Dissociative States
In psychology, the term dissociation describes a wide array of experiences from mild detachment from immediate surroundings to more severe detachment from physical and emotional experience. Dissociation occurs on a continuum—at the nonpathological end of the continuum, dissociation describes common events such as daydreaming while driving a vehicle. Further along the continuum are non- pathological altered states of consciousness. More pathological dissociation involves dissociative disorders.
Most individuals have experienced a dissociative state at some point in their lives. Consider if you are talking to a friend and suddenly you realize that you blanked out and missed half the conversation; or consider if you’ve been driving somewhere familiar, and you realize halfway through the drive that you weren’t fully paying attention but were instead on “auto-pilot.” These are both examples of dissociation. Dissociation of this sort is fairly normal from time to time; however, there are five types of dissociative disorders which are considered psychopathological: dissociative identity disorder, disociative amnesia, depersonalization/derealization disorder, other specified dissociative disorder, and unspecified dissociative disorder.
-Dissociative Identity Disorder
Dissociative identity disorder (DID) is a rare mental disorder characterized by at least two distinct and relatively enduring identities or dissociated personality states that recurrently control a person’s behavior; it is accompanied by memory impairment for important information not explained by ordinary forgetfulness. Amnesia in DID is understood to mean amnesia between two or more of the distinct identities; the host alter will experience “losing time” in the present another alter takes the place of the one the host alter. Rarely is the host alter aware of their time loss. Each of the distinct identities or personalities has its own way of perceiving, thinking about, and relating to itself and the environment.
Dissociative identity disorder (DID) is a rare mental disorder characterized by at least two distinct and relatively enduring identities or dissociated personality states that recurrently control a person’s behavior; it is accompanied by memory impairment for important information not explained by ordinary forgetfulness. Amnesia in DID is understood to mean amnesia between two or more of the distinct identities; the host alter will experience “losing time” in the present another alter takes the place of the one the host alter. Rarely is the host alter aware of their time loss. Each of the distinct identities or personalities has its own way of perceiving, thinking about, and relating to itself and the environment.
-Dissociative Amnesia
Amnesia refers to the partial or total forgetting of some experience or event. An individual with dissociative amnesia is unable to recall important personal information, usually following an extremely stressful or traumatic experience such as combat, natural disasters, or being the victim of violence. Some individuals with dissociative amnesia will also experience dissociative fugue (from the word “to flee” in French), whereby they suddenly wander away from their home, experience confusion about their identity, and sometimes even adopt a new identity (Cardeña & Gleaves, 2006). Most fugue episodes last only a few hours or days, but some can last longer.
Amnesia refers to the partial or total forgetting of some experience or event. An individual with dissociative amnesia is unable to recall important personal information, usually following an extremely stressful or traumatic experience such as combat, natural disasters, or being the victim of violence. Some individuals with dissociative amnesia will also experience dissociative fugue (from the word “to flee” in French), whereby they suddenly wander away from their home, experience confusion about their identity, and sometimes even adopt a new identity (Cardeña & Gleaves, 2006). Most fugue episodes last only a few hours or days, but some can last longer.
-Depersonalization/Derealization Disorder
Depersonalization is defined as feelings of “unreality or detachment from, or unfamiliarity with, one’s whole self or from aspects of the self” (APA, 2013, p. 302). Individuals who experience depersonalization might believe their thoughts and feelings are not their own; they may feel robotic, as though they lack control over their movements and speech; they may experience a distorted sense of time; and, in extreme cases, they may sense an “out-of-body” experience in which they see themselves from the vantage point of another person. Derealization is conceptualized as a sense of “unreality or detachment from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surroundings” (APA, 2013, p. 303). A person who experiences derealization might feel as though they are in a fog or a dream or that the surrounding world is somehow artificial and unreal. An episode of depersonalization/derealization disorder can be as brief as a few seconds or continue for several years.
Depersonalization is defined as feelings of “unreality or detachment from, or unfamiliarity with, one’s whole self or from aspects of the self” (APA, 2013, p. 302). Individuals who experience depersonalization might believe their thoughts and feelings are not their own; they may feel robotic, as though they lack control over their movements and speech; they may experience a distorted sense of time; and, in extreme cases, they may sense an “out-of-body” experience in which they see themselves from the vantage point of another person. Derealization is conceptualized as a sense of “unreality or detachment from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surroundings” (APA, 2013, p. 303). A person who experiences derealization might feel as though they are in a fog or a dream or that the surrounding world is somehow artificial and unreal. An episode of depersonalization/derealization disorder can be as brief as a few seconds or continue for several years.
The old category of dissociative disorder not otherwise specified is now split into two according to the DSM-5 (2013): other specified dissociative disorder and unspecified dissociative disorder. These categories are used for forms of pathological dissociation that do not fully meet the criteria of the other dissociative disorders, or if the correct category has not been determined. Other specified dissociative disorder covers a variety of different presentation, including some symptoms similar to DID but not matching the distinct criteria. Unspecified dissociative disorder is often used in an emergency room setting where there is insufficient information to make a diagnosis.
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