The iconic American author Thomas Merton famously said, “Love is our true destiny. We do not find the meaning of life by ourselves alone – we find it with another.” This is symbolic of the truth that we work better with others, and this is especially true in recovery. Millions of people struggle with issues of mental illness and addiction, including many who struggle with various types of dissociation. Many of these people remain isolated and do not get the help that they both deserve and desire. The good news is that there is help out there. The key is to reach out and ask for it.
What Are the 5 Types of Dissociation?
There are five distinct types of dissociation. These types are depersonalization, derealization, dissociative amnesia, dissociative fugue, and dissociative identity disorder (DID). Yet, to better understand these types of dissociation, one must first understand some of the underlying causes and issues associated with them.
Many people also jump to conclusions that dissociation is a symptom that does not affect many people. This is simply not the case. Dissociation is more common than many people think and can be the result of many different factors. This is why getting a better understanding of dissociation and being able to better spot the signs and symptoms of dissociation can be so important. So, what exactly is dissociation?
Better Understanding Dissociation
Distilled down, dissociation is what occurs when someone experiences a disruption between their thoughts and memories. It can also cause a disconnection between a person and their sense of identity. It is very often associated with instances of trauma and/or undiagnosed trauma.
According to the peer-reviewed journal Clinical Psychopharmacology and Neuroscience, “The central feature of dissociation is disruption to one or more mental functions. Such disruption may affect not only consciousness, memory, and/or identity, but also thinking, emotions, sensorimotor functioning, and/or behavior. Five phenomena constitute the primary clinical components of dissociative psychopathology: amnesia, depersonalisation, derealisation, identity confusion, and identity alteration.” There are also many other signs and symptoms that an individual may be struggling with dissociation.
The Signs and Symptoms of Dissociation
Dissociation is a pretty distinctive symptom of mental illness (and co-occurring disorders), but that does not mean that it is going to present itself in the same way in all individuals. However, there are some more universal signs and symptoms that someone may be struggling with dissociation. The following are just a few of those signs and symptoms:
- Feeling detached from your body
- Struggling with memory (including amnesia)
- Isolating away from loved ones
- Feeling anxious and/or depressed
- Struggles with identity
- Issues with sleep, including sleeping too much and not sleeping enough
- Negative changes in appetite
- Feeling like you are in a “dreamlike” state
- Emotional “numbness”
- Feelings of lightheadedness
- Mood swings
- Feelings of self-harm or a need to harm others
- Having suicidal ideations
As one can see, these can be very serious side effects. This is why reaching out for professional help as soon as possible is critical. Doing so could mean the difference between short-term side effects and long-term consequences. It will also start you on the road to recovery and living a symptom-free life.
Understanding Depersonalization
One of the most common types of dissociation is depersonalization. So, what exactly is depersonalization? According to the peer-reviewed journal, Innovations in Clinical Neuroscience, “First coined by Ludovic Dugas in 1898, the term depersonalization is defined as detachment from one’s sense of personal identity, wherein subjects experience themselves as outside observers of their own behaviors, emotions, and bodily sensations.”
Depersonalization can often feel like one is outside of their own body, looking down. It also involves feeling emotionally “numb” and struggling with cognitions. People can often feel disconnected from their own thoughts and memories. This often co-occurs with derealization, which is so common that there is a depersonalization/derealization disorder (DPDR). To understand this disorder, it is helpful to get a better understanding of what derealization is.
Understanding Derealization
As its namesake addresses, derealization has to do with feeling like certain situations are “unreal.” According to the peer-reviewed journal Discoveries, “Although there is no proper description of what a person feels in this condition, people experiencing derealization feel that their perception of the situation or the current state is unreal. Patients with DPDR may present with one or two or a combination of symptoms of derealization or depersonalization along with some other general symptoms as other psychiatric disorders like depression and anxiety disorders….”
Both depersonalization and derealization are often the results of a traumatic event or a series of traumatic events. It also involves feeling detached from everyone and everything around you. When experiencing these types of dissociation, it can feel very scary and can be hard to trust those around you. There may also be instances of visual and auditory hallucinations, which bring their own level of discomfort and fear.
