sordidcorvoid:

This is a PSA for everyone who knows (or may know) someone who dissociates. Because while it can be scary to watch, a lot of people don’t know what to do when it happens or how to help, and let me just get something straight – DO NOT TRY TO SNAP THEM OUT OF IT.

Dissociation is a STRESS RESPONSE. It is the mind’s (arguably flawed, but very much sincere) means of coping when it feels overwhelmed or unsafe, by withdrawing into itself in order to escape those feelings/the situation triggering those feelings. People who dissociate are traumatised, even though the origin of that trauma may be unclear. It is not just a product of physical or sexual abuse, and may coexist with or develop as a long-term side effect of trying to function with other untreated illnesses such as depression. It may also develop as a result of toxic living environments, emotional abuse, or prolonged feelings of powerlessness to change a current situation.
There are five different manifestations of dissociation (which is sort of an umbrella term for them all.) It’s important to understand and differentiate between these manifestations, as different people experience them to different degrees, so here they are in a nutshell:

Derealization: your environment feels unreal, as though you are in a dream. Objects may appear to shift and change in shape, size or colour. The people around you may not feel real, like robots or again, figments of a dream.

Depersonalisation: your body feels unreal, changing or dissolving; sometimes body parts may feel numb, oddly sluggish, or as though they do not belong to you. You may have out-of-body experiences, observing yourself as if watching a movie, or a video game character whom you are attempting to direct.

Amnesia: an inability to remember important personal information, incidents or experiences that happened at a particular time. Entire days, weeks or even months may be a vague blur. Memories that are recalled may be detached and with very little emotion, as they may all feel like events you’ve observed from a third-person perspective, or stories you’ve been told and not experienced. Severe amnesia with moderate-to-severe identity confusion (and often identity alteration) may result in states of dissociative fugue that last several days.

Identity Confusion: you may feel uncertainty and a constant internal struggle to understand the kind of person you really are. Questions about your personality/characteristic traits may be difficult to answer. You may feel chaotic, nebulous and undefinable. You may doubt aspects of yourself constantly, or fixate on your actions and what they may mean. Questionnaires and horoscopes that claim to identify what ‘category’ of person you are may be comforting or constraining.

Identity Alteration: a palpable shift in your role or identity, which others can notice. You may exhibit behaviours in certain situations that contrast with how you are at other times - ie, at work and at home. You may consciously ‘wear’ an entirely different personality in order to help yourself through stressful encounters or to deal with specific individuals, or unconsciously default to it when similar situations arise that you don’t feel you can deal with ‘as you’.

Reaction to stimuli in individuals who are dissociating differs to individuals who are not. Dissociation often significantly decreases sensitivity to stimulus, causing a person to default to the ‘freeze’ response as opposed to ‘fight’ or ‘flight’ whether they want to or not – as a result, it is important that you DO NOT TOUCH SOMEONE WHO IS DISSOCIATING unless they have expressly permitted it. Some people find physical contact soothing and it helps to ground them. Others, however, register unexpected touch as a threat and retreat even further into themselves, which can also be dangerous as it only makes it more likely that they will do so again. The further a person withdraws into themselves when they dissociate, the longer it may take for them to resurface – and while in that state, they may not even recognise you.

So if you’re with someone who is dissociating, and they’re not functioning properly, and you’re getting quite concerned:

- DO NOT RAISE YOUR VOICE AT THEM
- DO NOT BE ANGRY AT THEM/DEMAND THAT THEY PAY ATTENTION TO YOU
- DO NOT TRY TO MOVE THEM
- REMEMBER THEY ARE NOT CURRENTLY IN CONTROL OF THEIR ACTIONS AND THEY MAY NOT EVEN BE AWARE OF WHAT THEY ARE DOING
- SPEAK CALMLY AND QUIETLY; COAX OUT BASIC INFORMATION (what is their name/address/telephone number, do they know where they are, when did they last eat/drink, can they describe how they’re feeling. In addition a blanket gently draped over their shoulders may be helpful; offering pleasant distractions for them to focus on such as pets, colouring, quiet music or podcasts, certain scents etc are also things you may try. These are all mindfulness techniques that help ground a person and draw them back into the present.)
- DO NOT TRY TO FORCE THEM TO EAT OR DRINK (place food/drink within sight and within reach instead, and retreat)
- DO NOT STARE AT THEM OR TRY TO MAKE THEM LOOK YOU IN THE EYE
- ENSURE THEY ARE SOMEWHERE COMFORTABLE AND/OR FAMILIAR
- AVOID/REMOVE ANY TRIGGERS (loud noises, enclosed spaces, public places, people arguing – if you know anything that makes them stressed or uncomfortable, get it away. You may also want to do the same with any sharp objects, if they have a history of becoming self-destructive.)
- DO NOT LEAVE THEM ON THEIR OWN (if they are functioning, but detached and ‘spacey’, you may want to keep in regular contact. Some people may find it easier to respond to type than talk, or the other way around, which should be taken into consideration.)

The purpose of all these things is to encourage the mind NOT to perceive its environment as unsafe or stressful, and persuade it to stay present. Be respectful of personal boundaries – some people may find it comforting to be held or even to just have you sit nearby, but others may require more space. At the end of the day dissociation is an internal battle, and you can’t make a person stop dissociating any more than you can make a person stop being depressed. It’s not going to happen just because you tell them to, nor can you just jolt them out of it, and attempting either of these things will only inflict more stress on the person.

Further resources:

http://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociative-disorders/#.VZfz_XNwaM8

http://www.trauma-pages.com/
http://www.myshrink.com/counseling-theory.php?t_id=13

http://psychcentral.com/lib/in-depth-understanding-dissociative-disorders/

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Dissociation_and_dissociative_disorders
http://www.isst-d.org/?contentID=76