Treating Dissociation in Therapy

How does Dissociation Therapy work?

A wide range of therapies are used for dissociative disorders. It generally involves you talking to the therapist about your condition and related issues. Your counsellor will help you understand the causes of the condition and find coping strategies to cope with stressful situations.
Therapeutic treatment options that have been proven to help dissociative disorders include creative art therapy, somatic therapy, sensorimotor psychotherapy and other trauma-informed approaches. With the help of a qualified counsellor, these methods can help you shift out of dissociation into a more embodied sense of self, and into greater presence in a way that will improve your life.

Grounding Techniques for Dissociation

• The 5-4-3-2-1 technique: Name 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste.

• Physical grounding: Hold an ice cube, splash cold water on your face, or press your feet firmly into the floor.

• Breathing exercises: Focus on slow, deep breathing or try box breathing (inhale for 4, hold for 4, exhale for 4, hold for 4).

• Movement: Do jumping jacks, stretch, or walk around to reconnect with your body.

• Mental grounding: Say your name, age, and location out loud, or describe your surroundings in detail.

• Carry grounding objects: Keep a textured stone, stress ball, or essential oil to use when you feel disconnected.

How Others Can Help You Stop Dissociating

Most of the time the person who is dissociating does not realize it is happening. The key strategy to deal with dissociation is grounding, meaning connecting back to the here and now.

Some strategies you can use to help ground someone include:

• Firmly get attention to make eye contact: Call out, snap fingers, or wave your hand to capture their attention.

• Make direct observation about state of dissociation: Use phrases like "Seems like you spaced out, where did you go?" to gently acknowledge what's happening.

• Have the person talk about where they are currently: Ask them to describe their immediate surroundings and what they are doing.

• Ask the person to do something grounding: Try exercises like "Name 5 things you see, feel, or hear" or "Count how many blue items you can see."

• Give something grounding to do: Offer a calming smell (like lavender), have them eat a piece of candy and describe it, push their feet into the ground, or get up and move around.

Who can Therapy for Dissociation Benefit?

Therapy for dissociation can benefit people who are experiencing the following symptoms:

• Memory issues or a disconnection from your memory.

• Disconnection to one’s body & body sensations.

• Disconnection to one’s emotions.

• Disconnection from one’s sense of self.

• Feeling disconnected to one’s body and/or thoughts (confused thinking).

• A disconnection to one’s surroundings (feeling like you don’t belong, that the world is not real, seeing things from outside yourself).

• A disconnection or puzzlement of who one is.

• A disconnection or shift in role or identity, along with sudden changes in behaviour, such as a different voice, use of different names, or disconnection of yourself and or loss of control over one’s self.

• Dissociation is an escape from the full sensorium of experiences during a stressful or traumatic event. To follow this logic, the more stress, the more dissociation might occur.

PTSD and Dissociation

PTSD and dissociation often occur together because both are responses to trauma. When someone experiences a traumatic event, their mind may use dissociation as a way to protect them from overwhelming feelings and memories. 

People with PTSD may dissociate during flashbacks, nightmares, or when reminded of their trauma. This can make them feel disconnected from their body or like they're watching themselves from outside. Treatment for PTSD and dissociation works best when both issues are addressed together, helping people feel safe in their bodies while processing traumatic memories.

Dissociation and Depression

Dissociation and depression commonly appear together, creating a cycle that can be difficult to break. 

Depression may lead to dissociation as a way to escape painful emotions, while dissociation can worsen depression by making people feel disconnected from positive experiences and relationships. Someone might feel emotionally numb, like they're going through the motions of life without really being present. This combination can make daily activities feel overwhelming and relationships feel distant. 

Therapy focuses on helping people reconnect with their emotions and experiences while building healthy coping skills.

Dissociation and Anxiety

Anxiety and dissociation can trigger each other in a challenging cycle. High anxiety may cause someone to dissociate as their mind tries to escape overwhelming worry or panic. At the same time, dissociation can increase anxiety because feeling disconnected or "not real" is frightening. 

People might experience panic attacks that include dissociative symptoms like feeling detached from their surroundings or their own body. Treatment involves learning to manage anxiety before it leads to dissociation, as well as grounding techniques to reconnect when dissociation occurs.

Dissociation in Neurodivergent Individuals

People with autism or (Attention Deficit Hyperactivity Disorder) ADHD may experience dissociation differently or more frequently than others. 

For neurodivergent individuals, dissociation might occur during sensory overload, social overwhelm, or when masking their natural behaviours becomes too exhausting. Those with ADHD may dissociate when they feel overwhelmed by too many stimuli or when their attention becomes completely absorbed in something. 

Neurodivergent people might also use dissociation to cope with a world that doesn't always understand their needs. Treatment recognizes these unique triggers and works with the person's neurological differences rather than against them.