Understanding Dissociative Disorders

Depersonalization is the sense of our inner self being detached from the body. Sometimes while feeling dissociated, we may look in the mirror and feel like we don’t recognize who we’re seeing, or feel disconnected from our body in a way that feels numb, or in my case, like my body is a cloud.

Derealization is the sense of the world around us not being real. For me, it feels like I’m watching the world through an old-fashioned television set with poor sound. Others describe derealization as the world looking phony, foggy, or far away, or as though they’re detached.

Amnesia refers to memory loss beyond the realms of ordinary forgetfulness. Some people with dissociative disorders may have amnesia of the classic fugue variety, where they travel long distances before becoming alert and disoriented. At other times, amnesias are associated with important events that are forgotten, such as abuse, a troubling incident, or a block of time. Most commonly, we experience multiple micro-amnesias where discussions are not remembered. This can cause a scramble for clues as to what was, or still is, being discussed, while trying not to disclose the lack of continuity. Amnesia affects our perception of our own pasts, including our childhood, plus our moment-to-moment living. It causes a discontinuity in our sense of self, and can cause problematic relationships with others.

Identity confusion causes an insurity about who we are or what we can do. For example, I learned to fly light aircraft before realizing I had a dissociative disorder. While I never lost the ability to pilot an aircraft, I did notice that I could feel very different between or even within flights. My sense of self and emotions could swing from confident, to cautious, and then terrified.

Identity alteration refers to a more profound sense of alteration. As an example, I have absolutely no recollection of jumping up during a therapy session and informing my therapist that her sessions were, “dumb and stupid.” Later, while rubbing my forehead and disclosing that a voice inside my head wouldn’t stop complaining about therapy, she reported what had happened. That was quite a shock. However, it doesn’t have to be this extreme. There are more subtle forms of identity alteration, which may involve changes in voice tones, use and range of language, and minute changes in facial expressions. Additionally, these changes may accompany alterations in our view of the world. As another personal example, I was telling my therapist something unpleasant when the emotions of a terrified toddler swamped my body and I had to physically move myself from her line of sight. Going into and coming out of states such as these can sometimes feel smooth, or barely noticeable, but are most-often jarring. When I’m aware it’s happening, or become aware once it’s over, it can also feel extremely embarrassing. Fortunately, I have a patient and informed therapist who is taking time to help me become aware of the changes and sits with my feelings of shame.