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Understanding and Treating Dissociation: The Road to Recovery with CBT and DBT 

Dissociation, a phenomenon that might sound daunting, is surprisingly a common experience among many individuals. This can range from moments of daydreaming to more intense dissociative experiences. For example, have you ever found yourself lost in thought, unaware of your surroundings, or forgotten parts of a journey? Such instances are mild forms of dissociation. However, when dissociation becomes frequent and intense, it poses a significant challenge to one’s mental well-being. In this blog we will delve into the benefits of CBT, DBT, and Mindfulness in combating dissociation.  

What is Dissociation? 

Dissociation refers to a mental state where there is a disconnection or lack of continuity between thoughts, feelings, memories, or sense of identity. The American Psychiatric Association outlines dissociation as a disconnection in one’s thoughts, memory, and sense of identity, varying in severity from daydreaming to dissociative disorders. 

Common Forms of Dissociation 

Daydreaming 

Daydreaming is a mild form of dissociation where one temporarily disengages from the immediate surroundings and shifts focus to internal thoughts, feelings, or scenarios. While generally harmless, excessive daydreaming can become problematic, particularly when it interferes with daily activities. 

Depersonalization 

Depersonalization involves a sense of detachment from oneself, where individuals might feel like observers of their own thoughts or body, leading to significant disruptions in their daily lives. It’s as if they are watching a movie of themselves. This can be quite unsettling, leading to a significant disruption in daily functioning. People experiencing depersonalization might report feeling robotic, unable to control their speech or movements, and might have a hard time connecting their emotions to themselves. 

Derealization 

Derealization is the sensation of the world around you feeling unreal or distant. It’s a strange feeling where the environment seems foggy, lifeless, colorless, or artificially cartoon-like. This detachment from the environment can make familiar places seem alien or bizarre. The world might appear visually distorted, such as objects appearing smaller or larger than they are, or distances seeming incorrect. 

Amnesia 

Dissociative amnesia is characterized by gaps in memory. This isn’t the normal forgetfulness of where you left your keys; these gaps often involve significant parts of one’s life, traumatic events, or specific personal information. This type of amnesia can range from forgetting certain periods, events, people, and personal information to having complete loss of memory about one’s past life. 

Identity Confusion 

Identity confusion in dissociation involves a blurred or conflicted sense of self. Individuals might struggle with understanding who they are, their likes and dislikes, their values, and their place in the world. This can lead to significant inner turmoil, confusion, and distress, as they feel uncertain about their identity or have difficulty maintaining a stable sense of who they are. 

Identity Alteration 

This form of dissociation is where an individual may display multiple distinct identities or personalities, each with their own names, histories, and characteristics – known as Dissociative Identity Disorder (DID), formerly called multiple personality disorder. This is more than just behaving differently in different situations; it’s a profound divergence in one’s sense of self, and the alternate identities may have their own age, sex, or race. Each identity may have its own postures, gestures, and way of talking. 

Cognitive Behavioral Therapy (CBT) for Dissociation 

CBT is an effective treatment for dissociation, focusing on identifying and changing negative thought patterns and behaviors. Hofmann, Asmundson, and Beck (2013) highlight that CBT works on the principle that thoughts, feelings, and behaviors are interconnected, and modifying one aspect can lead to changes in others. 

How CBT Helps 

  • Identifying Triggers: Recognizing situations or thoughts that trigger dissociative episodes. 
  • Challenging Negative Thoughts: Techniques to counter irrational thoughts contributing to dissociation. 
  • Developing Coping Strategies: Equipping individuals with skills to manage symptoms of dissociation. 

Dialectical Behavioral Therapy (DBT) and Dissociation 

DBT, as outlined by Chapman (2016), combines cognitive-behavioral techniques with mindfulness practices and is particularly effective for those experiencing intense emotions. 

DBT Techniques 

  • Mindfulness: Focusing on the present moment in a non-judgmental manner. 
  • Distress Tolerance: Strategies to tolerate and cope with painful situations. 
  • Emotion Regulation: Techniques to manage and modify intense emotions. 
  • Interpersonal Effectiveness: Skills to assert needs and maintain healthy relationships. 

The Role of Mindfulness in Managing Dissociation 

Mindfulness, as described by Kabat-Zinn (1994), involves maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment. 

Benefits of Mindfulness 

  • Increased Awareness: Recognizing early signs of dissociative symptoms. 
  • Reduction in Stress: Reducing stress that can trigger dissociation. 
  • Improving Emotional Regulation: Managing emotions to minimize dissociative episodes. 

Practical Tips and Exercises 

  • Grounding Techniques: These are quick ways to connect with the present moment. For example, name five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste. 
  • Body Awareness Techniques: Learning to notice and stay connected with bodily sensations. This involves paying attention to physical experiences, such as tension or relaxation in different parts of the body. It helps in recognizing and responding to the body’s signals, which can be a grounding method to stay present and reduce dissociative episodes. Practicing body awareness can include techniques such as progressive muscle relaxation, mindful stretching, or simply observing the sensations of breath moving in and out of the body. This approach fosters a deeper connection between mind and body, enhancing overall mindfulness and presence. 
  • Journaling: Writing about your thoughts and feelings can provide insight into patterns of dissociation. 
  • Mindful Breathing: Focusing on breath to anchor oneself in the present. 
  • CBT Thought Records: Keeping track of triggering events, your thoughts about them, and the outcomes can help identify patterns and change negative thinking.  

Conclusion 

Dealing with dissociation can indeed be a challenging journey, but it’s important to remember that it’s a manageable one with the right tools and support. Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and mindfulness are not just theoretical approaches; they offer practical, effective strategies for understanding and coping with the symptoms of dissociation. These therapies provide a pathway to better understand your thoughts, emotions, and behaviors, and learn how to navigate them in a healthier way. 

It’s crucial to remember that seeking help is a sign of strength, not weakness. At Love This Therapy, we understand the complexities of dissociation and are dedicated to providing the support and guidance you need. You can start your journey to recovery today by contacting us at 604-229-4887 or email us at info@lovethistherapy.com for a free 15-minute consultation. Our team is here to listen, support, and equip you with the right skills to help you stay grounded in the present. We believe in a compassionate, personalized approach to therapy, where your well-being is our utmost priority. 

References 

  • American Psychiatric Association. (n.d.). What Is Dissociation? Retrieved from APA website 
  • Hofmann, S. G., Asmundson, G. J., & Beck, A. T. (2013). The science of cognitive therapy. Behavior Therapy, 44(2), 199-212. 
  • Chapman, A. L. (2016). The Dialectical Behavior Therapy Skills Workbook for Anger. New Harbinger Publications. 
  • Kabat-Zinn, J. (1994). Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. Hyperion. 

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