DISSOCIATIVE DISORDER TREATMENT

What Is Dissociation? 

Dissociation is the brain’s way of creating distance from overwhelming experiences. It separates you from thoughts, feelings, or memories that are too much to process in the moment. While dissociation is often linked to trauma, it is not always a sign of a disorder. Everyone dissociates to some degree at different times in life.

Dissociation on a Spectrum 

Dissociation happens on a continuum. On the mild end, it looks like daydreaming in class, zoning out during a long drive, or getting lost in a book. These experiences are harmless and common. On the severe end, dissociation causes memory gaps, feelings of detachment that last for long periods, or shifts in identity. These symptoms can disrupt relationships, work, and daily functioning, and this is when dissociation becomes part of a disorder.

Dissociation in Mental Health Conditions 

Dissociation can appear in a range of conditions. People with Borderline Personality Disorder (BPD), for example, may experience brief dissociation during moments of extreme stress. But for some, dissociation is not just a symptom: it becomes the core issue. This is when we talk about dissociative disorders.

The three primary dissociative disorders are:

• Dissociative Amnesia
• Depersonalization/Derealization Disorder (DPDR)
• Dissociative Identity Disorder (DID)

Dissociative Amnesia

Dissociative Amnesia occurs when someone cannot recall important personal information, usually related to stressful or traumatic experiences. This memory loss is not explained by ordinary forgetfulness or a medical condition. Memories may disappear for hours, days, or even years, often resurfacing later in unexpected ways.

Day in the life: Someone goes to work as usual but finds that coworkers talk about a meeting they cannot recall. They check their notes and see handwriting they recognize as their own, but they have no memory of writing it. They may spend the rest of the day feeling disoriented or ashamed, worried that others will notice the gap. Sometimes this amnesia is localized (around a specific event), while in other cases it is generalized, involving large pieces of life history that feel erased. Living with this condition often means carrying anxiety about “blank spaces” in your life.

Depersonalization/Derealization Disorder (DPDR)

DPDR involves two types of dissociation. Depersonalization is the experience of being detached from yourself, as if your thoughts and body are not your own. Derealization is the sense that the world around you is unreal, foggy, or distorted. Many people with DPDR know logically that the world is real, yet it feels disconnected and strange.

Day in the life: A college student sits in class and suddenly feels like they are watching themselves from outside their body. Their voice sounds like it belongs to someone else, and their hands don’t feel attached. On the walk home, the buildings look flat and unfamiliar, as if the environment is staged. This can lead to panic, fear of “going crazy,” and a constant search for ways to feel real again. Unlike daydreaming, these episodes can last for hours or days and cause severe distress.

Dissociative Identity Disorder (DID)

DID is the most complex dissociative disorder. It involves the presence of two or more distinct identities or personality states, often called “parts.” Each identity may have its own memories, emotions, and behaviors. These shifts are not under voluntary control and are usually linked to early, chronic trauma.

Day in the life: A parent is preparing dinner when they suddenly “lose time.” They return to awareness to find the stove turned on and a meal half-cooked, but they don’t remember starting it. Later, their partner mentions a conversation that one part of them remembers clearly, but another part has no memory of at all. These identity shifts can affect relationships, employment, and safety, leaving the person feeling like they cannot trust their own mind. DID is often misunderstood, but it is a response to overwhelming trauma that the brain compartmentalized into different parts to survive.

Daily Impact of Dissociation 

Living with dissociation can disrupt every aspect of life. People may find themselves missing pieces of time, struggling to trust their own memory, or feeling detached from their body for long stretches. Others may move through daily routines in a haze, disconnected from relationships and responsibilities. This unpredictability often creates shame, confusion, and fear, and it can feel nearly impossible to explain to others.

How to Identify if Someone May Be Experiencing Dissociation 

If you’re reading this section, it may be because you’ve noticed moments in yourself (or in someone you love) that are hard to make sense of. Dissociation can feel unsettling. You might realize that time has passed and you don’t know what happened, or that certain events or conversations are missing from memory. Sometimes the body feels far away, like you’re not fully inside it. Other times the world itself feels strange or unreal, as though it’s happening behind a glass wall.

For those watching a loved one, dissociation may look like zoning out, seeming far away, or suddenly becoming confused about simple details. A person might drift out of conversations, act differently than usual, or seem disconnected from their surroundings. In some cases, they may describe feeling detached from themselves or say that the world around them doesn’t feel real.

These are common signs of dissociation, and they can have a real impact on daily life. If you notice these patterns in yourself or someone you care about, it may be a sign that the dissociation has become more than just occasional and that extra support could help.

A Grounding Tool You Can Try 

One technique often used in dissociation treatment is “Orienting to the Present through Movement”. This can be as simple as standing up, feeling your feet on the ground, and slowly turning your head to look around the room while naming what you see. 

The purpose is not to distract from dissociation, but to gently signal to the nervous system: I am here, I am safe, this is now. This practice is frequently used in trauma therapy to help clients reconnect with their bodies when they begin to drift away.