Initially written for a
Special Research & Technical Writing Project,
Spring Quarter, 2002,
Currently being revised for publication
Dissociation, a Normal Response
to Trauma
Stress from Life’s
Experiences Affects People
Nearly 400,000 New York residents took an emotional battering from the September 11, 2001, terrorist attacks to the World Trade Center twin towers. As a result of the attacks, more than a half million people have sought mental health treatment.[1]
The above New Yorkers were diagnosed with post-traumatic stress disorder (PTSD). This disorder uses a natural human ability called dissociation. In this paper we will address dissociation and how it comes into play in our everyday life, as well as in times of extreme stress.
When the word dissociation is brought up, most people think of the Three Faces of Eve movie. Contrary to Hollywood’s portrayals, dissociation is a normal human capability used by everyone. Most of us understand association—where there is a connecting or joining together of things. Dissociation is when what should be together is separated. For example, association is when a person’s sight, sounds, smells, feelings, thoughts, meaning, memory, actions, and sense of identity are together. Dissociation happens when one or more of these elements are missing.[2]
Dissociation helps us cope with a wide range of situations—from the common and ordinary to traumatic events.
Everyone in one way or another uses dissociation. The following are illustrations of common dissociation:
· Losing touch with awareness of one’s immediate surroundings, such as
- a student daydreaming in a boring lecture
- a reader reading a book aloud and coming to awareness that he/she just blanked out the last two pages
- a driver driving some distance and suddenly realizing that he/she is not aware of the last few blocks just passed (called highway hypnosis)
- a reader getting lost in a good book
- a person watching a movie in a trance-like state, only to be jarred out by someone nearby getting up or touching him/her
· Dividing consciousness to more than one activity, such as
- a person talking on the phone, scanning the newspaper, and stirring the soup at the same time
· Diverting attention from a task at hand, as in
- an athlete focusing attention on the goal, rather than on enduring the race
· Diverting attention away from pain, like when
- a carpenter putting out of his/her mind a painful arthritic wrist, so that he/she can do their job well
- a soldier continuing on in the heat of battle not aware of a bullet wound
· Hiding emotions inside from self and from others, when confronted with something threatening, such as
- a law enforcement officer dropping his/her feelings during a stressful encounter
- a medical professional working mechanically on a heart patient in an emergency room setting
Dealing with Emergencies
Besides the common usage’s, dissociation also helps us get through emergency situations.
Here is an illustration about a driver experiencing a bad skid on an icy street. As the car skids, colors seem brighter and time passes slowly. The driver is totally engulfed in silence even though the radio is on. He/she is aware only of what is visually happening¾experiencing no thoughts or feelings. Afterwards the emotions hit—with heart pounding and legs shaking¾but the driver no longer can recall the visual memory.[3]
Another example would be a survivor from a car accident that calmly calls the ambulance, administers first aid, and possibly reroutes the traffic. Once the ambulance arrives, the feelings hit, and the survivor cries hysterically.
In the above two illustrations the survivors’ minds broke up an overwhelming experience into manageable pieces. As soon as it was safe to do so, the pieces were put back together. If the survivors had not put back together the pieces of the experience, he/she would suffer acute stress disorder or post-traumatic stress disorder symptoms[4]¾to be discussed next.
The uses of dissociation can be seen on a continuum.[5] Figure 1 illustrates this continuum. From left to right the usage of dissociation unfolds from our responding to everyday common experiences, to our reacting to emergency crises, to our handling of trauma-related survival situations.
Figure 1 Dissociation Continuum
|
Common Dissociation |
Acute Stress Disorder |
Post Traumatic Stress Disorder |
Dissociative Identify Disorder |
Structured Mind Control |
|
| |
| |
| |
| |
| |
We’ve already discussed common, ordinary dissociation. We will look next at dissociation when used in response to life threatening situations.
Dissociation becomes an important survival tool when trauma is involved. Trauma is the exposure to an inescapable, stressful event that threatens our life and overwhelms our ability to cope with the situation.[6] Traumatic events can be:
- Single events, like a motor vehicle accident, assault, rape, or witnessing a murder[7]
- Natural or accidental disasters, such as earthquakes, plane crashes, or violent weather[8]
- Repetitive abuse, like domestic violence, incest, political torture, war crimes, prolonged front-line combat, or ritual abuse[9]
·
Acute Stress
Disorder
Acute Stress Disorder usually happens with single traumatic events and/or the extreme stress caused by natural or accidental disasters. Most of the September 11, 2001, New Yorkers experienced this reaction. Symptoms are similar to those of post-traumatic stress disorder (PTSD) described below but last only one month or less.
A single event example is a victim rear-ended in his/her automobile. For a few weeks thereafter, the victim may fear stopping at an intersection. When another car approaches from behind, the victim will stiffen and brace his/her body, expecting impact.
Whether one’s dissociation becomes acute stress disorder or the more severe PTSD depends on how soon the individual gets help and verbalizes what happened to them.[10]
·
Post-Traumatic
Stress Disorder (PTSD)
You may have heard of “shell shock” experienced by our war veterans. It is a form of post-traumatic stress disorder (PTSD).
