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Dissociation - A complex concept explained

Last updated date: 27-Apr-2022

CloudHospital

14 mins read

Dissociation is a term used in both Chemistry and Psychology to describe the act of separation, disconnection or detachment. In Chemistry, dissociation is the process of splitting a molecule of a chemical element or compound into smaller molecules, atoms or ions, while in Psychology, the term is known as a mental process in which a person tends to disconnect from their own thoughts, feelings or sense of identity.

People who are most likely to experience dissociation are the ones that have been through traumatic events such as assault of any kind or losing someone they loved. Usually, this is resolved without professional treatment, but in some cases, dissociation can lead to dissociative disorders, such as dissociative amnesia, dissociative fugue, dissociation identity disorder or depersonalization. If this applies, professional assistance is required, including a medical diagnosis and treatment.

 

Symptoms of dissociation

It is essential to know that every person can experience dissociation differently, as there is a wide variety of symptoms of this particular mental process. The most common signs are memory loss of certain events, the sense of detachment from your own feelings and thoughts, or even the feeling that what is surrounding you is not real or distorted, including other people.

While experiencing this mental process, individuals tend to have gaps in their memories regarding specific periods of time or have difficulties remembering personal information, events, things that have happened, or people they’ve met. They usually observe multiple changes in their perspective on things: feeling like a different person, having out-of-body experiences, sensing that they or the world around them are unreal (called derealisation) and emotionally detaching from reality.

Physical symptoms include feeling light-headed or sensing that the heart’s rhythm is stronger and faster than usual, or feeling little or no pain at all.

Psychological symptoms of dissociative disorders are also various, depending on the type of disorder and also its severity: hearing unusual voices in your head, getting “stuck” in a fantasy that seems more palpable than the real world, having intense vivid flashbacks and a distorted sense of time. They can also be related to other psychological disorders such as anxiety and depression.

 

What does dissociation feel like?

People that have experienced or are currently experiencing dissociation or any type of dissociative disorder usually describe the difficulties they have in handling intense emotions, as they feel disconnected from themselves and the world. Their own feelings are distorted, and they experience unexpected mood swings. For example, they feel sad or anxious for unknown reasons. Concentration issues or any other cognitive problems may appear as well. Their perception of reality shifts rapidly: for example, seeing objects around them changing shapes, colors, and sizes or identifying the surroundings as being lifeless or blurry.

Many described dissociation as feeling like a different person, who was watching their own actions from the outside, fully disconnected, as their own bodies and emotions, feeling like they are no longer in control.

Regarding their behavior, they tend to feel pressured into acting a certain way, even if they would normally find that type of actions offensive, as their identity shifts constantly throughout a period of time. These personality changes take place often and they include acting like different people, even children, or speaking using multiple voices and tones. This leads to difficulties in expressing who they are and defining themselves.

 

Causes of dissociation

During their lifetime, most people are forced by circumstances to go through multiple stressful situations, some of them leading to trauma and other emotional responses. Mental health specialists confirm that most cases of dissociation are caused by childhood trauma such as physical or sexual abuse, emotional abuse, severe neglect, or unfriendly family environments. However, traumatic events experienced as an adult, for example, going to war, torture or natural disasters can also contribute to developing dissociation.

The amount of time for recovering after a traumatic experience may vary based on its emotional impact on the human mind.  If it is minimal, trauma can be healed over time, even though the shock and denial are a part of the recovery process. Otherwise, severe trauma can lead to dissociation or, in extreme cases, even dissociative disorders listed above.

Dissociation is a defense strategy, a way of coping with trauma. It is our human instinct to protect ourselves and respond to threats. The way we do that varies from one individual to another, but there are a few common reactions to trauma, such as the fight or flight psychological response. Disconnecting yourself from the tragic reality during trauma is also a natural reaction, such as tending to forget certain parts of the event that caused it and people that were involved in an incident. 

Other causes of dissociation are hypnosis and meditation which makes you reduce the awareness of your body. Last but not least, alcohol consumption and using certain types of drugs, such as psychedelics, such as psilocybin or LSD, can also trigger the feeling of losing the sense of identity and self.

 

Dissociative disorders

When the environment is no longer traumatic, but a person that has experienced trauma is still not able to let go and feels the need to dissociate in order to protect themselves, there are high chances of developing dissociative disorders. These are usually caused by getting used to using dissociation as a coping mechanism for a longer period of time, which leads to doing it instinctively in order to deal with any other form of stress.

As mentioned before, healthcare professionals observed four main types of dissociative disorders, as follows:  dissociative amnesia, dissociative fugue, depersonalization disorder, and dissociative identity disorder.

Dissociative amnesia, also known as psychogenic amnesia, happens when an individual has difficulties remembering specific details about a traumatic event while being aware that they are experiencing a type of memory loss. It can last from a few days to a few years and it may be related to other psychological disorders (for example anxiety disorder).

There are four types of dissociative amnesia: localized amnesia (they don’t remember anything at all about the traumatic event for a limited amount of time), selective amnesia (the memories of the traumatic event are incomplete), generalized amnesia (they don’t remember many details of their entire existence) and systematized amnesia (they completely forget a few particular things).

