Dissociation

Everyday dissociation happens when your brain puts a routine task on autopilot so it can think about something else. You might walk to class and not remember the walk, or stare out a window and lose track of time.

It usually

• Feels neutral or even pleasant
• Ends easily when someone speaks to you
• Doesn’t leave big gaps in memory about important things
• Doesn’t cause distress or get in the way of life

If zoning out is happening so often that you are missing a lot, or it feels scary, it’s worth mentioning to a doctor or counsellor. Sleep, stress and attention differences can all play a part.

When something is overwhelming and there is no way to fight or escape, the mind can create distance instead. Feelings shut down, pain feels less sharp, and the moment can feel unreal. This helps a person get through it.

Young children are especially likely to cope this way, because they can’t yet make sense of what is happening and have few other ways to protect themselves.

Later, it might show up as

• Going numb or “blank” when reminded of the trauma
• Feeling far away during arguments or loud noise
• Losing time, or finding gaps in your memory
• Feeling like your body or the world isn’t real

Hard experiences linked to dissociation include childhood physical, sexual or emotional abuse, war, kidnapping, accidents, disasters, being a victim of crime, and invasive medical procedures. For more, see the “Trauma: what it is & how it affects you” guide.

Dissociation often gets stronger when the nervous system is already stretched. Symptoms tend to show up or worsen during stress.

Common triggers

• Big stress or conflict
• Being very tired or not sleeping
• Reminders of past trauma: a smell, a song, a tone of voice, a date
• Alcohol and drugs, which can trigger or worsen detachment
• Feeling trapped, criticised or out of control

Learning your own triggers is a powerful first step. You can’t avoid them all, but you can plan for them and use grounding early. The “My signals & triggers” worksheet can help.

Depersonalization means feeling cut off from your own thoughts, feelings or body. People say it feels like watching themselves in a movie, or from outside their body.

People describe

• “My hands don’t feel like mine.”
• “I’m going through the motions like a robot.”
• “My voice sounds strange, like someone else’s.”
• “I know I should feel something, but I feel numb.”

An important point: people know these feelings aren’t real. That awareness can make it frustrating and scary, and many people find it very hard to describe in words. If you can’t explain it well, that is normal.

Derealization means the world around you seems unreal. People and places can seem distant, hazy, dreamlike, colourless, or even the wrong size or shape.

It can happen on its own or together with depersonalization. Episodes may last moments, or come and go over years.

It can feel like

• Looking at the world through glass or a fog
• Familiar people seeming like strangers or actors
• Sounds seeming muffled or far away
• Time feeling slowed down or sped up

This experience is most common in teens and young adults. On average the first episode happens around age 16, and it usually starts before age 20.

Dissociative amnesia means gaps in memory about your life or past events that are much bigger than ordinary forgetting, and not caused by another medical condition.

It can look like

• Not remembering a stretch of time, or a hard event
• Forgetting personal information, like parts of your history
• Losing a skill you had learned
• Finding yourself somewhere and not knowing how you got there

Memory gaps usually last minutes to days, and rarely months or years. Often, loved ones notice the memory loss before the person does.

DID used to be called “multiple personality disorder”. A person with DID experiences two or more separate identities, sometimes called parts or alters. Each can have its own name, voice, history and ways of acting.

Memories may not carry over between identities, so there can be gaps in memory about daily life, personal information or past events. Some people don’t notice when another part takes over, so they may have DID without knowing it.

DID is strongly linked to severe, repeated trauma in early childhood. About 90% of people with DID in the U.S., Canada and Europe experienced childhood abuse and neglect. It is best understood as a young mind’s way of surviving the unbearable.

Signs often start between ages 5 and 10, but are often mistaken for other conditions, so DID usually isn’t identified until adulthood.

Dissociation rarely comes alone. Many people also live with depression, anxiety, panic attacks, PTSD, OCD, mood swings, eating problems, sleep problems or substance use.

