Are You Or A Loved One Dissociating And You Don’t Realize It

Lissa Rankin, MD
11 min readMay 15, 2023

I’m preparing to teach a class called Becoming Unfuckwithable: Finding Your Sacred “No” So Your Yes Is A “Hell Yeah,” and as part of creating curriculum for that class, I’ve been pondering what makes people “fuckwithable” in the first place.

Part of what I’ve observed as I’ve worked with patients and clients over the years, especially the ones with chronic illnesses who struggle with codependent, people-pleasing, boundary wounded parts that struggle to stand up for themselves, say no, and protect themselves adequately, is that Complex-PTSD and the frequent dissociation that tends to go along with it is a risk factor for getting frequently f’ed with. And it’s dose dependent. The more severe the dissociation, the greater the risk.

Why? Because when you’re checked out, you’re not self-protective, you’re not present, your critical thinking is not online, your discernment and judgment go out the window, you’re not in what IFS calls “Self,” and you’re not feeling protective emotions (like fear that helps you spot dangerous people or anger that fires up your boundary setting “Hell no!) You’re also in a very suggestible trance state when you’re dissociating, and you may even have memory loss, so you don’t remember exactly how someone might be love bombing you or grooming you or exploiting you or seducing you into doing things you would definitely not say yes to if you were not dissociating. This makes you very vulnerable, especially to narcissistic or sociopathic individuals who prey upon those who dissociate frequently and might even intentionally seek them out.

Several of my severely traumatized loved ones experience traumatic dissociation enough to qualify for a dissociative disorder, so I’ve been reading up about coercive control, narcissistic abuse, the long term impacts of child abuse, and dissociative disorders. I just finished reading psychiatrist Marlene Steinberg’s The Stranger In The Mirror and IFS therapist Joanne Twombly’s Trauma & Dissociation Informed Internal Family Systems. I was particularly impacted by the list from Dr. Steinberg’s book about common descriptions of various dissociative symptoms, on a spectrum from normal everyday dissociation (like daydreaming or spacing out) to severe dissociation (like amnesia or floating above your body.)

Do any of these sound familiar?

  • When I become engrossed in a good book, I lose all track of time.”
  • “I feel that somehow my body is not doing what my head wants it to be doing.”
  • “My mind wanders, and I go in and out. I just go away to myself. Nowhere, really, just not there.”
  • “I have trouble remembering what I said in a presentation after I’ve made it.”
  • “I was at home with my mother, and the whole thing was unreal. I knew she was my mother, but I just had a feeling that she wasn’t really my mother.”
  • “I’m like a filter, who I am on a particular day depends on what’s coming into me and what’s going out. I don’t feel connected internally all the time.”
  • “I’ll explode at my husband, and afterward I can’t remember what I said.”
  • “It’s not feeling real or feeling that I’m just doing things automatically.”
  • “I feel like a girl most of the time; other times I feel more like a guy.”
  • “It’s like watching a movie in my head. You know, like when you’re watching a movie and you get all absorbed in the movie. And you forget who you are, where you are, what time it is, what’s going on in your life.”
  • “I can become so totally concerned about what people are thinking of me or expecting from me when I’m talking to them that I become lost. I lose me.”
  • “I couldn’t remember whether it really happened or I imagined it.”
  • “It’s like being shell-shocked, you know that you’re doing something, but you feel that somebody else is doing it. You’re watching yourself from a distance. Doesn’t everyone have that feeling sometimes?”
  • “I don’t feel like myself; I feel like some other person inside me.”
  • “I didn’t let myself feel anything about my divorce until after I was divorced. The emotional side of me just shuts down under stress.”
  • “I’ve been in a shell, and I feel empty inside.”
  • “A very powerful wave of emotion comes over me, and I don’t feel in control of myself. I feel that this person is going to do what she wants and I’m over in a corner, helpless, waiting to see what happens.”
  • “I act differently with different people.”

What Is Dissociation?

Using psychiatric language, dissociation is defined by these core dissociative symptoms:

  • Amnesia: Forgetfulness, lost time, gaps in memory or memory loss, especially lost memories related to triggering experiences), blanking out, sometimes even forgetting what just happened
  • Depersonalization: The sense that you’re kind of floating above your life and watching yourself from a distance, a feeling of being detached from yourself, your body, your emotions, or observing yourself from some distance (which is commonly encouraged by some meditation teachers who encourage dissociation in their students). Feeling like an alien or robot, feeling detached from your own body and thoughts, the sense that you’re observing your life as an outsider
  • Derealization: A feeling of detachment from your environment or a sense that people or your environment is unreal or not as it seems, a distorted or blurred sense of reality, a sense that life is kind of dream-like and ungrounded
  • Identity confusion:Continuing, ongoing struggle and inner conflict about who you are, confusion about morality, sexual or gender identity, religious identity, etc. While identity confusion is normal during adolescence, it can be related to dissociation in adulthood (and also during adolescence)
  • Identity alteration: A significant personality change or shift in role or identity, accompanied by changes in behavior, voice, mannerisms, or using different names that happens without your control. This often happens when someone joins a cult or winds up under the sway of a coercively controlling narcissist.