Dissociative fugue, also known as psychogenic fugue is when a person unexpectedly experiences memory loss over everything from their past and their existence, including who they are. As opposed to dissociative amnesia, they are not aware of facing memory loss and may create a new identity for themselves. Typically, they travel far away from home and “start a new life”. Dissociative fugue lasts from a few hours to a few months. Coming out of the fugue is usually very confusing for those experiencing it, because they have no memory of traveling, “inventing” the new self, or anything that happened after the incident.

Depersonalization disorder is indicated by a person feeling detached, disconnected from their own thoughts and emotions. People facing it usually affirm that they feel like they are watching themselves from the outside as if they’re watching a movie and are no longer in control of their own actions. Their perspective on their own bodies is distorted, as they visualize them differently regarding shapes and sizes. In extreme situations, they cannot even recognize themselves while looking in the mirror. Typically, this psychological disorder’s symptoms are difficulties in concentration and memory loss.

Dissociative identity disorder (DID) (previously called multiple personality disorder) is constantly disputed among mental health specialists, as it is truly the most controversial dissociative disorder.  Due to stressful situations and traumatic events, a person can develop multiple personality states, which means they behave like different people at different times, often changing their identity, perspective of life, opinions, and even voice tones. An individual affected by dissociative identity disorder is not aware of the personality shifts, as they simply consider their memory gaps. Most times, a person suffering from this disorder has dissociative amnesia as well. It is considered to be the most severe type of dissociative disorder.

 

Dissociative seizures

Also known as non-epileptic seizures, these are often mistaken for epilepsy, which is why many professionals find diagnosing it a challenge since epilepsy medication can have unwanted side effects. Most patients experience dissociative seizures a while after the epileptic ones, or might even face both at the same time. However, their causes are different. Epileptic seizures are caused by the abnormal electrical activity of the brain, while dissociative ones are linked to psychological traumas.

The treatment for dissociative seizures is similar to the one for other dissociative disorders, consisting of counseling and medication.

Double dissociation happens when two related mental processes (an example would be speech and language comprehension) function independently of each other (which means someone can understand a language perfectly and still be unable to speak it).

 

Signs of dissociation

As mental health is extremely important, it is recommended to pay attention to any warning signs you and the people around show. It is possible for a person to have a dissociative disorder and not be aware of it. These signs include fast and unexpected mood swings, issues remembering details from the past, personality state changes, mental health conditions such as anxiety and depression, panic attacks, self-harm or thoughts of self-harm, or any type of substance abuse.

Since children may develop dissociation disorders easily due to unfriendly environments, it is important to watch out for signs as being spacey, zoning out, having imaginary friends or any type of memory loss, for example, forgetting something they said or did in a short amount of time.

 

Triggers and flashbacks while experiencing dissociation

A person that usually dissociates or suffers from a dissociative disorder can easily be triggered by a visual image, a specific sound, taste, smell, or even a simple touch. A trigger is defined as a reminder of a traumatic event that has happened. If being triggered, an individual may experience a flashback consisting of vivid terrible memories of the incident coming back and it can cause some people to shift identities, especially the ones suffering from dissociative identity disorder (DID).

 

Diagnosis of dissociation

For no further complications, people experiencing any symptom of dissociation or dissociative disorders are strongly advised to consult a specialist. This type of testing consists of a physical exam and a consultation regarding any other previous mental health disorders and any use of illicit substances or medication. If there is the case, specialists might need to take a blood sample or take different tests in order to detect any other medical condition that may have caused dissociation, such as an electroencephalogram (EEG), Dissociative Experience Scale (DES) or Structured Clinical Interview for Dissociation, followed by potential appointments with a professional psychiatrist, psychologist or psychiatric social worker that will help discover the cause of dissociation and support the patient during the treatment.

 

Treatment for dissociation

As there is no specific medication for dissociation recovery, each person’s treatment may be different, depending on their own needs and the severity of the disorder they were diagnosed with.  A few options would be living in a safe and friendly environment, trying your best to relax, taking advice on stress management, and psychotherapy/counseling for a longer period of time. Specialists may also prescript psychiatric drugs (for example, barbiturates) or treatments for other disorders, such as antidepressants, mood stabilizers, or anxiety-relievers. Usually, mental health disorders are interconnected – a person suffering from a dissociative disorder may also have depression or anxiety.

Regarding psychotherapy, there are a few types that can help people suffering from dissociative disorders: 

  • cognitive behavioral therapy - helps eliminate any negative thoughts
  • hypnotherapy - professionals certified in hypnosis are able to help patients recover from traumatic experiences in a relaxed state
  • phasic trauma treatment - helps reduce most of the self-harm thoughts and process the trauma over time
  • family treatment - as a friendly environment at home is extremely helpful in these cases, emotional support from loved ones is completely necessary
  • dialectical behavioral therapy - a therapy developed in order to help manage intense emotions in a positive way

 

Mental health disorders linked to dissociative disorders

As mentioned above, it is very common for people affected by dissociative disorders to also show signs of depression, anxiety, or other psychological disorders such as PTSD/ CPTSD, BPD and ADHD.

