“How do I know if my client is zoning out or dissociating? They are so different, but can look similar . . . right?”
Dissociation is the clinical term for a lack of association or connection between things that are usually associated or connected. When I prick my finger, my face winces and my voice utters, “Ow!” If there is no change in facial expression and no vocal utterance, the experience is dissociated. The action and reaction don’t go together. Sometimes, the reaction is excessive for the action. This is known as a trigger.
Not all dissociation is pathological. If you walk into a room talking and your spouse doesn’t hear you as he is absorbed in the “big game” on the television, this is a type of dissociation called absorption. It may be annoying, but is not pathological. However, if one becomes so absorbed with inner experience that they find it difficult to function in daily life, this can be a form of pathological dissociation and a focus of clinical attention.
Unresolved traumatic experiences have a component of dissociation attached to them. This can be observed in the form of avoidance of related stimuli, amnesia to some or all the experience, or a surreal sense that this happened to someone else. When a disturbing memory is called to mind, one can be flooded with the emotions and body sensations experienced at the time of the event. Often, the part of the person holding the intensity of these memories, is “stuck in time.” Successful resolution of traumatic memories entails an emotional and somatic differentiation between the “there and then” vs. the “here and now”. The more dissociated an experience is, the more of the emotional weight is stuck in the “there and then”.
Trauma informed treatment, particularly EMDR therapy, helps a person digest a memory so they can remember that this thing happened in the past, it happened to me, it is over, and I am OK now.
Dissociation happens on a continuum and shows up to some degree in many clients. However, working with more profound dissociative processes requires advanced training. My journey into this world emerged from my own sense of ineffectiveness in working with complex trauma survivors. As I took more advanced trainings and sought frequent consultation, I came to love working with folks with dissociative disorders.
Here are two upcoming opportunities to increase your skills and knowledge treating clients who dissociate:
- I will be offering a workshop, Working with Dissociation and Complex Trauma as an EMDR Therapist on February 23, 2018 from 8:30 am – 4:30 pm at the Hilton Garden Inn Tallahassee Central, 1330 Blairstone Road, Tallahassee, FL 32301. CEUs and EMDRIA credits are offered for this training.
- Regina Morrow Robinson and I are co-facilitating a 10 session Complex Trauma Consultation Group for clinicians certified in EMDR therapy who wish to expand their knowledge as they do consultation on tough cases. This group will begin on January 18, 2017 from 8:30 – 10:30 am and continue the third Thursday of each month for 10 consecutive months. The group meets at Windermere Counseling, 104 West 6th Avenue, Windemere FL 32786. Attendance via computer is also available.
More details and registration information are available at www.connectemdr.com.
Featured image details: #61 (Rust and Blue) Mark Rothko 1953