What is dissociation?

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From the Guidelines

Dissociation is a state of impaired awareness, often characterized by a disconnection from one's thoughts, feelings, or surroundings.

Key Characteristics of Dissociation

  • It can manifest as dissociative (non-epileptic) seizures, which resemble epilepsy or syncope but are not associated with abnormal electroencephalography changes 1
  • Dissociation can be a symptom of complex post-traumatic stress disorder (cPTSD), which is characterized by self-regulation problems, including emotion regulation difficulties, disturbances in relational capacities, and alterations in attention and consciousness 1
  • Cognitive motor dissociation, seen in some patients with severe acute brain injuries, has prognostic implications for consciousness recovery and functional outcome 1

Treatment and Management

  • Psychological therapy, delivered by specially trained clinicians, is the main evidence-based treatment for dissociative seizures 1
  • A phase-based approach, starting with a stabilization phase, is recommended for treating cPTSD, which includes dissociation as a symptom 1
  • Sensory grounding techniques, such as noticing details in the environment, cognitive distractions, and sensory-based distractors, can help prevent dissociation 1

Important Considerations

  • Dissociation can be triggered by various factors, and identifying warning signs can help individuals and clinicians develop strategies to prevent or manage episodes 1
  • A comprehensive treatment plan, including psychotherapy and stabilization techniques, can help individuals with dissociation symptoms manage their condition and improve their quality of life 1

From the Research

Definition of Dissociation

  • Dissociation is a mental mechanism that plays a significant role in people's adaptational efforts 2
  • It is defined as a deficit in the capacity of integration of two or more different "systems of ideas and functions that constitute personality" 3
  • Dissociation is a process in which behavior, thoughts, and emotions can become separated from one another 3

Types of Dissociation

  • There are different types of dissociation, including detachment and compartmentalization, which have different definitions, mechanisms, and treatment implications 4, 5
  • Detachment and compartmentalization are two qualitatively distinct forms of dissociation, with different psychological mechanisms and clinical implications 4, 5

Mechanisms of Dissociation

  • Dissociation is the underlying mechanism in a number of defense mechanisms, including repression, intellectualization, and splitting 2
  • The mechanisms involved in dissociation are still not fully understood, but research on hypnosis and post-traumatic stress disorder has provided some insights 3
  • Different types of dissociation have different psychological mechanisms, and understanding these mechanisms is important for treatment and clinical practice 4, 5

Controversies and Debates

  • There are controversies and debates in the field of dissociation, with different researchers and theorists having different understandings of the concept 3, 6
  • Some researchers argue that the concept of dissociation has been overly broadened, while others argue that it has been too narrowly defined 6
  • A precise definition of dissociation is needed to clarify the concept and its relationship to other psychological phenomena 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The concept of dissociation.

The Journal of the American Academy of Psychoanalysis, 1990

Research

Contemporary concepts of dissociation.

Psychiatria Danubina, 2012

Research

Different types of "dissociation" have different psychological mechanisms.

Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD), 2006

Research

Dissociation in trauma: a new definition and comparison with previous formulations.

Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD), 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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