sight or words, and may no longer be available to conscious language-based or explicit memory recall. This dissociative process can serve as a self-protective mechanism. The content of the event or the affect connected with it can be dissociated. Therefore, someone may have memory of the event, but the feeling states accompanying it have been split off. The individual can narrate the sequence of events dispassionately, as if it happened to someone else. The most traumatic emotional aspects of the event are not integrated into the individual’s personal narrative. With these emotions split off, dissociated feeling states may then become expressed through intrusive recollections, nightmares, and flashbacks. Alternately, the actual event itself may have been dissociated, leaving just the feeling states, with no conscious content connected to them. In this case, there is no narrative story line to accompany what feel like disembodied emotional states that seem to come out of nowhere. For all practical purposes, the events have been forgotten; that is, they have been occluded from conscious available recall. When either of these two types of separations of event from affect occurs, it is as if the “words and the music don’t match” or they are not synchronized with one another. The following exercise will help to illustrate dissociation. The Dissociative Continuum There is a continuum to the process of dissociation, with one end of the spectrum being normative, or non-trauma- related dissociation. The other extreme of the spectrum is complete fragmentation of the self into nonconnected parts, which then qualify for the diagnosis of dissociative identity disorder, formerly referred to as multiple personality disorder or multiplicity. Normative Dissociation Normative dissociation is not trauma based; it is a phenomenon that everyone experiences occasionally. An example of normative dissociation is highway hypnosis, when someone operating a motor vehicle on a familiar roadway momentarily does not recognize or remember where they are, or the time spent traveling. This type of dissociation can also occur when someone “spaces out” and misses the exit on the highway, particularly on a frequently traveled route. The driver unconsciously feels free not to concentrate too intensely on the directions and trusts the “automatic pilot” to them there. This type of dissociation can also be experienced in a classroom situation, when a student suddenly becomes aware of having missed 10 minutes of a professor’s lecture. Dissociation exists along a continuum, the stages of which will be described below (Schiller, 2008). Temporary Separation of Thoughts and Feelings Temporary separation of thoughts and feelings can occur following an emotionally intense event (either positive or negative) that a person is able to put temporarily out of their mind in order to get through daily tasks or job responsibilities. The event will often flood back when the person’s guard is down or as they begin to relax. For example, consider someone who has experienced a death in the family and returns to work after taking time off for a period of grieving. The grief process is certainly not complete after a week or two, yet the individual is able to put it out of their mind all day in order to perform the job, often to have it flood back during the drive home or when sitting at home later that day. This phenomenon can also occur with positive or happy events that an individual needs to put aside in order to be effective throughout the day; for example, the therapist who just got engaged and wants to talk about it with everyone, yet is able to hold good boundaries with clients and not think about the feeling state
For the purpose of this exercise, think about an upsetting experience. Do not choose one that is too upsetting; it should rank no more than a 5 on a scale of 0 to 10, with 0 being feeling no distress at all and 10 being the worst distress possible. This is called the Subjective Units of Distress, or SUD, scale (Wolpe, 1969). Useful examples might be test anxiety, stage fright, or a distressing meeting with a boss; however, the experience should be nothing too extreme or personal. Then take a piece of paper, fold it in half, and write the incident on one half of the paper. On the other half, write down the emotions that were felt when it occurred or those felt when thinking about it now. Also write down where in the body these feelings are experienced (e.g., “anxiety in my stomach” or “sadness as a lump in my throat”). Next, tear the paper in half, rip up, and throw out the half that had the incident written out on it. What is left is the half of the paper that has the feelings and body sensations written on it. This remaining half page is equivalent to what remains for the survivor of trauma who has dissociated the traumatic event: The somatosensory memories. The feelings and sensations that accompanied the event remain, without conscious memory of the event itself. for hours at a time. The individual may have consciously decided to put the feeling aside for a while, or it may be something they are able to do without a conscious effort. An Event Is Remembered without Congruent Expected Feelings This level of dissociative phenomena begins to get into the realm of trauma response. It represents the numbing that can occur following a traumatic event and is functional in the immediate aftermath, during the shock period. However, if the trauma is not processed along with the concurrent expected feelings, such as fear, anxiety, anger, shame, pain, sadness, or disgust, these feelings become walled off and are no longer available for access. The therapist will then see a client who has the “words without the music” and who will recount an event as if it happened to someone else. Depersonalization Depersonalization is another form of numbing in which survivors feel that they do not inhabit their own bodies. It can be a sense of looking into a mirror and seeing a stranger who the individual recognizes as themselves, with whom they cannot connect. It can include a sense of unreality or, as several survivors have described it, the feeling of looking out at the world from the end of a long tunnel or through a telescope, rather than being a part of it. A Lack of Memory of the Event, with Just Feelings Remaining A lack of memory of an event, with just feelings remaining, is the classic form of dissociation, in which the memory of the event has been walled off and the subsequent intrusive thoughts, nightmares, panic, and other disconnected thoughts, feelings, and somatic states seem to come out of nowhere, without connection to an explainable reason. Some panic disorders and seemingly free-floating anxiety have their source here. Case Example During a therapy session, Joelle reported waking up during the night with the sensation that someone was in her room and touching her genitals. She reported screaming, bolting upright, and turning on her bedside lamp to find that no one was there. This series of events began happening every few nights, until Joelle developed a terror of going to sleep for fear that she would experience the same unnerving
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Book Code: PYCA2725
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