Understanding Dissociation: Why It Happens and How Therapy Helps

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:

• Parts of the self holding traumatic memories may separate
• Other parts may disconnect to handle daily life
• Severe separation can create memory gaps or lack of awareness between different parts of the self
  
  

This degree of internal division is what distinguishes everyday dissociation from DID and other complex dissociative disorders (van der Hart, Nijenhuis, & Steele, 2006).

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:

• Memory gaps or “lost time”
• Difficulty focusing or completing tasks at work or school
• Struggles maintaining relationships
• Feeling “out of your body” or disconnected from your emotions
• A sense of watching life from the outside rather than participating in it
  
  

Living with chronic dissociation can feel confusing, frightening, or isolating, especially if you don’t yet have the words to describe what’s happening.


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:

• “I don’t feel real.”
• “It’s like I’m watching myself in a movie.”
  
  

Your body may feel numb, far away, or unfamiliar. Some people describe feeling robotic or disconnected from their emotions.

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:

• Missing parts of conversations
• Not remembering how you got somewhere
• Losing minutes, hours, or occasionally longer periods
  
  

This is especially common in individuals who experience complex dissociation or DID.

4. Identity Confusion or Shifts: Different “parts” of you take over

You may experience:

• Sudden changes in mood, preferences, or behavior
• Feeling unsure who you really are
• Not recognizing your own handwriting, belongings, or decisions
  
  

In individuals with DID, these shifts may involve distinct identity states with their own perspectives, memories, or ways of interacting.

5. Emotional Numbing or Disconnection

For many, emotions feel:

• Muted
• Distant
• Trapped behind glass or a wall
• Hard to access at all
  
  

This can make relationships or daily tasks feel overwhelming or meaningless.


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:

• Learning grounding and emotion-regulation skills
• Strengthening daily routines and relationships
• Improving communication and cooperation between different parts of the self
• Reducing crises, self-harm urges, or overwhelming symptoms
  
  

Phase 1 can take time, but it lays the foundation for deeper healing.

Phase 2: Trauma Processing

Once you have enough stability, therapy may gently explore and process traumatic memories. This often involves:

• Making sense of past experiences
• Grieving what was lost
• Reducing the emotional charge of traumatic memories
• Techniques like EMDR therapy, somatic therapy, narrative processing, or parts-oriented therapies
  
  

The goal is not to relive trauma, but to integrate traumatic memories safely.

Phase 3: Integration & Reconnection

This phase supports building a meaningful life beyond trauma. It may include:

• Strengthening identity and sense of self
• Reconnecting with loved ones or community
• Developing new goals and life roles
• Increasing cooperation among parts and decreasing conflict
  
  

Healing doesn’t always mean becoming a single unified identity (as integration is not a goal for all individuals/ systems), it often means creating harmony, connection, and internal safety.


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.