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By: Megan Samuels, MSW, LCSW-C, Trauma and Eating Disorder Therapist  Have you ever felt disconnected from yourself or your surroundings? That experience is called dissociation, a mental process where you feel detached from your thoughts, your body, or even the world around you. Many people experience mild dissociation from time to time, like zoning out while driving or daydreaming during a stressful moment. For others, however, dissociation can become intense, persistent, and disruptive. In its most severe forms, dissociation appears in dissociative disorders, including Dissociative Identity Disorder (DID), where different parts of the self become separated in daily functioning. Why Dissociation Happens Dissociation often begins as a natural coping mechanism. During overwhelming stress or trauma, the mind creates distance from what’s happening to protect you. In moments where escape isn’t possible, dissociation acts like a psychological “shield,” allowing the person to mentally step away from the experience. Over time, especially in chronic or early childhood trauma, this protective mechanism can become ingrained. For some people:
Research indicates that approximately 4.1% of Americans experience complex dissociation or a dissociative disorder at some point in their lives (Simeon & Putnam, 2022). Many experts suspect the actual number is higher because dissociation is frequently misunderstood, underreported, or misdiagnosed as anxiety, depression, ADHD, or even psychosis. Even long after trauma has ended, people may continue to dissociate. This can lead to:
Common Symptoms of Dissociation Dissociation shows up differently for everyone, but these are some of the most common experiences: 1. Depersonalization: Feeling detached from yourself You might notice thoughts like:
2. Derealization: The world feels strange or unreal Your surroundings might seem dreamlike, foggy, muted, or distorted. Sounds may become muffled or overly sharp. Rooms might look skewed or like they’re behind a veil. 3. Amnesia or Time Gaps: Forgetting events or losing track of time This can include:
4. Identity Confusion or Shifts: Different “parts” of you take over You may experience:
5. Emotional Numbing or Disconnection For many, emotions feel:
How Therapy Can Help The good news is that dissociation, especially when trauma-related, is treatable. Many people improve significantly with the right support. The most widely used approach for complex dissociation is the three-phase trauma treatment model (Herman, 1997; ISSTD, 2011): Phase 1: Safety & Stabilization This phase focuses on building internal and external stability. Key goals include:
Phase 2: Trauma Processing Once you have enough stability, therapy may gently explore and process traumatic memories. This often involves:
Phase 3: Integration & Reconnection This phase supports building a meaningful life beyond trauma. It may include:
Bottom Line Dissociation is a natural protective response, your mind’s way of surviving what once felt unbearable. But when dissociation becomes chronic, intense, or disruptive, it can interfere with work, relationships, self-understanding, and daily functioning. Recognizing the signs and seeking trauma therapy can help restore connection, stability, and emotional well-being. You are not “broken," you adapted. With the right support, you can also heal. Schedule a FREE 15-minute consultation to explore how you can find freedom from trauma and dissociation. 🌟 Available in MD & VA for trauma therapy 🌟 Available in MD, VA, DC, PA, FL, and CA for eating disorder therapy 🌍 Offering recovery coaching worldwide The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping children, teens, and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington, D.C. We also provide eating disorder therapy in Arlington, Virginia and virtually throughout Virginia. Additionally, we offer eating disorder therapy virtually in Florida, Pennsylvania, and California. We provide eating disorder and EMDR trauma therapy in Rockville, Maryland and virtually throughout Maryland and Virginia. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com
References: Herman, J. L. (1997). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror (Rev. ed.). Basic Books. International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12, 115–187. Simeon, D., & Putnam, F. W. (2022). Pathological dissociation in the National Comorbidity Survey Replication (NCS-R): Prevalence, morbidity, comorbidity, and childhood maltreatment. Journal of Trauma & Dissociation, 23(5), 577–597. https://doi.org/10.1080/15299732.2022.2082331 van der Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006). The haunted self: Structural dissociation and the treatment of chronic traumatization. W. W. Norton & Company.