Some people feel less physical pain during episodes, and some have seizure-like episodes or fainting. These need a proper check with a doctor.

Self-harm and suicidal thoughts can also be part of the picture, especially for people with severe trauma. If this is you, you deserve help right now. See “When to get help”, and the If you’re having suicidal thoughts guide.

Horror and thriller films often show people with DID as violent. That picture is not based on research. In one study of 173 people in treatment for dissociative disorders, only 3% had been charged with an offence in the past six months, and 0.6% had been jailed.

The researchers found that contact with the legal system was low, and that dissociation symptoms did not predict criminal behaviour.

The far bigger risk is to the person themselves. More than 70% of people diagnosed with DID attempt suicide or hurt themselves.

DID has been included in official diagnostic manuals since 1980, and hundreds of research papers have been published about it.

Studies have found records of severe childhood abuse in most people with DID, and a strong link between trauma and dissociation. Far from seeking attention, some people with DID don’t even realise when another part takes over.

Being doubted can feel like being hurt again. Believing someone, even when you don’t fully understand, is a powerful gift.

The old names “multiple personality” and “split personality” give the wrong idea, as if there are several people in one body. DID is better understood as one person whose identity is divided into parts, often because the trauma began before their sense of self was fully formed.

“Split personality” is also sometimes confused with psychosis or schizophrenia. They are very different. People with DID usually know the world around them is real.

Switching between parts is usually not dramatic. To others, it may just look like a mood change, forgetfulness or acting “not like yourself”.

Community studies using careful interviews found DID in about 1.1% to 1.5% of people. Studies have come from at least seven countries, not only North America.

DID is more often missed than over-diagnosed. People often spend 6 to 12 years in mental health care before getting the right diagnosis.

There is no quick cure, and recovery is usually a long process. But with therapy, many people have fewer symptoms, less self-harm, fewer hospital stays and a better daily life.

Researchers have found no study showing that therapy following expert guidelines harms people with DID. The research still has limits, which we explain honestly in “Therapy and recovery”.

Using your senses pulls attention out of the fog and into the real room. It gives the busy, frightened brain a simple job to do.

Try it

1. Name 5 things you can see (say them out loud if you can)
2. Name 4 things you can touch, and notice how they feel
3. Name 3 things you can hear
4. Name 2 things you can smell
5. Name 1 thing you can taste

When you feel numb or far away, a clear, safe physical sensation can help you feel your body again. Running cool or warm water over your hands, or squeezing and releasing your fists, are simple examples.

Ideas

• Hold something cold, like an ice cube or a cold drink
• Squeeze a stress ball, then let go
• Chew a strong mint or sour sweet
• Smell something sharp, like peppermint or coffee
• Press your feet firmly into the floor

Simple mental tasks give your brain something solid to hold onto. Try counting to 10 and back, saying the alphabet backward, or sorting things around you by colour or size.

More ideas

• Name an animal for each letter of the alphabet
• Say today’s date, where you are and how old you are
• Describe your surroundings as if to someone on the phone
• Recite a song, poem or prayer you know well

Saying reassuring words to yourself can calm the alarm. Something as simple as “I am safe in this moment” can help.

Examples

• “My name is ___. I am ___ years old.”
• “Today is ___. I am in ___.”
• “That was then. This is now.”
• “This feeling is uncomfortable, but it will pass.”

Slow breathing with a long out-breath can help calm the body’s alarm system. Gentle stretching also reconnects you with your body.

Try it

1. Breathe in gently through your nose for a count of 4
2. Breathe out slowly through your mouth for a count of 6
3. Repeat 5 times, feeling your feet on the floor
4. Then stretch your arms up, or take a short walk

If focusing on your breath makes you feel more anxious (this happens for some trauma survivors), keep your eyes open and focus on movement or sounds instead. For more, see the Breathing for anxiety, panic & big feelings guide.

