Dissociation is still a very controversial subject in the field of mental health because it is so routinely equated with Dissociative Identity Disorder (DID). However, if dissociation is looked at instead as we would any other mental state phenomenon, we will see that all human beings dissociate, and much of our dissociativeness is adaptive.
Dissociation is a disconnection between a person’s thoughts, memories, feelings, actions, or sense of who he or she is. This is a normal process that everyone has experienced. Examples of mild, common dissociation include daydreaming, highway hypnosis, or “getting lost” in a book or movie, all of which involve “losing touch” with awareness of one’s immediate surroundings.
Tragically, ongoing traumatic conditions such as sexual abuse, community violence, war, or painful medical procedures are not one-time events. For people repeatedly exposed to these experiences, especially in childhood, dissociation is an extremely effective coping “skill.” However, it can become a double-edged sword. It can protect them from awareness of the pain in the short-run, but a person who dissociates often may find in the long-run his or her sense of personal history and identity is affected. For some people, dissociation is so frequent it results in serious pathology, relationship difficulties, and inability to function, especially when under stress.
As many as 99% of people who develop Dissociative Disorders have documented histories of repetitive, overwhelming, and often life-threatening trauma at a sensitive developmental stage of childhood (usually before the age of nine). When faced with an overwhelming situation from which there is no physical escape, a child may learn to “go away” in his or her head. Children typically use this ability as a defence against physical and emotional pain, or fear of that pain. By dissociating, thoughts, feelings, memories, and perceptions of the trauma can be separated from the mind. This allows the child to function normally. This often happens when no parent or trusted adult is available to stop the hurt, soothe, and care for the child at the time of traumatic crisis. The parent/caregiver may be the source of the trauma, may neglect the child’s needs, may be a co-victim, or may be unaware of the situation.
Dissociative Disorders are often called a self-protection or survival technique because they allow individuals to endure “hopeless” circumstances and preserve some healthy functioning. For a child who has been repeatedly physically and sexually assaulted, however, dissociation becomes a reinforced and conditioned defense.
Identity formation is an important part of normal development, and takes place across the lifespan. Identity — including one’s sense of being good enough, integration of emotion and intellect, basic awareness of emotional state, feeling secure and coherent as an individual, and even the basic experience of who one actually is — is disrupted by developmental trauma, because basic survival takes precedence over, and uses resources ordinarily allocated for, normal development of the self. Early trauma shifts the trajectory of brain development, because an environment characterized by fear and neglect, for example, causes different adaptations of brain circuitry than one of safety, security, and love. The earlier the distress, on average, the more profound the effect.
The task of identity development in adulthood, challenging enough (though rewarding) for those with a secure, safe, and enriching upbringing, is especially difficult for those grappling with the aftermath of developmental trauma. Because of developmental delays and the adult consequences of trauma, which often include substance abuse, eating disorders, depression, higher risk for many health problems, behavioral issues, and difficulty in personal relationships and professional development, identity development gets stuck.
Identity for adults with unresolved developmental trauma is often organized around being a survivor and maintaining basic safety in relation to others, leading to re-traumatizing and disheartening repetitions, preventing growth-oriented experiences. Individuals in this situation become highly identified with a “traumatic self,” at the expense of a more inclusive, flexible sense of self. People with significant developmental trauma dissociate from their environment and from themselves early on — a last ditch survival mechanism — and may remain disconnected from themselves throughout childhood, adolescence, and early adulthood, only recognizing what has happened when there is no other choice but to do so.