Traumatic exposure is believed to be the biggest contributor to dissociative symptoms like depersonalization and derealization. According to the Journal of Public Health, “There is a robust correlation between dissociative symptoms and exposure to trauma, particularly early childhood trauma and disruptions in attachment and caregiving. Dissociation can be defined as a disconnection between thoughts, feelings, behaviors, sensations, and other mental processes that would normally be connected. It is a human phenomenon, experienced by all to varying degrees on a continuum ranging from benign to problematic.” Dissociative amnesia lies on the more problematic side of the spectrum.
Understanding Dissociative Amnesia
Dissociative amnesia relates to one’s memories. According to the peer-reviewed journal Frontiers in Psychiatry, “Dissociative amnesia (DA) is a psychiatric disease in which patients experience a failure to recall important autobiographical memories in the absence of any known neurological or other medical condition. Due to the imprecision of the psychiatric definition, DA encompasses a broad group of clinical presentations. Some patients experience a focal loss of memory encompassing a limited time period (e.g., 5 years of their life) or a specific theme (such as a relationship or a work experience), most of the time, stressful.”
Dissociative amnesia is also more common than many people may think. According to the peer-reviewed journal Cureus, “It has a prevalence of 1.8%, is the most common of the dissociative disorders, and is often diagnosed within the ages of 20-40 years old. The memory loss is retrograde, sudden, and cannot be explained by a neurological cause or being forgetful. It usually follows an extremely stressful experience and is often associated with child abuse (particularly sexual and physical), suicide attempts, interpersonal violence, victimization, and deliberate self-harm.” It is often closely associated with dissociative fugue.
Understanding Dissociative Fugue
Dissociative fugue is much less common than dissociative amnesia and can be very dangerous. According to the Industrial Psychiatry Journal, “Dissociative fugue is one of the rare psychiatric disorders characterized by sudden, unexpected travelling from one’s customary place of living or work. Traumatic circumstances, leading to an altered state of consciousness dominated by a wish to flee, are thought to be the underlying cause. Splitting is the underlying defence mechanism used by individuals to cope with traumatic memories.”
As with the other types of dissociation, dissociative fugue is distinctly related to trauma. Also, many people don’t realize just how common trauma and traumatic events can be. According to the peer-reviewed journal Psychological Medicine, “General population studies have shown that a large proportion of people in developed countries have been exposed to at least one TE [traumatic event] in their lifetime (estimates from 28 to 90%), with the most common events being the unexpected death of a loved one, motor vehicle accidents, and being mugged. Much more limited evidence for less developed countries suggests that fatalities due to injuries and accidents are more common…” Some individuals who experience these traumas may develop dissociative identity disorder (DID).
Understanding Dissociative Identity Disorder (DID)
Dissociative identity disorder is perhaps still more commonly known as multiple personality disorder. According to the peer-reviewed thesis Dissociative Identity Disorder, by Doctors Mitra and Jain, “Dissociative identity disorder (DID) is a disorder associated with severe behavioral health symptoms…. Approximately 1.5% of the population internationally has been diagnosed with dissociative identity disorder. Patients with this diagnosis often have several emergency presentations, often with self-injurious behavior and even substance use.” DID is one of the most serious types of dissociation. Also, this type of dissociation requires very specific conditions to be met in order to be diagnosed.
According to Cureus, “The existence of two or more separate personality identities is one sign of dissociative identity disorder (DID), along with potential neurobiological factors such as altered brain structure and function, particularly in regions like the hippocampus and amygdala, as well as disruptions in memory, identity, and emotion regulation mechanisms…. According to the theory, people who can dissociate are more likely to create alters with distinct names and identities, have intense traumatic experiences that distort reality, and lack external stability…. DID cannot develop without these four conditions being met.” As previously mentioned, it is not uncommon for dissociation and substance misuse to co-occur.
Dissociation and Addiction
There is now a greater understanding of addiction and dissociation. This is because many people who have reported symptoms of dissociation also present with issues of alcohol and/or substance misuse.
To understand dissociation and addiction, it is also important to understand that they often present with “Alexithymia.” According to the Handbook of Clinical Neurology, “Humans are highly adept at differentiating, regulating, and responding to their emotions. At the core of all these functions is emotional awareness: the conscious feeling states that are central to human mental life. Disrupted emotional awareness – a subclinical construct commonly referred to as ‘alexithymia’ – is present in a range of psychiatric and neurological disorders and can have a deleterious impact on functional outcomes and treatment response.” This includes the outcomes of treating individuals with dissociation and addiction.
