What is dissociation?

Dissociation is a protective mechanism of the mind in the face of a situation perceived as extremely stressful or traumatic. When someone goes through an unbearable experience, their brain may fragment certain perceptions, memories or emotions in order to soften the impact of the pain.

In some cases, this survival strategy becomes problematic and settles in over time, producing symptoms that deeply affect everyday life.

The DSM-5, the diagnostic manual of mental disorders, recognises a subtype of post-traumatic stress disorder (PTSD) with dissociative symptoms. In other words: on top of the classic symptoms of psychological trauma, the person affected may present significant dissociative manifestations.

The six main manifestations of dissociation

1 — Depersonalisation: feeling like a stranger to oneself

Some people describe the disturbing sensation of no longer being connected to their own body, thoughts or emotions. This often takes the form of questions:

• Why do I feel like a spectator of my own life?
• Am I losing my mind?
• How can I find the feeling of being myself again?

The experience can feel like floating outside one’s own body, or being on “autopilot”, which deeply alters the sense of identity.

2 — Derealisation: a world that seems unreal

In derealisation, it is no longer oneself that seems strange, but the outside world. The people concerned feel that their environment is distorted, hazy, artificial, as if in a dream. They may wonder:

• Is any of this real?
• Why do I feel detached from my surroundings?
• Am I the only one going through this?

This sensation can be distressing, because it gives the impression of being cut off from the world, which reinforces isolation and incomprehension.

3 — Somatic symptoms: when the body expresses the trauma

Dissociation does not only affect the perception of oneself or of the world: it is also expressed through the body. Some people experience:

• chronic pain (migraines, muscular tension, abdominal pain);
• numbness or tingling, with a sensation of physical disconnection;
• digestive troubles (nausea, bloating, transit disorders).

These symptoms, although medically unexplained, are real and may bear witness to untreated psychological suffering.

4 — Time distortion: a blurred, elusive present

The people concerned may experience time in an irregular and unpredictable way. Time slows down: a simple conversation seems endless. Time speeds up: hours pass in an instant, with no precise memory. Or temporal amnesia sets in: whole stretches of the day seem to be erased.

These distortions disrupt the organisation of daily life and create a feeling of confusion and loss of bearings.

5 — Absorption: when attention disappears entirely

Absorption is a phenomenon in which attention focuses to an extreme degree on one activity or one thought, to the point of forgetting everything else. A person may become immersed in a task and lose all sense of time, no longer hear the surrounding noises, feel entirely cut off from their environment.

While this form of dissociation can sometimes be useful — when one is absorbed in a book or a film, for instance — it becomes problematic when it leads to a regular loss of contact with reality.

6 — Dissociative amnesia: when memory fades

Some people affected by trauma develop significant memory gaps, particularly in connection with painful events. This amnesia can take several forms:

• selective blocking: forgetting a specific detail or event;
• compartmentalised memory: certain memories are stored separately and are only accessible in particular contexts;
• reminiscence: buried memories resurface unexpectedly.

Here again, this is a protective mechanism of the brain, seeking to avoid the suffering attached to those memories.

Why recognising these symptoms matters

Dissociation is a psychological warning signal. If these symptoms are frequent and interfere with daily life, it is essential not to ignore them: therapeutic support can help address them.

If you recognise yourself in these manifestations, two simple bearings: talk about it with a professional — a psychologist, a psychiatrist or a therapist specialised in trauma — and surround yourself with support, because it matters not to face this alone.

Understanding better in order to act better

Dissociative symptoms are sometimes little known, yet they have a considerable impact on the lives of those who experience them. Understanding them better allows one not only to know oneself better, but also to help other people put words to their experience — sometimes words they did not dare to say.

These six manifestations are detailed one by one in the video below, in French.