative challenges. [1] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
Steps
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Describe where you are at this moment. This is a simple way to remind yourself of where you are. Start by stating the location, then try to list as many details about it as you can. By doing this, you’ll be able to come back to the situation you’re in rather than feeling detached. [2] X Research source
- For example, you might say this: “I am at the dinner table. My sister is here eating with me. We are eating cereal. The cereal tastes very sweet and smells fruity. I’m wearing pajamas that feel soft on my skin. My sister is talking to me. She’s asking me if I want something to drink.”
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Identify things in the space around you, such as “everything that’s blue.” This helps you engage with the present, which grounds you in the moment. It’s similar to the game “I spy,” in that you’ll pick out certain things in your environment. Here are a few great prompts for doing this grounding activity: [3] X Research source
- How many red items do I see?
- How many round objects can I count?
- What kinds of patterns do I see?
- What can I smell?
- What do I hear?
- How are my senses engaged?
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Activate 1 or more of your 5 senses. Your senses provide you with the best link to the present because they make you more aware of where you are. When you feel like you’re detached, start by triggering 1 sense. Then, engage each of your senses, if you can. Here are some ways to do it: [4] X Research source
- Rub a piece of ice on your skin, run cold water over your hands, or snap a rubber band on your wrist. [5]
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Expert Source
Noel Hunter, Psy.D
Clinical Psychologist Expert Interview. 18 December 2020. - Apply a drop of essential oil to your pulse points and sniff.
- Eat something and focus on the flavors.
- Listen to the sounds of your environment.
- Describe what you can see around you.
- Stand on one foot—trying to balance will force your body to reengage with yourself. [6]
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Expert Source
Noel Hunter, Psy.D
Clinical Psychologist Expert Interview. 18 December 2020.
- Rub a piece of ice on your skin, run cold water over your hands, or snap a rubber band on your wrist. [5]
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Expert Source
Noel Hunter, Psy.D
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Use mindfulness to stay grounded. Mindfulness is the practice of living in the present. It can be very helpful if you struggle with dissociation. You might want to read books and magazines about mindfulness, or work through a workbook. It’s a skill that takes time to develop, but here are some ways to get started: [7] X Research source
- Do just 1 thing at a time.
- When you eat, focus on the flavors of your food.
- Go on a nature walk and focus on what you hear, feel, taste, smell, and see.
- Focus on your breath.
- Meditate . You can try using a free meditation app, such as Insight Timer, Calm, or Headspace.
- Try yoga .
- Check out magazines like Mindful , Happinez , Breathe , and Flow .
- Read books like Wherever You Go, There You Are by Jon Kabat-Zinn.
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Focus on how your feet feel on the ground. It’s best to do this barefoot. Place your feet on the ground and press them into it. Notice the sensations, such as smooth tile, scratchy carpet, or slick, wet grass. Walk around, concentrating on your feet touching the ground. [8] X Research source
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Watch for common symptoms of dissociation. This will help you recognize when you’re having episodes. Write down the symptoms you experience, as well as what was happening at that time. Keep in mind that dissociation occurs on a spectrum, with daydreaming or zoning out while driving along a familiar road being minor dissociative experiences. On the opposite end of the spectrum is dissociative identity disorder, which is a serious condition. [9] X Research source Common symptoms include: [10] X Research source
- Feeling mentally detached, spaced out, or not present
- Absent-mindedness or mind-wandering
- Perceiving the world as being unreal (known as derealization) or your sense of self as distorted (known as depersonalization )
- Observing your body as an "outsider"
- Emotional numbness and being unable to express how you feel
- Excessive fatigue or sleepiness
- Experiencing delayed reactions to life events
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Notice how you feel when you dissociate. This will help you identify episodes so that you can try to stop dissociating. Pay attention to your thoughts, sensations, and feelings. You should also notice triggers that occur often, as this will help you identify what is causing your dissociative episodes so that you can overcome them. Ask yourself these questions: [11] X Research source
- How do I feel? For example, you might feel detached, foggy, or like you’re floating above the situation.
- What am I thinking? You might have trouble forming thoughts or find that your mind has gone blank.
- What’s happening right now? You might identify what’s stressing you out.
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Keep a journal to help work through your experiences. Journaling is a great way to work through your emotions and cope with difficult experiences. Not only can journaling help you keep track of your episodes and learn to process them, it can also help you process your past. [12] X Research source
- Write in your journal every day. Document your everyday life, your feelings about the past, and your dissociative experiences.
- When you do notice an episode, record what lead up to it and how you felt.
- In some cases, you might choose to bring your journal with you to your therapy sessions, if you go to therapy.