Alexithymia leads to trauma, which can lead to dissociation and alcohol/substance misuse. According to the peer-reviewed journal Psychiatry Investigation, “The inability to identify or name emotions, coupled with the feeling of being overwhelmed, may cause individuals to experience trauma. These individuals may become accustomed to expressing their affect through the development of a compensatory, non-verbal strategy, such as pathological drinking, to disrupt a sense of psychological numbing and/or to avoid and manage intense, seemingly uncontrollable emotions.” This pathological drinking and/or substance use only exacerbates the situation and requires a more individualized focus when it comes to recovery.
Healing at the Cellular Level: Effective Recovery Options
There are many effective recovery options for individuals who struggle with dissociation (as well as co-occurring issues of mental illness and addiction). The key is to utilize multiple recovery modalities at the same time. This is also known as the multi-angled approach.
Now, it is important to treat dissociation with evidence-based therapies. In fact, most recovery plans should begin with a foundation of evidence-based therapies such as cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT). These psychotherapies can help get to the underlying traumas that lead to dissociation. It is only when these underlying issues are addressed that healing at the cellular level can begin.
However, one should not stop with just one type of therapy. It is important to utilize many types of treatment so that all issues can be fully addressed. Also, you may respond better to one therapy than the other, and the only way to discover this is to try many different methods. This includes experiential therapies like nature immersion therapy and art therapy, as well as holistic healing methods like yoga therapy and mindfulness meditation.
Utilizing Psychotherapy for Dissociation
Psychotherapies like CBT and DBT can help an individual see the skewed view that they hold of themselves and the world around them. Once this skewed view becomes apparent, there is a basis by which the therapist and client can work. It is important to note that in some instances of dissociation, pharmacology is recommended.
However, psychotherapy cannot stand on its own when it comes to healing at the cellular level. There should also be the addition of psychoeducation (for both the individual and the family). According to the Indian Journal of Psychiatry, “Psychoeducation is an inevitable aspect in the management of dissociative disorder. [It] should focus on normalizing and acknowledging patients’ symptoms and relating them to dysfunction in daily life. [Psychoeducation] also enables an understanding in the patient and family members about the intellectual strengths and the key role of coping skills in therapy.” It is also important to help an individual struggling with dissociation to reconnect with the world around them. Nature immersion therapy can help with this.
Utilizing Nature Immersion Therapy for Dissociation
In today’s world, it can be very common to become disconnected from our surroundings. With dissociation, this disconnection is much more pronounced. Nature immersion therapy can help an individual reconnect with themselves via reconnecting to Mother Nature.
There is perhaps no better place on Earth to connect with nature than where Exclusive Hawaii Rehab™ is conveniently located on the Hamakua Coast of Hawaii’s Big Island. Here, our luxury 30-acre property is mere minutes away from outstanding overlooks, wondrous waterfalls, beautiful beaches, and even a live volcano.
Nature immersion therapy also offers a myriad of other benefits. According to the International Journal of Environmental Research and Public Health, “Besides improvements to physical and psychological well-being, exposure to natural environments has been shown to bring about positive impacts on cognitive functioning… While cognitive restoration and physiological well-being are the prominent and renowned benefits of nature exposure, there is one important construct that is often overlooked in environmental psychology research studies – that is, the human-nature relationship, also known as connectedness to nature (CN).”
Healing at the Cellular Level With Exclusive Hawaii Rehab™
Thomas Merton also famously said, “Happiness is not a matter of intensity but of balance, order, rhythm, and harmony.” These are also critical components of healing at the cellular level.
Here at Exclusive Hawaii Rehab™, we believe in long-term success over short-term “fixes.” Yes, dissociation can feel debilitating, but we have the most comprehensive individualized recovery plans that can help you be your most successful self.
If you are sick and tired of being sick and tired, then the time to recover is now. You can do this! We can help.
Dissociation can be highly disruptive to everyday life. This includes all five types of dissociation: depersonalization, derealization, dissociative amnesia, dissociative fugue, and dissociative identity disorder (DID). The good news is that there are many effective means, methods, and modalities that can help you recover from the symptoms of dissociation. If you feel like you or a loved one is struggling with issues of addiction, mental illness, or co-occurring disorders, we can help get you on the right road to recovery right away. You don’t have to go through this process alone. For more information about dissociation and effective recovery options, please reach out to Exclusive Hawaii Rehab™ today at (808) 775-0200.
