When Life Doesn't Feel Real: Alterations and Lowering Of Consciousness

When Life Doesn't Feel Real: Alterations and Lowering Of Consciousness

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A special warning for those who experience dissociation: sometimes reading, talking or thinking about these experiences can lead to alterations of consciousness or other forms of dissociative hypoarousal. If that happens for you, consider taking breaks or reviewing this information with a supportive therapist who is knowledgeable about the topic.


“And almost every second of every minute I’m with them, I feel like I’m seeing the scene from somewhere else. In front of a screen maybe, watching someone else’s life." 

--Helena Fox, how it feels to float


In a previous article, I mentioned that a common understanding of the word dissociation in psychology involves alterations or lowering of consciousness. But what exactly are those?

Alterations of consciousness are changes in experience that feel strange or unreal. Lowering of consciousness refers to a dampening of experience. These events include common experiences as well as those more specific to people with trauma. Research indicates that trauma survivors endorse more frequent and more severe alterations of consciousness than their peers. (e.g., Frewen and Lanius, 2014).

Common alterations or lowering of consciousness can occur when people daydream or space out. When tired or overwhelmed, people can feel fuzzy or dizzy. They may “lose time” while watching a program or playing a video game or “numb out” while doom scrolling on a phone. People may experience alterations or lowering of consciousness under the influence of alcohol or drugs. Alterations of consciousness can arise with illnesses such as dementia or a brain tumor. 

Alterations and lowering of consciousness due to trauma involve the following unique characteristics (van der Hart et al., 2006):. 

  1. They indicate the presence of a fragmented self including at least one part that houses the hypoarousal defense.
  2. Their onset can be traced to trauma-related triggers 
  3. They present as animal defenses, including hypoarousal.

Survivors who exist in a "deadened" state (e.g., van der Kolk, 2021) likely experience a pervasive lowering of consciousnessTrauma triggers, on the other hand most likely present with alterations of consciousness  (van der Hart et al., 2006).  Trauma-related alterations and lowering of consciousness occur across the four dimensions of thought, body, time and emotion (Frewin and Lanius, 2014). 

When someone feels so overwhelmed or unsafe that they slip into dissociative hypoarousal, thought processes such as clear thinking, reasoning, problem-solving, planning, perception and awareness become more challenging (Ogden and Fisher, 2014). Body alterations and lowering of consciousness can result from feeling unsafe in your own body. These alterations include feeling disconnected or outside of your body, Lowering of consciousness of one's body can mean not feeling pain and not sensing basic needs such as hunger (van der Kolk, 2014). The following is an example of alterations in body consciousness during dissociative hypoarousal:


“Here I am, in bored bones, in makeshift skin, looking out of eyes that are a construct, breathing with lungs that are only a step–a basic rearrangement–away from leaves. How funny, to have a body when I am not a body? How funny to be inside when I am outside?...I turn off the shower. From light years away. I rub the strange thing that is my body with the strange thing that is a towel. I put on clothes and they are the strangest things” 

--Helen Fox, how it feels to float 


Time alterations most often include alterations in memory, such as "losing time" or forgetting aspects of trauma. For example, in my previous article, a sexual assault survivor had trouble remembering details about her assault while talking to police. It is common for survivors of trauma to forget aspects of their traumatic experience. Emotion alterations and lowering  of consciousness often include lack of emotion, apathy and numbing. Marie, the survivor in my previous article, appeared emotionless and apathetic to her friends. 

Lanius et al. (2014) propose that the release of higher than usual amounts of endogenous opioids during trauma accounts for much of dissociative hypoarousal. These high amounts of endogenous opioids lead to alterations of consciousness, lowering of consciousness and splits in personality. Endogenous opiates inhibit the fight or flight response and cause hypoarousal. If you have ever taken or know someone who has used opioid drugs such as hydrocodone or morphine, the effects are similar. 

Opioid drugs relieve pain, cause sedation, and slow nerve transmission--all alterations that occur with trauma-induced hypoarousal. The DSM-V describes the symptoms of opioid intoxication as “initial euphoria followed by apathy, dysphoria, psychomotor…retardation [slowed movement, and], impaired judgment” (DSM-V, p. 547)  Other symptoms include drowsiness, slurred speech, confusion, and impairment in attention or memory. Opioid use can cause inattention to the environment, emotional numbing, muscle weakness, distorted perceptions, and sleepiness. 

Although alterations and lowering of consciousness can feel strange and scary to some, others find the ability a welcome escape from challenging situations. Whatever a survivor's take on them, it can be useful to remember that these experiences emerged as survival strategies. Rather than getting rid of the strategy, survivors often benefit from learning to recognize it. In time, a person can choose whether or not to slip into dissociative hypoarousal rather than being hijacked into it.

For my next two articles, I explore the concept of emotional hijacking. The concept helps explain how alterations and lowering of consciousness at times overtake a trauma survivor. 


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.).

Frewen, P.A. & Lanius, R.A. (2014) Trauma-Related Altered States of Consciousness: Exploring the 4-D Model, Journal of Trauma & Dissociation, 15:4, 436-456, DOI: 10.1080/15299732.2013.8733:https://doi.org/10.1080/15299732.2013.873377

Lanius, U.F., Paulsen, S.L., & Corrigan, F.M. (2014). Neurobiology and the Treatment of Traumatic Dissociation: Toward an Embodied Self. Springer.

Ogden, P. & Fisher, J. (2015). Sensorimotor Psychotherapy: Interventions for Trauma and Attachment. W.W. Norton. 

Van der Hart, O., Nijenhuis, E.R.S., & Steele, K. (2006). The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. W.W. Norton. 

Van der Kolk, B. (2014). The Body Keeps The Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books. 

Van der Kolk, B. (2021). 2-day Trauma Conference: The Body Keeps the Score- Trauma Healing with Bessel Van Der Kolk, MD. [Video]. PESI. 


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