Post-Traumatic Stress Disorder (PTSD) is a mental disorder that may develop after a person goes through a traumatic event and symptoms include flashbacks, avoidance of reminders and unexpected changes of perspective, being very similar to the dissociative disorders listed above. Complex- PTSD is a medical condition that involves symptoms of PTSD and some additional other symptoms such as finding it difficult to control intense emotions. Dissociation and Post-Traumatic Stress Disorder are strongly linked and they often occur together. While dissociative disorders result most often from childhood trauma, PTSD develops regardless of age. The symptoms of PTSD may intensify the dissociation mental process.

Borderline Personality Disorder (BPD) is a mental illness that consists in distorting the way someone feels about themselves and others, having strong effects on their daily life. People that have Borderline Personality Disorder typically have issues regarding self-image, mood swings, management of feelings, and creating stable relationships with people surrounding them. They also struggle with the fear of neglect, abandonment, and instability. This disorder usually starts in early adulthood. Around 75% to 80% of people facing BPD confirm also experiencing dissociation.

Attention-deficit hyperactivity (ADHD) is one of the most common mental disorders experienced during childhood. Symptoms include having difficulties in concentrating and controlling impulsive behaviors, daydreaming more than usual and finding it a challenge to get along with others. The causes can be genetics or premature delivery, consumption of alcohol or tobacco during pregnancy, low weight at birth or even brain injuries. Studies found that children that faced any sort of physical or emotional abuse have higher chances of developing ADHD, which indicates they might also struggle with dissociation and due to the lack of treatment they might even develop dissociative disorders. Especially for children, the family and school environments are extremely important factors of developing or reducing symptoms of ADHD and, if it applies, dissociation or dissociative disorders.

As explained above, there are many psychological disorders linked to one another, most of them being caused by traumatic events experienced during their lifetime, from childhood and adolescence to adulthood. They all have negative effects on one’s personal life and relationships they develop with the people surrounding them, which is why they need to be treated professionally by a mental health specialist.

 

Complications of dissociative disorders

Treatment is a very important part of the recovery process. Without it, a person suffering from a dissociative disorder risks dealing with multiple complications, for example having difficulties in creating meaningful relationships with people or feeling like a part of a community, having trouble regarding respecting a normal sleep schedule (getting insomnia), developing eating disorders such as anorexia or bulimia, getting addicted to different substances (drug use, alcoholism) and in extreme cases self harm, including suicide.

Mental health has a strong impact on the way we socially behave, our feelings, and our perspective of life. It affects the way we respond to stressful situations, the way we form social connections, and make important life decisions. At the same time, mental health has a great importance on our physical health. Stress and mental disorders can lead to strokes, heart attacks and eating disorders like obesity or anorexia.

 

Fun fact - Dissociation in Chemistry, biochemistry and pharmacology

Dissociation is also the process of splitting molecules or ionic compounds into smaller molecules, atoms or ions, most times using a reversible procedure. The general equation of dissociation is AB ßà A+B. It is not defined as a chemical reaction and it is the opposite of association and recombination, as the process is usually reversible. For example, a complex dissociates into its components molecules and a salt dissociates into its components ions.

The dissociation constant (Kd) is calculated as the ratio of dissociated to undissociated compound and it is defined as a particular equilibrium constant, measuring the propensity of a larger object to dissociate.  It is the inverse of the association constant.

The dissociation constant of an acid (Ka) indicated the strength of that specific acid in solution.  Most times, the Ka value is expressed as pKa, which is calculated using the formula pka=-log10Ka. Using this value we can determinate the strength of the acid (a value between -2 and 12 indicates a weak acid in water, while an acid with a value of pKa less than -2 is considered to be strong. The percentage dissociation is calculated by dividing the mass of dissociating ions by the total mass of dissociated and undissociated compound. For example, the acetic acid (CH3COOH) dissociates partially into acetate and hydrogen ions in a reversible process, having the value of pKa=4.74, meaning it is a weak acid.

The bond dissociation energy for a bond between two elements A and B which is broken after the dissociation process is described to be the standard-state enthalpy change for the procedure at a specified temperature.

The oxygen-hemoglobin dissociation curve, also known as oxyhemoglobin dissociation curve or oxygen dissociation curve (ODC) is defined as “the curve that plots the proportion of hemoglobin in its saturated form on the vertical axis against the prevailing oxygen tension on the horizontal axis”. This links the saturation of oxygen and partial pressure of oxygen in blood, which help us get a better perspective on the way human blood carries and releases oxygen.

 

Conclusion

In Psychology, dissociation is a psychological process of feeling disconnected from one’s own emotions and sense of identity caused by experiencing traumatic events that can develop into dissociative disorders such as dissociative amnesia, dissociative fugue, depersonalization and dissociative identity disorder (DID) that require professional treatment. 

In Chemistry, dissociation is defined as breaking up a molecule into smaller particles such as smaller molecules, atoms or ions.

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