Dissociation

Dissociation

HOW WE COPE WITH TRAUMA

Dissociation

Introduction

Team Menber

The notion that we have a 'model of the world' that must be updated when significant change occurs is key to understanding trauma. Though change can occur in an instant, it is not possible for us to grieve in an instant. This is because we are not fundamentally in touch with the 'real' world where objects collide purely according to the laws of physics.

Rather, we live in a sort of model-world of our own construction inhabited by feelings and attachments. The formation of this model is a lifelong project starting shortly after conception. It occurs slowly and incrementally and in the background so that we never notice that it is there. The model of the world in our heads becomes the unquestioned foundation on which we make sense out of new situations and people. Though this model of the world allows us to predict with good accuracy what will happen next, it is not the same thing as the world itself.

When our model ceases to conform to reality (because the world itself has changed) we generally attempt to ignore the changes (denial), and when that doesn't work out, we freak (e.g., emotional outburst).

Traumatic events are precisely those events that shatter people's world models; their just world hypotheses. People exposed to events with the potential to induce trauma (such as untimely violent death or maiming, torture, combat, rape, etc.) lose the foundation upon which beliefs and understandings vital to their well-being (such as their ability to conceive of the world as a place which is good, plentiful, abundant, nurturing) rest. Without this foundation, the world becomes a fundamentally more chaotic, capricious and terrifying place, and the task of grieving becomes exponentially more difficult.

There is another reason why traumatized people don't 'get better' easily and that is that they get into an avoidance loop. They rightly fear their trauma memories, do not wish to re-experience them, and run from them (or take steps to avoid them) whenever feasible. This sort of avoidance can be bad enough when people are in full command of their memories. It is worse when they are not - as in the case of trauma-related dissociation.

In severe trauma cases, phenomena called dissociation can occur. Dissociation is a sort of coping mechanism that helps some people to manage shocking or stressful events by altering the way that memory about those events gets processed. Dissociated memories are cut off from other memories and cannot be easily retrieved via normal recall.

In general, fathers who reported that they had not worked through their grief 4 to 9 years after the loss of the child were significantly more likely to suffer from poor physical and mental health compared with fathers who had worked through their grief. They were also more likely to report that their physical and mental health had deteriorated in the preceding 5 years.

Other researchers have found that observers judge sick people as responsible for their illnesses. One experiment showed that persons suffering from a variety of illnesses were derogated on a measure of attractiveness more so than healthy individuals were. Victim derogation was found to be higher for those suffering from more severe illnesses, except in the case of cancer victims. Many studies have looked at derogation of AIDS victims specifically. Higher beliefs in a just world have been found to be related to greater derogation of AIDS victims.

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Dissociation

Explored

The unconscious is like a great holding area or reservoir of unprocessed events. Anything we don't or can't assimilate consciously goes there.

It also holds important things that need to be brought into conscious awareness but may be too big to fit our existing system (conscious mind).

Children are commonly seen to dissociate---not because of trauma, but because every time they get a new type of experience, they have to modify or expand their faculties in order to assimilate it. In the meantime, the experience is dissociated and held in the unconscious.

There, they "play with it," using their imagination until they work out a way to make a fit. Children go through a very high rate of new experiences and may frequently dissociate as a normal response to an unfamiliar event. They are continually modifying and expanding their system, or conscious mind. This is the process of growth and learning.

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Dissociation

Child Sexual Abuse

Team Menber

Depression is the body's warning to the individual that they need to address issues in their lives. For people who deny that they have problems despite experiencing traumas in their lives, the 'warning' of depression is a warning of events yet to come.

Participants reporting any type of childhood abuse demonstrated elevated levels of dissociative symptoms that were significantly higher than those in subjects not reporting abuse.

Higher dissociative symptoms were correlated with early age at onset of physical and sexual abuse and more frequent sexual abuse.

A substantial proportion of participants with all types of abuse reported partial or complete amnesia for abuse memories. For physical and sexual abuse, early age at onset was correlated with greater levels of amnesia.

When severe sexual abuse had occurred, dissociative symptoms were even more prominent.

Adults with a history of sexual abuse often present for treatment with a secondary mental health issue, which can include substance abuse, eating disorders, personality disorders, depression, and conflict in romantic or interpersonal relationships.

The effects of child sexual abuse include depression, post-traumatic stress disorder, anxiety, propensity to re-victimization in adulthood, and physical injury to the child, among other problems. Sexual abuse by a family member is a form of incest, and can result in more serious and long-term psychological trauma, especially in the case of parental incest.

In dissociating an experience, children split off a part of their self to hold the trauma.

In severe trauma cases, phenomena called dissociation can occur. Dissociation is a sort of coping mechanism that helps some people to manage shocking or stressful events by altering the way that memory about those events gets processed. Dissociated memories are cut off from other memories and cannot be easily retrieved via normal recall.

When the abuse is over, the original self "returns" and resumes "normal" life, having no/little awareness of what has just transpired. If severely abused children were forced to experience the trauma they just lived through, they would probably NOT survive.

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Dissociation

PTSD

PTSD is a dysfunctional grief process; one so severely over burdened that the normal grief process gets interrupted and blocked. It is a suspension of normal 'emotional processing'.

In a normal grief process initial outcry and anger gives way to cycles of denial, disbelief and numbing, and intrusion (of painful loss-related memories), all of which ultimately work their way through to a new reality. Though painful, neither the denial nor the intrusion is overwhelming for too long.

In contrast, PTSD involves re-living trauma related memories which never cease to be overwhelming and paralyzing. The traumatized person is unable to cope with the intrusive traumatic memories and is pushed towards extreme ways of avoiding them; drugs to dull the pain, prolonged avoidance of intimacy, etc.

Processing of these painful emotions does not happen because processing requires the ability to accept what has been lost, and in PTSD that ability to accept is not possible.

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Team Menber