Neuro-Affirming Dissociation Spectrum 101
A resource for both therapists and clients about the dissociation spectrum!
What is dissociation?
Dissociation becomes much easier to understand when we couch it in the idea of severance. It stems from Latin and its root quite literally means “to sever.”
Dissociation exists on a spectrum. We can sever from the present moment, our trauma, our feelings, our experience, our physical discomfort, or our drive home from work. Everyone experiences dissociation to some degree. It can look like anything from remembering an event but not remembering feelings about it to doom scrolling, to substance use, to having a child part inside and anything in between. Dissociation can be protective or it can meet a need and this is not a conscious decision - it is a decision made by a brain in response to stimuli or lack thereof.
A brain scans its environment for threat or input multiple times per second in a process called neuroception. When a brain chooses dissociation as a response to something it detects, both the choice and response often happen before any cognitive awareness occurs. So often folks who experience dissociation report a lot of shame about it despite the fact their brain is usually making the choice before they’re aware of it.
It's a spectrum!
The dissociation spectrum includes Depersonalization/Derealization Disorder, or a persistent disconnection from body or the environment. The experience of disconnection from both or either body and environment can occur for a variety of reasons, including as a response to chronic aversive sensory input. The dissociation spectrum also includes what are known as Other Specified Dissociative Disorders (OSDD) and Dissociative Identity Disorder (DID). These are ICD-11 labels for a specific set of criteria that include separate personality states within one body and amnesia around experiences, perceptions, or emotions.
Importance of learning from those with lived experience
Dissociation and dissociative identities can be overwhelming and upsetting to those who experience them but they can also be such gargantuan strengths. Approaching dissociation and multiplicity from a strengths-based perspective can help destigmatize the experience for our clients and support them in unlearning the prevailing narrative that “something is wrong with me.” Nothing is wrong about experiencing dissociation or dissociative identities, something was wrong with the environment. Multiplicity advocate and psychologist with lived experience Dr. Jamie Marich+ notes that shame is not a criteria for multiplicity.
I recognize and honor the importance of incorporating clients’ experiences and preferences into verbiage. This is something I uphold first and foremost but in this explanation I refer to OSDD and DID as multiplicity. My personal belief and one echoed by many with lived experience of multiplicity is that to refer to this as a disorder does a huge disservice to both those who experience it and our conceptualization of it. What was disordered was the environment in which a system (a human with dissociative identities) grew up, not the way their brain was forced to survive.
Ultimately, think of dissociation as an umbrella term to describe any way in which people might disconnect from something. Multiplicity describes the experience of having multiple and separate in some way parts. See “Importance of Cultural Humility” for more about this.
Dissociation is a topic near and dear to my heart! If you're a therapist who has questions about it or an organization interested in learning more, I offer consultation so please don't hesitate to reach out below!