Dissociation and dissociative disorders

Explains what dissociation and dissociative disorders are, including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

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What are the causes?

Dissociation is a normal defence mechanism that helps us cope during trauma. For example, some people dissociate after experiencing traumatic events such as war, kidnapping or an invasive medical procedure.

But this can become a dissociative disorder if your environment is no longer traumatic but you still act as if it is, and if the dissociation you needed to protect yourself means you haven't been able to process past traumatic experiences.

Dissociative disorders are usually caused when dissociation is used a lot to survive complex trauma over a long time, and during childhood when the brain and personality are developing. Examples of trauma which may lead to a dissociative disorder include:

physical abuse
sexual abuse
severe neglect
emotional abuse.

You may get so used to using dissociation as a coping strategy that you do not develop other strategies and you start to use dissociation to deal with any kind of stress.

How does trauma cause dissociation?

Trauma can cause dissociation because of the way we respond to threat. There are different theories about how exactly this leads to different dissociative disorders.

You may have heard of fight or flight. They are instinctive ways that we respond to threatening situations. But if you can't do these things (for example if you are very young) then you may respond by 'freezing' or 'flopping'.

The freeze response makes the body immobile and releases chemicals which 'numbs' your body and mind. You might feel paralysed or unable to move.
The flop response is where lots of the thinking processes in the brain are shut off. Your muscles become floppy and you act a bit like a zombie - doing what you are told without protest.

Our instinctive reactions to threat are the basis of dissociative experiences.

Dissociative disorder: losing myself and finding myself

"I had numbed senses, everything was lost, and nothing felt familiar."

Read James' story

"It became uncontrollable and it would happen in various places when I felt stressed or under threat."

One theory suggests that whenever we think there is a threat, our body reduces blood flow to areas in the front of our brain (the thinking, analytical, rational part) and 'turns on' areas in the back of our brain (the automatic, instinctive part).

Using the back of our brain to freeze or flop helps protect us from trauma that we can't prevent or run away from. But reducing the blood flow to the front of our brain can make it more difficult to process what happens and may mean we experience dissociation.

The front of our brain includes areas which help us:

understand where we are in time and space
use language and speech
feel connected to our body
store memories
make sense of information coming through our senses.

You might separate different parts of an experience so you do not have to deal with them all together. Different parts of the experience (such as actions, memories, feelings, thoughts, sensations and perceptions) may not be 'joined up'.

"I would disconnect myself from being in the room where the abuse was happening. I almost felt like I was watching it happen to me but I wasn't feeling it or wasn't part of it. It became something that happened automatically."

For example, you might store an experience in a way you can't access day to day (this is usually called amnesia). Or you might remember what happened but don't feel the emotions or sensations that were part of it (this is usually called derealisation).

If you experience dissociative identity disorder (DID), you might feel as if different memories, sensations or beliefs happened to different people (usually called identity states) inside you.

This can help you cope if the things that happened would be too much for you to deal with all together as a child - but may prevent you from developing one clear identity as you grow up.

What makes dissociative disorders more likely?

Not everyone who experiences trauma will have a dissociative disorder. But many experts agree that there are some experiences of trauma that make dissociative disorders more likely:

abuse or neglect that begins at an early age (the younger you are, the harder you will find it to cope with traumatic experiences without dissociation)
abuse or neglect that is severe and repeated over a long period, or by many people
abuse or neglect that is painful and makes you scared
there is no adult who you have a good relationship with and is able to provide comfort and help you process and deal with the trauma
a child's parents or caregivers dissociate themselves
abuse or neglect that is done by someone you feel attached to
the abuser tells you that things didn't happen or that you were dreaming
things are different at different times - for example things seem normal during the day but at night you are abused.

You can read more about the causes of dissociative identity disorder on the PODS website.

For more support you can contact these organisations:

The National Association for People Abused in Childhood (NAPAC) offers support for adults who were abused as children.
Survivors UK provides support for men who have been abused.
Childline is there to help children who are upset or scared about anything, including abuse.
If you are worried about a child you know, the National Society for the Prevention of Cruelty to Children (NSPCC) can help.
The Survivors Trust provides contact with local organisations which offer support for people who have experiences sexual abuse.
For other organisations which may be able to help you, see our useful contacts page.