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Understand that there are different kinds of dissociation. Although mild detachment is generally a normal psychological response to stressful situations, some people can experience this condition chronically and for a longer period of time. [13] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source Severe and prolonged dissociative episodes can be symptomatic of mental illness; thus, you should consider talking to a mental health professional if you are genuinely struggling with your experiences. According to the Diagnostic and Statistical Manual of Mental Disorders (5th edition) , conditions in which dissociation is a prominent symptom include: [14] X Research source
- Depersonalization disorder occurs when you feel detached from your life or yourself.
- Dissociative amnesia occurs when you forget parts of your life, often to mask a trauma.
- Dissociative fugues occur when you forget who you are and also travel to a new, unfamiliar location.
- Dissociative identity disorder (DID) occurs when your mind splits into separate, individual personalities as a response to extreme trauma.
- Dissociative Disorder Not Otherwise Specified (DDNOS) is diagnosed when you experience symptoms of dissociation but don’t meet the requirements for diagnosis for any particular disorder.
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Ask for help identifying when you dissociate, if necessary. It’s normal to not realize when you're dissociating. Luckily, it’s easy for the people who care about you to notice, as you’ll likely appear as though you’re in a daze. Ask them to help you recognize when this happens. [15] X Research source
- You could say, “I know that I tend to dissociate when things get rough, but it’s hard for me to notice when I’m doing it. Can you tell me if I look spaced out?”
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Meet with a therapist who specializes in trauma. Dissociation most often results from trauma, so it’s important that your therapist have experience working with trauma victims. Ask your potential therapists about their experiences. You may also choose to look at their website or advertisements to see if they list trauma among their specialties. [16] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
- You can ask your doctor for a recommendation or find a therapist online.
- Since a safe environment is essential for your recovery, ask to visit the office ahead of time. You need to feel completely comfortable in order to work through the underlying trauma that triggered your use of dissociation as a coping skill.
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Undergo talk therapy to work through your underlying trauma. Talk therapy is the most recommended treatment for dissociative disorders. Your therapist will help you work through your past trauma and learn how to stop dissociative episodes when they start. [17] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
- They will likely help you work through the grounding process provided above.
- They’ll also help you talk through your trauma without dissociating.
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Develop new coping strategies. Dissociation is a coping strategy, so you’ll need alternative strategies to help you overcome it. Your therapist will help you identify options for you. For example, you might learn to call a friend when you feel stressed, use deep breathing , or engage in daily self care. [18] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
- Strategies like this require a lot of daily practice to be effective, so don't worry if your progress seems to be slow at first. [19]
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Expert Source
Noel Hunter, Psy.D
Clinical Psychologist Expert Interview. 18 December 2020. - Find practices that help lower your overall stress and anxiety levels, like grounding exercises, breathing exercises, or progressive muscle relaxation. [20]
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Expert Source
Noel Hunter, Psy.D
Clinical Psychologist Expert Interview. 18 December 2020. - You could create a self-care box to pull out in your time of need. You might include a comforting book, essential oils, a soft sweater or blanket, a CD with relaxing music, hard candies, or tools for a hobby. You can pull out your box to help you ground yourself and cope with what’s happening.
- Strategies like this require a lot of daily practice to be effective, so don't worry if your progress seems to be slow at first. [19]
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Expert Source
Noel Hunter, Psy.D
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Consider antidepressants if you have depression or anxiety. There’s no medication for dissociation. However, you may experience feelings of depression and anxiety along with your dissociative disorder. This is normal and treatable. Your doctor can determine if antidepressants are right for you. [21] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
- Antidepressants can cause side effects. Common side effects include dry mouth, nausea, blurred vision, constipation, increased appetite, weight gain, fatigue, dizziness, restlessness, agitation, insomnia, and sexual issues. [22] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
- Similarly, medications aren't intended to fully solve your problems. Instead, they can help manage your symptoms while you work through them in therapy.
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Join a support group for trauma survivors. A support group allows you to share your experiences with people who can relate because they have had similar experiences. You can also learn from others who’ve been through a similar situation. This can provide much needed emotional support to help you on your road to recovery. [23] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
- Ask your doctor about groups that meet in your area. You can also ask local treatment centers or look online.
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Go to physical therapy if you experience physical symptoms. In rare cases, people with dissociative disorders have physical symptoms, like paralysis, loss of speech, or trouble walking. Luckily, physical therapy can help! Your therapist and doctor can help you get a referral to someone who can help you manage or overcome these symptoms, if you have them. [24] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
- You may also try Sensorimotor Psychotherapy to help you overcome past trauma and dissociation. This will help you overcome somatic symptoms that your issues may cause by helping you reconnect with physical sensations and your body. [25] X Research source
- Most people who have dissociative disorders won’t need physical therapy, but it’s a helpful resource for those who need it.