While mild versions of all five core dissociative symptoms can happen to anyone, those with dissociative disorders experience these symptoms more frequently. (To figure out whether your symptoms are mild, moderate, or severe, you can take the quizzes in Stranger In The Mirror, which are adapted from the diagnostic SCID-D test Dr. Steinberg developed, which is used (though underused) by mainstream psychiatrists.)

The Range of Dissociative Symptoms

We’ve all heard of the extreme cases of dissociation- the Multiple Personality Disorders (now called Dissociative Identity Disorders) typified by movies like Sybil (https://en.wikipedia.org/wiki/Sybil_(1976_film) and The Three Faces of Eve (https://en.wikipedia.org/wiki/The_Three_Faces_of_Eve). Yet dissociation happens on a spectrum. Those who qualify for the DSM-V criteria of Dissociative Identify Disorder make up only a fraction of people who sometimes dissociate, but even then, Dr. Steinberg points out that because it’s so underdiagnosed, it’s probably more like 10% of the population qualify for a dissociative disorder.

At its most benign and basic, dissociation happens to all of us when our minds wander or when we drive somewhere on autopilot and arrive at our destination without really being aware how we got there. We even consciously choose to dissociate when we practice escapism and get absorbed into fiction novels, binge watch Netflix, use consciousness- altering substances like alcohol or marijuana, practice transcendent forms of meditation, or even sometimes when we wind up in flow states- when time/space awareness disappears and you’re fully absorbed in running, making art, or otherwise entering ecstatic realms that can feel really great.

Voluntary dissociation is different than involuntary dissociation, which is a trauma symptom and happens on autopilot, sometimes as a default setting. You might voluntarily dissociate by getting totally absorbed in 3D movie at the theater. But when you involuntarily dissociate, it’s like a switch flips and you disconnect and detach from your sensory experience, your thoughts, your sense of self, your body, your awareness of time, place, and identity, your sense that the world is real and you belong to it, and even your personal history and memories. Dissociation impacts your consciousness, identity, memory, emotions, self-awareness, awareness of your surroundings, and embodiment. You could say that its opposite is a kind of integrated wholeness alive with presence, awareness, sensation, embodiment, emotions, intact critical thinking, a strong sense of identity and a healthy weaving between aspects of your being, and a good strong reality check.

Anytime you’ve had an out of body experience- like a near death experience, a sense of floating above yourself (as might occur during a traumatic event), astral travel, mystical journeying to other realms, meditative experiences when you transcend or leave your body or lose time, or even a kind of waking dream state, it’s likely that you’re dissociating.

Dissociation May Have Been Your Best Helper

From a trauma-informed perspective, dissociation is a defense mechanism, or in Internal Family Systems (IFS) language, we’d call it a “protector part.” As such, it’s an intelligent strategy that may have helped you survive hard times- or even unbearable or deplorable times, such as childhood physical or sexual abuse or living through wartime or enduring torture. When your body isn’t a safe place to be or when your emotions are just too intense for your young nervous system to handle, it makes sense that your consciousness would leave your body and go someplace where it doesn’t hurt so much- or that parts of your identity would split off so you didn’t have to be present for the trauma.

As a child in an abusive situation, you might even become so masterful at dissociating that you prefer it or do it automatically and involuntarily- once you’re an adult. After all, when you’re dissociated, you don’t tend to feel your painful emotions, you can numb or leave your body so you feel less pain, you may not remember bad things that happened to you, and you may even gain access to ecstatic mystical realms that fill you with hormones like oxytocin, endorphins, dopamine, and serotonin, giving you a kind of blissed out (but spaced out) high.

In the entirety of my career as a trauma-informed physician, I’ve never in my life seen as many people actively dissociating as I’ve seen since Covid. This all makes sense when life is as hard as it is for so many folks right now. If this sounds familiar, you’re not alone. I’m in no way intending to pathologize or stigmatize anyone who dissociates often. But it might help you to understand that riding shotgun with dissociation are some behavioral and physical side effects which may impact your life. Some of these behaviors may be more readily noticed by other people than by the one dissociating, so pay attention to whether people have said such things about you or you’re noticing these behaviors in loved ones.

Dissociation is often a side effect of the dorsal vagal “freeze” response of the autonomic nervous system, when the body feigns death and lets you check out because something is hurting emotionally, physically, or spiritually. If you’re a gazelle on the run and about to get eaten by a cheetah, dropping the body in death-like state and dissociating the gazelle’s consciousness out of the body makes being eaten less painful and easier to exit, so it makes sense biologically. But when involuntary dissociation becomes chronic, as is common with people who, as children, did not get their needs for connection with the primary caregiver met in the first year of life, a certain predictable set of behaviors may be side effects of dissociation. (Learn more about what happens when an infant’s need for connection with the mother goes unmet here.

