Trauma is an experience that can have profound and lasting effects on a person's mental and emotional health. It is an injury to the nervous system. Traumatic injury can come from big events, often call ed “big T trauma” which might be things we traditionally think about when we think about trauma, like a car crash, being assaulted, or seeing someone be harmed. Trauma can also stem from small events that accumulate over time, also known as “little T trauma." Examples of little t trauma might be growing up in poverty, growing up in a home with an alcoholic parent, or living with a chronic illness. Others may have what is called “complex trauma” which is when someone has more than one kind of trauma or traumatic event happen to them. Many symptoms may occur as a result of trauma such as being on edge, panic attacks, and feeling hypervigilent about danger in general. On the other hand, trauma can manifest in a more shut-down state, also known as dissociative states, which can be characterized by feelings of detachment, depersonalization, and derealization. In this blog, we'll explore what dissociative states are, how they relate to trauma, and some ways that people can cope with them.
Dissociation and the Window of Tolerance
All day long we ride a wave of our nervous system feeling stress and relaxation, and for the
most part we typically handle it without getting overwhelmed. But for people who have experienced trauma, they can get knocked out of the window of tolerance (the internal threshold for how much stress we can handle). Getting knocked out of the window of tolerance means that our nervous system has been activated to the point we are feeling like we are having a panic attack (hyperarousal), or if we are even further activated, we completely shutdown (hypoarousal). It is during this hypoarousal that the spectrum of dissociation can take place. It is important to remember that the person does not get to choose if they will be hyperaroused or hypoaroused in response to an traumatic or activating trigger. What is in their control is to notice the sensations when they are still in our window of tolerance, and the signs that ramping up or shutting down are occuring, and then they can do different coping exercises to keep them in the window of tolerance. Dissociation is a normal and natural response to stress and trauma, but it can become problematic when it becomes chronic or interferes with a person's ability to function in their daily life.
Dissociative Disorders
Dissociative states can take a variety of forms and is often seen as a spectrum. Several mental disorders may include symptoms of different types of dissociation. These mental disorders include bipolar disorder, intermittent explosive disorder, PTSD, Borderline personality disorder, acute stress disorder, OCD as well as many others. One issue people face during dissociative episodes is depersonalization, which is when a person is feeling like they're outside of their own body . Sometimes people report that it feels like they are standing next to themselves or looking down on their body from above, even though they know they are not really outside of their body. Another form of dissociation are feelings of derealization, or feeling like your surroundings are unreal or dreamlike. This can cause issues with distinguishing if things really happened, or if it was imagined. At times, others may experience memory gaps or amnesia because they are not mentally present. As you can imagine and may have experienced- losing track of time or items, not being able to tell the difference between reality and fantasy, and not being able to connect with others around you can have huge impacts to our social, professional and personal lives.
One of the ways that dissociative states can be related to trauma is through the concept of dissociative amnesia. This is when a person forgets important details about a traumatic event, often as a way of protecting themselves from the overwhelming emotional impact of the experience.
While dissociative amnesia can be helpful in the short term, it can also prevent a person from processing and healing from their trauma over time. It can also cause problems when being interviewed by law enforcement if the traumatic event is tied to a crime. It can cause a person to feel very confused and further upset because they cannot remember what happened to them, but their body is on alert for danger.
Another way that dissociative states can be related to trauma is through the development of dissociative disorders, such as dissociative identity disorder (DID). DID is a complex and controversial disorder that is characterized by the presence of two or more distinct personality states within one individual. While the exact causes of DID are not fully understood, many experts believe that it is related to severe and ongoing trauma in childhood.
Reducing Dissociative Symptoms
If you are experiencing dissociative states as a result of trauma, it's important to seek professional help.
A mental health professional can help you develop coping strategies and work through the underlying trauma that is contributing to your dissociation. Some strategies that may be helpful include mindfulness practices, grounding techniques, and gradual exposure to triggers.
Learning about your nervous system, how it feels to be in your body when you are feeling safe and when you are feeling danger, and ways to bring your body back into your window of tolerance. Different somatic exercises such as polyvagal exercises and yoga, medications, and trauma therapies have been proven effective for many people who want to manage these symptoms that are getting in the way of having a successful life.
Dissociative states can be a challenging and distressing experience for people who have experienced trauma. However, with the right support and tools, it is possible to learn to manage and eventually overcome these symptoms. If you or someone you know is struggling with dissociation or trauma, don't hesitate to reach out for help. Reach out to Amy Groven at Amygrovenlmft@gmail.com to book an appointment today.