Dissociation & Trauma Therapy: Causes, Symptoms & Healing
Dissociation is a trauma response that affects emotional processing. Learn grounding techniques, symptoms, and how therapy helps with healing and recovery.
“Dissociation” is a common term used in trauma healing work; it is a type of survival mechanism that helps individuals detach from overwhelming experiences. It may feel like your soul has left your body, your mind goes numb, or you are suddenly forced to watch your life from the outside. These experiences often occur in response to trauma, difficult flashbacks, violence, and/or prolonged stress. There are some positives to this way of coping, as it can help you get through a difficult experience without feeling overwhelmed emotionally. However, it becomes a challenge when it starts to appear involuntarily in day to day life and hinder tasks one would like to accomplish, or the feelings of numbness take away from one’s ability to feel positive emotions or be regularly present in their life.
Why It Matters in Therapy
Dissociation is a common response to trauma and can interfere with emotional processing and daily functioning. Unlike fleeting feelings of boredom or temporary jumpscares, dissociation usually lasts much longer and is a deeper detachment much more difficult to feel present again. It can be difficult to function in school, work, relationships, and overall quality of life. Trauma-informed therapy is essential for addressing dissociation safely.
What Is Dissociation?
When a traumatic experience happens, the brain "locks away" unbearable experiences to cope with trauma. This can be a short-term response or a chronic survival mechanism. As stated by the American Psychiatric Association, some examples of dissociation includes the following:
Dissociative Amnesia: Inability to recall traumatic events.
Chronic Dissociation: Long-term detachment from reality.
Split Neural Pathways: One part seeks normalcy, while another stays hypervigilant. (American Psychiatric Association, n.d.)
The DSM-5-TR shares some examples of dissociative symptoms (under the diagnosis Acute Stress Disorder F43.0) as seeing oneself from another’s perspective, being in a daze, time slowing, as well as the inability to remember an important aspect of the traumatic events usually due to dissociative amnesia. (American Psychiatric Association, 2022) Common symptoms of dissociation include feeling disconnected from oneself or the environment. Or, there may be sudden emotional shifts, intrusive memories, or difficulty receiving compassion. It can also surface as physical symptoms of unexplained physical pain. Your inner critic or voice (that is not psychosis) may also be linked to past traumas, such as a parental figure regularly telling you mean things when you were younger, which alternatively can manifest as a challenging inner critic telling you the same things as an adult.
The Role of Trauma-Informed Therapy
General therapy may overlook dissociation without proper training. Therapists use observation (eye expressions, breathing, difficulties with attention) to detect dissociation in clients. Though, some clients are also aware of these terms and verbalize them as well, which is very helpful for therapists to know what the client is experiencing.
Therapeutic Approaches
With trauma informed care, the therapist often makes careful decisions of what activity to introduce to help ground the client. There are a wide range of grounding techniques that may bring awareness to the present, such as guided deep breathing for emotional regulation, creating a calm, safe space for gradual healing. It must be noted that it is important to distinguish if the client is comfortable with certain activities, such as closing eyes for deep breathing may alternatively feel unsafe, or the difference between if a client would benefit from a sensory minimal space vs. engaging senses in a space to feel grounded.
11 Effective Grounding Techniques for Dissociation
There are many ways individuals can cope with dissociation to build effective ways of grounding when triggers do happen. Since dissociation may feel like an out of body experience, many of the themes used to ground involve what is here in the now. The following activities may be helpful in building your toolkit of grounding activities.
Use Scent – Mint or lemon candies, essential oils, etc.
Remind Yourself of the Present – State your name, date, and location.
Body Awareness – Body scans, from head to toe, what do you feel in each body part? Any pain, hunger, discomfort, comfort?
TIPP from Dialectical Behavioral Therapy Approaches - TIPP in DBT are the acronyms for Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation. (Safilian-Hanif, 2024) Although not centered around trauma work, this technique focuses on being present during times of emotional distress and may be helpful addressing dissociation symptoms as well.
Temperature - cold water showers, swimming, splashing water with a cold face, a frozen icepack to touch.
Intense exercise - jog on the treadmill, intense home workouts, running in place, jumping jacks
Paced breathing - slow breathing down with deep breaths, from the stomach.
Progressive muscle relaxation - tense muscles in the body, hold for a few seconds, then completely release. Repeat until you feel calm.
5-4-3-2-1 Technique – Identify:
5 things you see
4 things you touch
3 things you hear
2 things you smell
1 thing you taste
Connect with Nature – Walk barefoot on grass, go for a walk and feel the wind.
Physical Touch – Ask for a hug from someone, give yourself a hug, or hug an object.
Talk to Someone – Call a safe person for reassurance.
Engage in Art Making or Art Therapy - Draw, write, or sculpt something to help engage most or all of your senses in a calming activity outside of your body. Though, it is important to note for art therapy, working with an art therapist is advised for accurate care and a proper safe space for art making.
Engage with Music – Sing, listen to a favorite song, or play an instrument.
Move Your Body – Stretch, sit up straight, jump, or do gentle exercises.
Practice Deep Breathing – Use slow, intentional breathwork.
Seeking Professional Support
If dissociation significantly impacts daily life, trauma-informed therapy is recommended. Additional resources are cited here for those who may be interested in investigating further:
NAMI
NIH - Psychological Interventions for Dissociative disorders
For direct care, seeking therapy with keywords such as “trauma informed”, “trauma sensitive”, “EMDR”, “somatic”, and so forth can be helpful depending on therapy goals and what an individual would like to experiment with. Overall, proper therapy can help integrate past trauma, regulate the nervous system, and restore a sense of control in a safe, contained environment with a trained professional.
Conclusion
Dissociation is a natural but complex response to trauma. If one is experiencing difficulties in their day to day life, it is advised that they seek out a therapist with trauma-informed approaches to explore what ways may help each individual client ground themselves. Grounding techniques provide practical ways to reconnect with the present. Overall, trauma therapy offers structured support for managing and healing dissociation.
Citations
American Psychiatric Association. (2022). Desk reference to the diagnostic criteria from DSM-5-TR. American Psychiatric Association Publishing.
American Psychiatric Association. (n.d.). What are dissociative disorders? Psychiatry.org.
https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders
Safilian-Hanif, C. (2024, February 11). TIPP: Distress tolerance skills. Dialectical Behavior
Therapy. Medically reviewed by Cimone Safilian-Hanif, PhD.
https://dialecticalbehaviortherapy.com/distress-tolerance/tipp/