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Written by: Guest Writer Allyson Inez Ford, LPCC, Founder of ED & OCD Therapy  What is Neurodiversity, really? Neurodiversity has become somewhat of a buzzword recently, but what is it exactly, and what does it mean to be neurodiversity affirming? When you hear the word neurodiversity, you might think of fidgets or noise cancelling headphones. While you're not wrong to think of these things, neurodiversity is also so much more. At its core, neurodiversity refers to the natural variation in human brains and nervous systems. Just as biodiversity recognizes that ecosystems thrive through difference, neurodiversity recognizes that there is no single “right” way for a brain to work and differences in attention, sensory processing, communication, learning, emotional regulation, cognition, and more, are all part of normal human diversity, not inherently signs of disorder or something negative. What Is Included Under the Neurodiversity Umbrella? Neurodiversity is an umbrella term that includes many forms of cognitive and neurological difference. ADHD and Autism are commonly thought of when someone hears the word neurodivergence, however, many scholars and activists consider all forms of mental health diagnosis to be forms of neurodiversity.. These may include but are not limited to:
Whether or not someone identifies their mental health diagnosis as neurodivergence varies and depends on the person. It’s important we don’t name someone’s experience for them, though we can offer language and introduction to a neurodiversity affirming lens and see if it fits for them. Importantly, neurodiversity is rooted in self-identification and disability justice. For the purposes of this blog post, I will share examples of how eating disorders intersect with autism and ADHD, since these are the neurotypes people will often self identify with in eating disorder treatment. Being Affirming of Neurodiversity Being neurodiversity-affirming goes beyond offering fidgets in your waiting room or dimming the lights. Being truly neurodiversity affirming rejects the assumption that neurotypical functioning is the gold standard. It asks us to examine how systems like ableism and sanism create distress for neurodivergent people- and how that distress is often mislabeled as individual pathology. In mental health and eating disorder care, this distinction matters deeply. When neurodivergent traits are misunderstood or pathologized, support can quickly turn into harm. A neurodiversity-affirming approach shifts the focus from “fixing” the person to accommodating the unique needs and abilities of the person. Neurodiversity and Eating Disorders Neurodivergent folks experience high rates of eating disorders, yet most eating disorder treatment models were not designed with neurodivergent needs and experiences in mind. This is reflective of the broader mental health system, and a society that privileges neurotypical (“normal”) brains and pathologizes anything outside of what is deemed “normal.” Interestingly, what is considered normal is entirely socially constructed, which is why I am putting it in parenthesis. Traditional approaches to eating disorder treatment often prioritize behavioral compliance and symptom reduction without exploring whether the function of the eating disorder behavior is related to sensory differences, executive functioning challenges, masking for social safety, or other neurodivergent ways of relating to food and the body. At best, standard treatment simply won’t be as effective for neurodivergent clients, but at worst, it can actively harm neurodivergent clients. Neurodiversity-affirming eating disorder care offers a path to healing that rejects the myth of normality and seeks to understand and support neurodivergent experiences of food and the body-. rather than attempting to “fix” neurodivergent traits. This approach centers accommodation, acceptance, and body-mind liberation. Huge shoutout to Naureen Hunani, RD who created the neurodiversity affirming model and brought it to the eating disorder treatment world! Neurodiversity Paradigm vs. the Pathology Paradigm in Eating Disorder Treatment The Pathology Paradigm The pathology paradigm dominates much of Western mental health care, including eating disorder treatment. Within this model:
In eating disorder care, this can show up as rigid meal plans, forced exposure to foods that may cause sensory distress (or even trauma), assumptions that food avoidance is always ‘the eating disorder talking’ or assumptions that clients access hunger and fullness cues in neurotypical ways and thus, leaving neurodivergent clients with interoceptive challenges to feel as if something is wrong with them. The Neurodiversity-Affirming ParadigmThe neurodiversity movement, rooted in disability justice and autistic self-advocacy, understands neurological differences as a natural and valuable part of human diversity, the same way race and body size are a natural form of human diversity that should be celebrated. From a neurodiversity-affirming lens:
In eating disorder treatment, this paradigm shifts the clinical question from “How do we eliminate this behavior?” to “What purpose does this behavior serve, and how can we support adequate nourishment without harming the person or adding to the ableism they already experience?” Eating Disorders and Autism: Common Characteristics and Affirming Care Autistic folks are significantly overrepresented in eating disorder populations, particularly in restrictive eating and ARFID-like presentations. Autistic Traits That Often Get Labeled as Eating Disorder Behaviors
Neurodiversity-Affirming Support Pathologizing approaches may label these patterns as resistance or avoidance. Neurodiversity-affirming eating disorder care instead:
Affirming care does not force autistic clients to abandon coping strategies that help them function. Eating Disorders and ADHD: Understanding Executive Functioning Differences People with ADHD are also at elevated risk for eating disorders, differences in stimulation needs, executive functioning and dopamine regulation all play a role here. Common Eating Challenges for ADHD Folks
Neurodiversity-Affirming Support Rather than emphasizing willpower or insisting the client is making up excuses, affirming care looks like:
For many ADHD clients, eating struggles reflect the need for support around executive functioning and stimulation needs, not further blame for being “difficult.” Key Takeaways and Final Thoughts Across neurotypes, neurodiversity-affirming eating disorder treatment often includes:
This approach does not ignore medical risk and is not about colluding with the eating disorder. It simply refuses to frame neurodivergent bodies and minds as inherently disordered. You can accommodate neurodiversity and work to get nutritional needs met! This work might look different than someone who is not neurodivergent, but with an affirming approach, it is entirely possible to have a more peaceful relationship to food and your body. Allyson Inez Ford, LPCC is the founder of Eating Disorder and OCD Therapy, a group therapy practice specializing in neurodiversity-affirming and anti-oppressive care for eating disorders, OCD and body image concerns. The clinicians at ED and OCD Therapy work with clients who have often felt misunderstood, pathologized, or harmed by traditional treatment models. Our approach to eating disorder treatment centers:
ED and OCD Therapy provides virtual therapy for clients located in California, Washington State, Utah, Florida, Maryland, and Tennessee, as well as in person therapy in San Diego, CA.. Reach out to schedule a free consultation call or email us directly at [email protected]  Looking for a MD, VA, DC or PA based therapist?-meet our team. |
The Eating Disorder CenterWe are a premier outpatient eating disorder therapy center in Rockville, Maryland.
We also provide eating disorder recovery coaching to people worldwide via Zoom. Click here to book your free 15 minute phone consultation! Phone: 301-246-6856 Email: [email protected] Archives
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