Exploring Different Types of Dissociative Disorders and the Necessity of Treatment

We may take for granted our grasp of reality and identity. But when we lose touch with those foundational elements of life through trauma and dissociation, our everyday existence becomes unsettling and distressful. We can trace different types of dissociative disorders back to past experiences of trauma that caused protective dissociation. In order to effectively reintegrate disconnected parts of the self and of life, it’s important to seek long-term psychotherapy treatment and rehabilitation.

Our sense of self and identity is a complex bundle of all our life experiences, our relationship to the world around us, and our working relationship with the inner landscape of our minds and emotions. This layered sense of identity acts as a lens and a buffer through which we experience life every day. Most of us have experienced what it’s like when this lens occasionally contracts in times of mindlessness or stress and we “zone out.” But for some of us, this state of dissociation persists or recurs, unsettling our sense of identity and getting in the way of our everyday functioning.

We may take for granted that cumulative collection of experiences, familiar responses, and ways of understanding ourselves. But when this foundational buffer is confused or inaccessible, we can become disconnected from reality and from ourselves. We may end up feeling numb or like our bodies and perceptions are not our own. The experience of dissociation can result in different types of dissociative disorders, including dissociative identity disorder, depersonalization, derealization, and dissociative amnesia. However the dissociation manifests, the road to reconnection and recovery is a personal one for each of us.

What Causes Dissociation and Dissociative Disorders?

The reason people develop dissociative disorders in adulthood is generally traced back to earlier trauma. Often related to physical, sexual, or emotional abuse or neglect in childhood, individuals adapted to cope with this trauma by detaching or dissociating from the experience as it was happening and as the memories or reminiscent triggers arise in the future. Whereas this adaptation can help affected individuals to handle the overwhelming fear and emotions at the time of the trauma, the dissociation may continue to kick in years later, even when there isn’t any real danger or significant trauma. This reactive coping mechanism muddles their sense of identity or their ability to experience their reality, and it can leave them feeling disconnected and spaced out.

If you have someone in your life who experiences dissociation, you may find it very difficult to relate to their struggles. In most cases, the source of their dissociative adaptation is buried deep in their past, so you may not be able to draw a line directly to stressors around them at the present. Even though the root cause of the disorder may be far away, it’s still critical that they receive the help they need to live and thrive the best they possibly can now. Let’s look a little closer at the different ways dissociation can develop, so we can better understand the course of treatment.

Different Types of Dissociative Disorders

Originally, a person’s dissociation serves to protect them from the intense trauma they encounter, often through repeated early experiences of abuse, neglect, or dissociative behaviors in a parent, caregiver, or someone else close to them. When dissociative patterns arise again, typically by early adulthood, even when original traumas are no longer present, this coping response can significantly affect the way they experience and participate with life. Here are some of the various ways that dissociative disorders manifest.

Dissociative Identity Disorder

Formerly known as multiple personality disorder, dissociative identity disorder (DID) develops as the experience of more than one distinct identity, and the person’s memories, personality, thoughts, and behaviors shift when their identity experience shifts. People may face lapses in their recent memory due to these shifts, as well as lapses in traumatic memories from their past due to protective dissociation. The unpredictability and disorientation make everyday functioning, independence, and a productive work life difficult. Because the experience is so confusing for the individual and those around them, socialization and relationships suffer. Someone with DID may also experience shifts in their perception of time and place, believing that they are living an earlier traumatic incident.

Depersonalization Disorder

When someone develops depersonalization disorder, they tend to feel out of place in their own body, mind, and sense of self. They may feel that their body parts or their reflection in the mirror are unfamiliar, which can be unsettling and bring up feelings of anxiety and fear. With this confusing disconnection between the person and their everyday experiences, they can also feel numb to their thoughts and emotions as if they are running on autopilot.

Derealization Disorder

Derealization disorder is similar to depersonalization, but the individual experiences the dissociation with the environment around them, including people and things. They may feel detached from their experience as if they’re witnessing everything from far away or through a window or movie screen. Things around them may seem two-dimensional, unreal, or hazy.

Depersonalization and derealization can occur separately or they can show up together with an individual feeling disconnected both from themselves and from their external world. These experiences are stressful, even if the individual is detached from and unable to express their emotions.

Dissociative Amnesia Disorder

Dissociative amnesia is characterized by memory challenges and lapses, which most likely developed to protect the individual from the trauma they experienced. A memory gap may be specific to a past traumatic event or a broader length of time. The gap may be more narrowly focused on certain details from an event or timeframe. Or it may be broad, and the individual loses memory of their own life history and the understanding of what makes up their identity.

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Why Treatment for Dissociative Disorders is Essential

With dissociative disorders, living a normal life can be challenging and may feel like a goal that is completely out of reach, which is why our loved ones need help to process the sources of trauma where their dissociation originates and to become aware of the ways that they are disconnected from life in the present. Successful programs integrate personalized psychotherapy and rehabilitation to help them readapt to everyday life in grounded and productive ways.

The experiences and severity of dissociative disorders vary among individuals, and even for an individual the experience and severity of dissociation may change with time. Stress and trauma in the present can trigger symptoms or make them worse. Because the primary effect is disconnection, it is important to be able to bring awareness and empowered perspective to the experience as much as possible with the help of a knowledgeable therapist. When we are functioning and feeling our best, the elements of memory, emotion, thinking, sensing, perceiving, and acting are integrated. With treatment for dissociative disorders, the goal is to gradually reintegrate these elements of self and experience.

Because treatment for dissociation involves reconnecting threads that were separated around past trauma, the treatment itself can be stressful when revisiting those areas. Treatment can also be challenging for individuals who have developed a distrust of others through their experience of dissociation. For these reasons, along with the overwhelming challenges to everyday functioning, people with dissociative disorders benefit from long-term residential treatment programs. Here, they are able to build a familiarity with the setting, the community, and their own place in the program.

From that safe foundation, they can approach the difficult but important work of compassionately reintegrating the unique parts of themselves, all with the support and guidance of expert therapists and caregivers. Family and friends can also offer powerful support during this time and especially for the long-term recovery of a loved one. Family involvement is strongly encouraged through therapy sessions and educational groups from week to week. Peer support groups for people with dissociative disorders also give them a continued opportunity to maintain perspective as they practice empowering social interaction. In some cases, transitional residential programs are a great way for clients to continue living in a community of recovery before living more independently.

While there isn’t medication to treat dissociative disorders directly, people may be treated for co-occurring disorders such as depression and anxiety. Beyond the critical phase of reintegrating the self, clients will also have dedicated opportunities to learn strategies to cope with stress and anxiety; to manage diverse independent responsibilities, such as finances, interpersonal skills, and time management; and to socialize and relate to others. This treatment approach is designed to reintegrate life as a whole and to empower clients so they can move on from the program feeling ready to live a life of greater connection.

Hanbleceya offers comprehensive long-term treatment for people struggling with mental health disorders and co-occurring substance use disorders and process addictions. Contact us to learn more about our renowned San Diego-based program and how we can help you or your loved one start the journey toward recovery.