Our normal, adaptive response to trauma is to fight a threat or flee it. If we succeed in fighting or fleeing, the stresses to our mind and body will lessen, allowing us to return to a normal level of function. However, PTSD develops when
- no fight or flight is possible
- the threat persists for a long time
- the victim[11] is left with nothing else to do but freeze in his/her response[12]
Trauma events most associated with PTSD[13] are:
- events threatening to life or bodily integrity, such as
§ military combat, sexual, and/or physical assault
§ hostage or imprisonment, and/or torture
§ natural and man-made disasters and/or accidents
- witnessing threatening or deadly events, such as acts of terrorism
- inappropriate sexual treatment of children—even without the child being threatened or actual physical injury occurring
Reactions from traumatic events can be disturbing to the victim. But they are normal reactions to an abnormal event[14]¾to be expected. There are three main groups of PTSD reactions:
- Intrusions, where the traumatic event is re-experienced in a flashback or in a nightmare, as if the original event is still happening.
A flashback is a memory brought into consciousness—just as it happened—even though the current experience had nothing to do with the past trauma.[15] For example, a backfiring car may bring up the memory in a veteran soldier of him/her witnessing his/her war buddies loses their life in gunfire.
Like a puzzle, flashback memories also show up in pieces of what happened. These can come either as smell, taste, sound, picture, emotion, or all these together.[16] A flashback can last a moment or linger for weeks.
The reaction to reminders is called triggering. Cues and signals are the reminders that trigger the memory. With the soldier, for example, the backfiring car was a cue to trigger the memory of the gunfire, causing the veteran to run and hide.
If the victim does not know what a flashback is¾why he/she is having such an experience, it can be terrifying. At the same time, a flashback is a sign a victim is ready to deal with the event previously he/she was unable to cope with.[17]
- Avoidance, in which a victim tries to reduce making contact with similar people or events that might trigger the uncomfortable flashback memory or a nightmare.
- Heightened alertness, such as being on edge—alarmed, expecting something dangerous, but not sure what or why. This can include bodily responses like a faster heartbeat, cold sweating, rapid breathing, and/or jumpiness. These responses can disturb sleep and affect one’s appetite and sexual health, plus cause difficulties in concentrating.[18]
Flashes are like pieces of a puzzle. Over time, parts of what happened come together to fill in the picture. Take a woman raped by group of men of the same ethnic group. Let’s call this the X group. Men that looked like the perpetrators, but were not part of the original group triggered the following flashes. Piecing together these flashes helped the victim accept and start to come to grips with the traumatic event of the group rape:
- While at a nursery, a man of the X group standing up in a truck stooped down to hand the victim a plant. Flash: next thing victim is lying on the ground, nude, and surrounded by a group of men looking at her like she is part of their dinner.
- While working in a store, a couple of men from the X group asked for a special item. When the victim starts to hand it to them, (flash) she sees bright lights and is blinded, like when someone is taking snapshots.
- Driving home from work, the victim stops at a streetlight. A couple of men from the X group walked across the street in front of her car and looked at her. Flash: next thing she is seeing a fat penis coming down towards her, and she hears men laughing around her.
The victim’s mind would not have been able to handle all the above pieces of memory at once—nude/exposed, pictures taken (probably used for pornography), and the rude/course laughing.
But our wonderful minds know how much a human being can take. As a victim grows stronger, parts of the event are recalled into consciousness. Even through these pieces (flashbacks) intrude on a victim’s normal life, the person who deals with the memory is headed towards recovery. Eventually the victim will become a survivor and will be free.
Other Areas of Life Affected
A victim of a gang rape, for example, also can react to seemingly everyday events that trigger pieces of the puzzle:
- When a couple is not discreet with their affections in public, this behavior can trespass on others’ personal boundaries. But to someone who has been molested or raped, reaction will be more severe. The view can evoke flashbacks—feelings of disgust, filth, and a desire to quickly leave the area.
- A natural thing like the monthly menstrual periods can be a reminder. The sight of blood will bring terror—even with the victim not aware of her past trauma.
- For a victim that was drugged before being raped, he/she may experience anxiety when served a drink or food by another. Other than buffets, restaurants are places avoided.
- Group settings, especially with everyone sitting or standing in a circle, can bring considerable discomfort—without the victim knowing why.
How dissociation happens in our brain
There are two kinds of memory: normal and trauma.[19]
- Normal memory is where normal events are stored in the front part of the brain¾and are recalled in story format. Over time the memory changes to fit into our story telling. Thus, normal memory is not pure memory.
Near our forehead is the part of the brain is called the frontal lobes. These handle conscious functions, like language, speech, and normal memory.
- Trauma memory is stored in the back part of the brain that handles emotions and sensations, as well as our hearing, sight, and smell. Trauma memory is not part of ordinary consciousness. Nor can it be called up at will or be changed over time. Trauma memory is a raw, pure-form of memory.[20]
Whether an ordinary or traumatic experience becomes normal or trauma memory depends on a “safety value” built into our human brain. Within the center of our brain is an area that regulates survival behaviors—such as eating, sexual reproduction, and the instinctive defenses of fight or flight. This area also handles emotional expression and memory processing.
Called the Limbic System, this central area includes the hippocampus and amygdala. These two parts determine where our memories are stored—either in the frontal lobes or in the back part of the brain. Please refer to Figure 2 to see this area of the brain.
Figure 2 The Human Brain