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Expert Q&A
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QuestionHow do you quickly overcome dissociation?Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.Do something that physically brings you back into your body. For instance, you might engage one of your 5 senses, like holding an ice cube or snapping a rubber band on your wrist. You might also stand on one leg—when you do balancing exercises, it forces your body to reengage with yourself.
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QuestionDoes dissociation ever go away?Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.Dissociation is the freeze part of the fight-flight-freeze response. Preventing that from happening requires a lot of daily exercise to get your overall level of stress and anxiety down when you're not in that situation. For instance you might practice grounding exercises, breathing exercises, and progressive muscle reaction. That way, when your stress levels do rise, you don't automatically slip into that freeze response.
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Tips
- Remember that dissociating is a coping strategy that helps you deal with negative events. Don't feel bad about doing it. It can be helpful once you learn how to manage it. [26] X Research sourceThanks
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References
- ↑ https://www.nhs.uk/conditions/dissociative-disorders/
- ↑ https://depts.washington.edu/hcsats/PDF/TF-%20CBT/pages/7%20Trauma%20Focused%20CBT/Dissociation-Information.pdf
- ↑ https://depts.washington.edu/hcsats/PDF/TF-%20CBT/pages/7%20Trauma%20Focused%20CBT/Dissociation-Information.pdf
- ↑ https://depts.washington.edu/hcsats/PDF/TF-%20CBT/pages/7%20Trauma%20Focused%20CBT/Dissociation-Information.pdf
- ↑ Noel Hunter, Psy.D. Clinical Psychologist. Expert Interview. 18 December 2020.
- ↑ Noel Hunter, Psy.D. Clinical Psychologist. Expert Interview. 18 December 2020.
- ↑ https://www.harleytherapy.co.uk/counselling/dissociation.htm
- ↑ https://depts.washington.edu/hcsats/PDF/TF-%20CBT/pages/7%20Trauma%20Focused%20CBT/Dissociation-Information.pdf
- ↑ https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders
- ↑ https://www.harleytherapy.co.uk/counselling/dissociation.htm
- ↑ https://www.psychologytoday.com/us/blog/the-sum-my-parts/201107/dissociating-is-watching-your-life-50-feet-the-ground
- ↑ https://www.harleytherapy.co.uk/counselling/dissociation.htm
- ↑ https://www.nhs.uk/conditions/dissociative-disorders/
- ↑ http://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20%28%20PDFDrive.com%20%29.pdf
- ↑ https://www.psychologytoday.com/us/blog/the-sum-my-parts/201107/dissociating-is-watching-your-life-50-feet-the-ground
- ↑ https://www.nhs.uk/conditions/dissociative-disorders/
- ↑ https://www.nhs.uk/conditions/dissociative-disorders/
- ↑ https://www.nhs.uk/conditions/dissociative-disorders/
- ↑ Noel Hunter, Psy.D. Clinical Psychologist. Expert Interview. 18 December 2020.
- ↑ Noel Hunter, Psy.D. Clinical Psychologist. Expert Interview. 18 December 2020.
- ↑ https://www.nhs.uk/conditions/dissociative-disorders/
- ↑ https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20049305
- ↑ https://www.nhs.uk/conditions/dissociative-disorders/
- ↑ https://www.nhs.uk/conditions/dissociative-disorders/
- ↑ https://www.goodtherapy.org/learn-about-therapy/types/sensorimotor-psychology
- ↑ https://www.harleytherapy.co.uk/counselling/dissociation.htm
About This Article
Article Summary
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Dissociating can be scary, but you can learn to recognize the signs and cope with it when it happens. When you dissociate, you may feel detached, numb, sleepy, or like you’re watching your life from outside yourself. It’s different for everyone, and it’s also normal to not even realize when you start to dissociate. Try telling someone you trust about your dissociation, so they can help you recognize it when it happens. When you notice an episode coming on, try to ground yourself by describing where you are and what you’re doing. You might say, “I am at the table with my sister. I’m eating cereal. The cereal tastes sweet.” You can also ground yourself by activating one of your senses. For instance, try rubbing a piece of ice on your skin or applying some essential oil onto your wrist. Keep in mind that dissociative episodes can be mild or more severe. If you have trouble remembering what you’ve just done or where you’ve been, talk to a doctor. They’ll be able to help you find the best treatment option, such as therapy or medication. To learn how to document your dissociative episodes, read more from our Counselor co-author.
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