Soothing things can help you feel safe enough to come back. Cuddling a pet, playing a favourite song, or walking on grass are all ideas.

Hearing a calm, familiar voice can be grounding too. Some people ask a trusted friend to simply talk with them about ordinary things until they feel more present.

Experts in trauma and dissociation recommend going in stages, rather than jumping straight into painful memories. Guidelines from the International Society for the Study of Trauma and Dissociation describe three phases.

The three phases

1. Safety and stabilising: building trust, staying safe, and learning skills to manage feelings and dissociation
2. Working through trauma: carefully processing and grieving painful memories, only once the person is ready
3. Bringing life together: connecting parts of the self, and building relationships and daily life

Going too fast into detailed trauma memories usually makes people worse. A good therapist goes at your pace.

Cognitive behavioural therapy (CBT) helps you notice and change unhelpful thoughts and patterns. Dialectical behaviour therapy (DBT) teaches skills to manage strong emotions and distress, balancing acceptance with change.

Skills you might learn

• Spotting the early signs of drifting away
• Grounding and calming skills
• Handling urges to self-harm
• Getting through a crisis without making it worse

Therapy can also help you identify your triggers, which makes episodes feel less random and scary.

Eye movement desensitisation and reprocessing (EMDR) is a therapy for PTSD where you process trauma memories while doing guided eye movements. It is sometimes also used for dissociation.

For people who dissociate a lot, trauma processing should be approached carefully and only after stabilising skills are in place. Ask any therapist about their training in dissociation.

Individual, group or family therapy may all help. Family therapy can help loved ones understand what dissociation is and how to respond in helpful ways.

Groups can reduce shame. Hearing someone else describe the exact feeling you could never put into words can be a huge relief.

When someone is dissociating, their brain is in protection mode. A soft voice and simple words help more than questions or explanations.

Try saying

• “You’re safe. I’m here with you.”
• “It’s Tuesday afternoon, and we’re in the kitchen.”
• “Can you feel your feet on the floor?”
• “Take your time. There’s no rush.”
• Later: “What helps you when that happens?”

Use their name. Tell them what you’re doing before you do it, like “I’m going to sit next to you”.

Try to avoid

• Shouting, snapping fingers or shaking them
• Touching them without asking (it can feel threatening)
• “Snap out of it” or “You’re just ignoring me”
• “You’re faking” or “That’s not real”
• Asking for details about their trauma
• Treating them like a curiosity, or joking about films

If they don’t remember something, try not to make them feel tested or embarrassed. Gently fill in what they missed.

Practical support often helps more than big talks. Ask your loved one, at a calm time, what would be most useful.

Ideas

• Make a grounding plan together for when it happens
• Keep their grounding items handy
• Help with reminders, like shared calendars or notes, if memory gaps happen
• Notice patterns (time of day, places, stress) and share them kindly
• Offer to help find a trauma-informed therapist, or go with them to an appointment
• Encourage sleep, meals and time outdoors

If your loved one has DID, it can help to ask how they’d like you to respond to different parts. Treat every part with the same respect.

People who dissociate, especially those with DID, have a higher risk of self-harm and suicide. Take any talk of suicide or self-harm seriously.

What to do

1. Stay with them, calmly
2. Ask directly: “Are you thinking about hurting yourself?” Asking doesn’t put the idea in their head
3. Call or text 988 together
4. If a life is in danger, call 911

See the Helping someone who may be suicidal guide for more on how to help.

Watching someone you love disconnect can bring worry, sadness, frustration or a feeling of helplessness. All of these are normal.

Look after yourself

• Learn about dissociation, so it feels less scary
• Set kind but clear limits on what you can do
• Talk to your own friend, counsellor or support group
• Keep up your own sleep, food and joys
• Remember you can’t fix it alone; professionals are part of the team

See the Caregiver stress & burnout guide for more on caring for yourself while caring for someone else.