Editor's Note: This article discusses reactions to trauma and may be triggering for some readers.
What is dissociation?
The British television series, Fleabag, depicts a heroine who frequently turns to the camera to share her thoughts. Talking to the camera helps her push away feelings of traumatic grief from her past. At one point in the second season, a character referred to as “The Priest” notices the moments when she disconnects from conversation. He asks her,
“What is that thing you're doing? It’s like you disappear.”
When he says this, viewers realize that Fleabag breaking the fourth wall is not merely a dramatic device. When she "disappears," she experiences an alteration of consciousness, of going into herself and disconnecting from her surroundings. Fleabag's painful memories of trauma remain separate from her everyday experience and show up as a shift in consciousness commonly referred to as dissociation.
Despite being one of the oldest concepts in psychology, defining dissociation can prove confusing. Different sources in psychology speak about dissociation in different ways. For example, Ego State Theory describes dissociation in terms of shifting states of consciousness. The Dissociative Experiences Scale (DES) measures dissociation in terms of experiences. The DSM-V manual for diagnosing mental disorders presents dissociation in terms of symptoms. The Structural Dissociation Theory of Personality presents dissociation in terms of personality structure. So, which one is it?
From the earliest days of psychology, theorists defined dissociation as a splitting of the self. Janet theorized that the mind splits itself off from trauma to defend against the extreme pain of it. Because of this, a number of trauma theories work with parts of the self to heal from trauma (e.g., Schwartz, 2021).
Nowadays, mental health professionals often use the term dissociation to refer to altered states of consciousness, such as the feeling of floating outside your own body, retreating into a fog, or “spacing out.” Others consider dissociation an everyday experience, such as becoming completely absorbed in a book. One article describes the process of becoming absorbed in social media as dissociation (McQuate, 2022). What authors tend to agree on is that dissociation due to trauma has unique qualities. Dissociation due to trauma is its own phenomenon with its own unique characteristics, including biological ones.
Unique physiological processes underlie traumatic dissociation (e.g., Lanius et al., 2014). Traumatic dissociation involves a biological reaction of hypoarousal. Hypoarousal is a state of the nervous system and type of animal defense against extreme threat. During traumatic hypoarousal brains and nervous systems greatly reduce their activity as a survival mechanism known as immobilization.
However, everyday experiences of absorption and disconnecting from our surroundings don't appear to involve hypoarousal. In a common example, the normal experience of spacing out while driving on a familar route has been labled dissociation. But during experiences of "being on autopilot," such as driving, our brains do not shut down. Instead, they remain engaged and active (Hamzelou, 2017). More importantly, being on autopilot does not appear to involve animal defenses, our reactions to extreme threat and trauma.
In an attempt to avoid confusion, I will be using the term dissociative hypoarousal to define the experience that is the primary focus of this blog. The term encompasses both the splitting of personality due to trauma (dissociation) and the biological manifestation of the personality split (hypoarousal). Dissociative hypoarousal is unique from other types of alterations in consciousness.
Dissociative hypoarousal may be defined as a biological phenomenon resulting from trauma that manifests in a fragmented self. It is experienced and/or observed as alterations of consciousness, lowering of consciousness, emotional numbing, subjective reports of having trauma parts, and a presentation that indicates both personality splits and a predominance of the immobilization response.
When the heroine of Fleabag seems to disappear, she does so because her self split due to trauma. Her humorous discussions with the audience represent attempts to remain split off from trauma. Each time she faces a reminder of the traumatic events of her past, she shifts away from the painful experience.
Dissociative hypoarousal presents as an internal experience that largely goes unnoticed to the outside world. Like physical pain, dissociative hypoarousal is frequently experienced subjectively and is hard to explain to others. To make matters more complicated, the term dissociation has been used with different meanings in psychology. Trauma survivors may find it helpful to think of their experiences as dissociative hypoarousal, a particular type of dissociation unique to them.
In my next article, I elaborate on the concept of dissociative hypoarousal and how easy it is to miss.
The content of this blog is for informational purposes only and is not intended to diagnose, treat, cure, or prevent any condition or disease. This blog is not intended as a substitute for consultation with a licensed practitioner. Please consult with your own therapist or healthcare provider regarding any suggestions and/or recommendations made in this blog. Although the author has made every effort to ensure that the information in this blog was correct at publication time and while this publication is designed to provide accurate information in regard to the subject mater covered, the author assumes no responsibility for errors, inaccuracies, omissions, or any other inconsistencies herein and hereby disclaim any liability to any party for any loss, damage, or disruption caused by errors or omissions. Unless otherwise indicated by name or direct reference, any resemblance to persons, living or dead, or actual events is purely coincidental. The use of this blog implies your acceptance of this disclaimer.
The following sources were invaluable in writing the above article:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Carlson, E. B., & Putnam, F. W. (1993). An update on the Dissociative Experiences Scale. Dissociation: Progress in the Dissociative Disorders, 6(1), 16–27.
Hamzelou, J. (2017). Your autopilot mode is real—now we know how the brain does it. New Scientist. 23 (October). https://www.newscientist.com/article/2151137-your-autopilot-mode-is-real-now-we-know-how-the-brain-does-it/
Lanius, U.F., Paulsen, S.L., & Corrigan, F.M. (2014). Neurobiology and the Treatment of Traumatic Dissociation: Toward an Embodied Self. Springer.
McQuate, S. (2002, May, 23). I don't even remember what I read: People enter a 'dissociative state' when using social media. NeuroscienceNews.com. https://neurosciencenews.com/dissociative-state-social-media-20640/
Schwartz, R. (2021). No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family System’s Model. Sounds True.
Van der Hart, O., Nijenhuis, E.R.S., & Steele, K. (2006). The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. Norton.
Waller-Bridge, P. (Writer), Williams, H., & Williams, J. (Executive Producers). (2016,2019). Fleabag. [TV Series]. Two Brothers Pictures.
Watkins, J.G., & Watkins, H.H. (1997) Ego States: Theory and Therapy. Norton.
© Nancy B. Sherrod, PhD