Dissociation is a phenomenon estimated to occur at least once in the lifetimes of roughly 75 percent of people. It is defined by a sudden involuntary break from reality, often caused by severe trauma. Dissociative feelings may be triggered by an attempt from the mind to separate oneself from a violent or abusive situation. However, no two dissociative experiences are necessarily alike, and the way dissociation occurs can vary greatly. Some people might recall it as an out-of-body experience. Others feel detached from their own identity temporarily, as though they were inside someone else.

In teens with dissociative disorders, these breaks from reality are often far more severe, far more prolonged, and/or far more common. Roughly 2 percent of people qualify for chronic episodes, which may be considered a dissociative disorder. Dissociative disorders vary in severity and don’t always lead to drastic outcomes such as split personalities and total depersonalization. Other examples include dissociative amnesia, and symptoms of perceiving events to be unreal or surreal.

Understanding Dissociative Disorder

Dissociation is different from “zoning out” or struggling with anxiety or self-doubt because of success (impostor syndrome). It refers to episodes of partial or total separation from reality, in one way or another. The most common types of dissociation are:

Dissociative Amnesia

  • Situation/event amnesia (either blocked out or inaccessible)
  • Unknown triggers (i.e. places or people)
  • Intuitive apprehensions
  • Fugue episodes (sudden and purposeful wandering or escape)

 

Dissociative Identity Disorder

  • Split identities, with their own backgrounds and mannerisms, due to trauma
  • Describing self as consisting of several distinct voices
  • Feeling removed from realities of life
  • Watching time pass ambivalently or “from the outside”

 

Depersonalization/Derealization

  • Typically episodic in nature (lasting minutes to months)
  • Physical or emotional numbness to surroundings and events
  • Feeling isolated and trapped inside someone else’s body
  • Surreal perceptions of reality (distortions, abnormally heightened awareness)

 

Dissociative disorders are thought to occur due to trauma, but while most people experience one or two dissociative episodes in their lifetime, those affected by a dissociative disorder may have a genetic predisposition towards such experiences, and may have neurological differences, particularly in reaction to stress. These differences aren’t fully understood yet.

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Teen Dissociative Disorder Treatment Programs

Because symptoms can vary so greatly across different cases, every teen at Visions undergoes a thorough assessment process wherein a licensed psychiatrist and a team of specialists evaluate a teen’s mental and physical health, communicate with their family to learn more about their medical history and past, and investigate every relevant factor contributing to the teen’s mental state, including past stressors and any and all medication, supplementation, or drug use.

If physical factors are contributing to the teen’s condition (such as a severe head injury or a brain tumor), such factors will be addressed first. Because dissociative disorders often co-occur with substance use, depression, and insomnia, treatment may include medication to help with sleep and co-occurring symptoms. At Visions, our treatments for a dissociative disorder include:

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a form of therapy specially designed for trauma patients, going over painful or traumatic experiences while engaged in a rapid eye movement activity and similar activities (such as hand tapping). These distracting activities can help dampen the effect of recalling triggering memories and help engage in constructive talk therapy while focused on eye movement and other rhythmic activities.

Talk Therapy and Exposure Therapy

Other forms of talk therapy, from exposure therapy to cognitive behavioral therapy, have been shown to be useful when tackling dissociative disorders. These forms of therapy attempt to help patients distinguish from reality and the disorder, while gradually improving a patient’s ability to revisit and deal with their past.

Brainspotting

Trauma connected to disassociation can overwhelm the brain in the way that it processes an experience, leaving those unprocessed memories either frozen in time or lost. Brainspotting, a technique derived from EMDR treatment, utilizes the way trauma develops to identify the link between a traumatic experience and a region of the limbic system, a portion of the brain dedicated to long-term memory and motivation. It targets the sensorimotor memories by identifying gazes and eye positions that trigger emotions that allow the individual to reprocess information in a safe, attentive environment.

There is no short-term fix for a dissociative disorder. Treatment will be long-term and may require periods of intensive care during particularly severe episodes, especially if certain destructive characteristics come into play such as drug overuse or self-harm. At Visions, we coordinate with parents to ensure they know what to expect and are equipped with the resources needed to support their teen in the future.