What is Dissociation, and How Does It Affect Therapy?
Clients experience dissociation when they disconnect from specific sensory experiences, thoughts, senses of self, or personal histories. An example of this includes someone who has trouble remembering a certain period in their life. Dissociation can be seen as a defence mechanism, as the psyche protects itself by separating conflicting impulses or threatening ideas. Occurring as part of a dissociation disorder, it can also be a symptom of other mental health conditions, like PTSD and schizophrenia.
How can Dissociation Impact one’s Life?
Usually, dissociation disrupts consciousness, identity, memory, and self-awareness, four areas of personal functioning that tend to work together smoothly, potentially resulting in a sense of unreality and a loss of connection to time, place, and identity. While dissociation can be mild and manifests itself in daydreaming, it’s also quite severe at times when the person feels as if the world’s no more than an illusion. The person can also feel dissociated from themselves and potentially blank out, experience a distorted sense of reality, feel disconnected/detached from their emotions, and feel numb from themselves and their surroundings. Sometimes, a person can experience dissociation without being aware of it and can also experience symptoms of other serious mental health issues, such as depersonalisation (feeling as if the self is not authentic) and derealisation (feeling as if the world is not real), usually as a response to overwhelming traumatic events.
Why it’s important to understand Dissociation
Understanding dissociation and its signs is needed for therapists as it can set the therapy process off course, positively and negatively, depending on how it is managed. During a therapy session, clients who dissociate may become emotionally detached. It’s more than just a mere distraction as they might end up feeling as if their feelings have been silenced, not only detaching from their feelings but also from their thoughts/memories. They find it harder to engage fully in the therapeutic process or work on issues. In addition, clients might struggle to express themselves clearly or lose track of conversations, making therapy feel disjointed. Clients may feel too embarrassed to keep doing the sessions, especially since, very often, dissociation becomes a response to trauma.
Even Therapy ain’t immune from the effects of Dissociation
Therapy can also be affected if the client isn’t just daydreaming but becomes wholly disconnected from the present moment. Their gaze might seem vacant or unable to track or recall parts of the conversation. When dissociating, a client can affect therapy by experiencing short-term memory loss. When this happens, clients might not remember certain parts of the session or entire sessions. Since identity and sense of self can shift during a session, clients can refer to themselves in the third person. During therapy, clients can even feel detached from their bodies, numb or experience physical sensations that seem out of place.
Conclusion
Despite the challenges above, dissociation can be addressed in therapy with the right therapeutic strategies and a strong therapeutic relationship. It is always recommended to work at the client’s pace and start by building safety and stability.
If you think you can benefit from professional support on this issue, you can reach out here.
Johanna Cutajar graduated from the University of Malta with a master’s degree in counselling. She works with children and adolescents as a counsellor in the education sector on a variety of issues, including relationship issues, trauma, bereavement, transitions, and general mental health.
References
Marich, J. (2023). 5 Signs of Dissociation in Therapy Sessions. Retrieved from https://therapywisdom.com/5-signs-of-dissociation-in-therapy-sessions/?srsltid=AfmBOop2Y7MGtvguxeGrY-XJwLXmcqygSfBNUWhLDXMp-pShr9ba3skJ