Signs That You Or A Loved One May Be Dissociating

  • Emotional or physical numbness, feeling blocked when you know you should be feeling something, like grieving a pet or lost loved one
  • Brain fog, feeling like you’re in a tunnel with the world fading out around you or finding it hard to concentrate
  • Not knowing what you really want, difficulty making decisions or expressing preferences
  • Not settling and enforcing clear boundaries because you’re not fully present, feeling your boundary-protecting feelings, or inhabiting your body)
  • People pleasing, accommodating, conflict avoidant behavior (inability to say no)- because bullies, pushy people, narcissistic entitlement, or confrontation make you dissociate
  • Tendency to behave in ways others might interpret as two-faced (because conflict avoidance makes you appease one person in one moment — and appease someone else in ways that feel like a betrayal moments later
  • Being chronically late (because you’re dissociated from awareness of time or you have amnesia around making an appointment)
  • Being perceived by others as lacking empathy or being emotionally out of touch (not co-regulating with others, lacking attunement to the emotions and needs of others, which Deb Dana calls “biological rudeness”)
  • Chronic illness, weakness, or chronic fatigue (because the dorsal vagal freeze state wears down the body’s self-healing mechanisms and is hard on the body, the tendency to move at a very slow pace, take frequent naps, sleep more than 8 hours/day, or even collapse into narcolepsy)
  • Getting lightheaded or even fainting when triggered
  • Sexual dysfunction (because you’re not connected to your body when you’re dissociating) or hypersexualization (because you’re not in your body and trying to feel it erotically)
  • Not being present or tuned in to what’s happening around you (because parts of you are checked out)
  • Aloofness and/or frequent daydreaming/ active fantasy life
  • Being spacey, floaty, or ungrounded (which may make people seem unreliable, immature or have difficulty “adulting”)
  • Tendency to “spiritually bypass” through frequent or lengthy meditations or yoga classes or seeking out blissful spiritual experiences that promote dissociation, such as hallucinogenic medicine journeying, meditation retreats, etc.)
  • Attracted to extreme sports (because you’re not in your body and trying to feel it by pushing it to the extreme)
  • Unusually high tolerance to physical pain
  • Short term memory loss or losing time in certain circumstances, such as not being able to remember certain things people said 5 minutes later, especially if there was conflict or someone was protesting a behavior they didn’t like or being critical
  • Long term memory loss of whole swaths of time, especially during trauma
  • Forgetfulness, which might be misunderstood as not caring or being insensitive, but is related to amnesia during dissociative episodes
  • Paranoid feelings and distrust of others, even when they’re generally trustworthy, often related to episodes of dissociative amnesia and paranoia about what happened during that lost time
  • Procrastination and difficulty with tedious tasks or things that require precise attention, like filling out forms (dissociation may be misdiagnosed as ADHD)
  • A tendency to lie or cover up deceptively (usually to save face, protect from humiliation, or cover up some hurtful behavior that may have happened while in a dissociated state)

All Trauma Deserves Our Compassion

Suffice it to say that the psyche and body are amazingly brilliant at helping us survive the unbearable and intolerable, but the nervous system can get stuck on a default setting that makes it very hard to function at maximal capacity. If you or someone you love dissociates frequently, be gentle. These folks are our canaries in the coal mines and their nervous systems are very sensitive to any little trigger. This can be hard, because dissociation also means these folks don’t always behave well, so they tend to trigger others with what seems like insensitive, careless, or disrespectful behavior.

It’s very hard for someone who dissociates frequently to engage in healthy relationships, function optimally at a job, or keep their body healthy at full capacity. And…it’s not their fault. It’s a trauma symptom, and all trauma deserves our compassion. This doesn’t mean we shouldn’t hold people accountable for abusive or hurtful behavior, but keep in mind that scolding someone who is dissociating is only likely to make them dissociate more.

While there’s no magic bullet or quick fix pill or treatment, and while it’s not easy to become unfuckwithable if you’re chronically dissociating, the good news is that dissociation is treatable with cutting edge trauma treatments and nervous system regulation. If you or your loved ones are suffering from dissociative symptoms, I’m sorry it’s so hard. I know this past few years have been particularly hard for our most sensitive souled trauma survivors. My heart goes out to you all.

We certainly won’t be able to heal all the parts that underlie dissociative tendencies in an online program, and it’s absolutely not a replacement for one on on therapy. But for those with milder symptoms who have a tendency to get taken advantage of, we will be offering at least the psychoeducation and boundary-setting toolkit to support people who need help standing up for themselves in Becoming Unfuckwithable. You can register here.

--

--

Lissa Rankin, MD

Lissa Rankin, MD, New York Times bestselling author of Mind Over Medicine, The Fear Cure, and The Anatomy of a Calling.