Dissociation can make you feel far away from yourself.
Some people come to dissociation therapy because they lose time or struggle with their memory.
Others come because life feels unreal, like watching it from the outside.
Some have never heard the word, but know they often check out or go somewhere else in their mind.
Maybe you feel:
- detached
- foggy
- numb
- spaced out
When something feels like too much, your brain can numb the pain with its own natural painkillers.
Dissociation therapy can help you feel more present and connected.
What is Dissociation Therapy?
Dissociation therapy helps you understand why you disconnect and feel safer in the present.
It holds dissociation as protection, whether you feel cut off from your mind, body, emotions or the world.
Therapy can look at the environments or experiences that made disconnecting necessary.
It can help with zoning out, feeling unreal, memory gaps or different parts of yourself.
Everyone dissociates sometimes, and therapy can help when it gets in the way of life.
The work is about feeling safe enough to stay present.
How Dissociation Therapy Helps
Therapy gives you a place to understand the ways you leave, and what helps you come back.
It can help whether dissociation is mild and occasional or has shaped your life for years.
In dissociation therapy you can learn to:
- ground yourself in the present
- notice when you start to drift
- reconnect with your feelings and body
- tolerate more without shutting down
- understand different parts of yourself
Therapy can’t erase what made it necessary to leave, but it can help you stay when it feels safe.
Progress takes time, because dissociation affects you physically, mentally, emotionally and socially.
Being present can start to feel safe.
What is a Dissociation Therapist?
A dissociation therapist is a registered therapist who works with people who dissociate.
Dissociation is often missed in general training, so dissociation therapists seek training specific to it.
Some train in approaches built for dissociation, which teach them to notice when you drift and help you come back.
Some train with the International Society for the Study of Trauma and Dissociation (ISSTD), which focuses on complex trauma and dissociation.
Some specialize in dissociative identity disorder (DID).
What matters most is that the therapist is a good fit for you, whatever approach they use.
Some Approaches for Dissociation Therapy
Attachment-Based
It builds a steady, safe relationship, which can help you feel connected.
Expressive Arts
It uses art, movement or writing to express what’s hard to reach with words.
Somatic
It helps you gently return to your body and the present moment.
Trauma-Sensitive
It puts safety, choice and pace first, so you can stay present while you heal.
What to Expect in Dissociation Therapy
Dissociation therapy often starts with grounding.
You might practice noticing your feet on the floor or naming things you can see in the room.
Early sessions often explore what helps you feel safe, present and connected.
Your therapist might ask how dissociation shows up for you and what tends to bring it on.
Some therapists suggest tracking when you drift between sessions, without judging yourself for it.
If past therapy moved too fast or left you feeling more disconnected, that’s worth sharing with your therapist.
Dissociation therapy can be short-term for mild dissociation, or longer when it’s tied to complex or early trauma.
Dissociation keeps being rediscovered.
In 1889, French psychologist Pierre Janet described patients in the port city of Le Havre who seemed to lose parts of themselves.
One young woman, Marie, went cold and shook each month and had lost sight in one eye. Janet traced each symptom to a frightening memory Marie couldn’t recall on her own.
He called this splitting of the self désagrégation, which came into English as dissociation. He believed overwhelming experiences could leave memories cut off from the rest of the mind.
The next year, he joined neurologist Jean-Martin Charcot at the Salpêtrière hospital in Paris, where women diagnosed with hysteria were shown to audiences of doctors. Janet became known for listening closely to their histories.
Janet saw that his patients’ physical symptoms came from overwhelming experiences, and he took their stories seriously. He became a pioneer of trauma therapy, and his work on split-off parts of the self shaped how we understand dissociation today.
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Janet’s work also influenced early psychoanalysis. In 1896, Sigmund Freud, who also studied under Charcot, proposed that many of his patients’ symptoms came from childhood sexual abuse. By the next year, he had privately abandoned the idea and begun to treat many of these memories as fantasy. Freud’s idea of repression took center stage, and his fame overshadowed Janet’s work.
In 1915, during the First World War, British doctor Charles Myers described soldiers who were mute, paralyzed or unable to remember. He used the term shell shock, which soldiers were already using, in a medical journal for the first time. Some soldiers were labeled cowards instead of being treated.
In 1980, psychiatry’s diagnostic manual recognized multiple personality disorder, later renamed dissociative identity disorder.
In 1992, parents accused of childhood sexual abuse by their adult children formed the False Memory Syndrome Foundation. Some therapists had used hypnosis and suggestion to plant false memories, and the backlash grew into what became known as the memory wars. People who reported abuse were often doubted, and dissociation itself came under attack.
In 1996, psychologist Jennifer Freyd, whose own parents helped found the foundation, argued that children may block out abuse by someone they depend on to survive. She called it betrayal trauma.
In 2010, Canadian psychiatrist Ruth Lanius at Western University in London, Ontario, published a review of brain imaging research, including her own, on people with post-traumatic stress disorder, or PTSD. She found some people’s brains shut down emotions under stress instead of becoming more alarmed.
In 2013, psychiatry’s diagnostic manual added a dissociative subtype of PTSD, based partly on her work.
But dissociation is still missed, doubted or misunderstood.
Many health professionals miss the signs of dissociation, so people can be given diagnoses that don’t fit.
When people describe lost time, different parts of themselves or unexplained physical symptoms, they are often not believed.
Some therapy asks people to face trauma memories before they can stay present, which can make dissociation worse.
Movies and TV often show dissociation as fake, frightening or dangerous, which adds to the shame.
And many people don’t recognize their own dissociation, so they believe something is wrong with them.
Trauma-sensitive dissociation therapy works inside those gaps. It believes your experience. It builds safety and grounding first. It goes at a pace your mind and body can handle. And it treats every part of you with respect.
Trauma-sensitive therapy starts by helping you feel safe enough to be here.
Trauma-Sensitive Dissociation Therapy
What if leaving was the only way to stay?
When there was no way to escape, your mind found a way to leave or your body numbed the pain, so you could survive.
Trauma-sensitive therapists understand dissociation as protection, not something to get rid of.
5 phrases you might hear in Trauma-Sensitive Dissociation Therapy:
- Every part of you is welcome here.
- Let’s pause for a minute.
- Can you press your feet into the floor?
- I noticed you just drifted.
- What happened just before that?
Trauma-sensitive dissociation therapy invites you to come back to yourself, gently.
Principles of Trauma-Sensitive Dissociation Therapy
Parts are protection
Dissociation helped you survive. When parts of you separate, they are protecting you from pain.
Safety in the body
Grounding and stabilization help you feel safe in your body, because feelings can return as dissociation lifts.
All parts welcome
Different parts of you each hold something important, and the work is to welcome each part, at a safe pace.
Dissociation time
You can learn to notice when you drift and make time for dissociation during your day if it is helpful.
Questions You Can Ask a Dissociation Therapist
A consultation is a good time to ask questions. Trust how you feel after the conversation as much as the answers themselves.
Do you have training in working with dissociation?
How do you work with trauma memories?
What if I dissociate in a session?
Do you work with parts?
How will we know if it’s too much?
What if I don’t remember everything?
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