Online Therapy for Dissociative Disorders and OSDD/1a UK

There are five main ways in which the dissociation of psychological processes changes the way a person experiences living: depersonalisation, derealisation, amnesia, identity confusion, and identity alteration.

Depersonalisation is a feeling of detachment, often from oneself and one’s identity. It can also be associated with derealisation, where the world seems unreal or “lifeless.” People experiencing depersonalisation may feel like they are observing their actions, feelings, or thoughts from a distance. It’s a form of dissociation, which occurs when the mind copes with excessive stress.

Derealisation is an alteration in the perception of the external world, causing those with the condition to perceive it as unreal, distant, distorted, or, in other words, falsified. People experiencing derealisation may feel as if their environment lacks spontaneity, emotional colouring, and depth. It’s a symptom associated with dissociative disorders, where individuals feel disconnected from their surroundings or perceive the world as unreal.

Amnesia is a condition characterised by the inability to recall facts or previous experiences. It can manifest in various ways, such as: Inability to Remember Past Events or Activities: People with amnesia struggle to recall events from their past. Inability to Learn New Information: They may find it challenging to retain new knowledge. Confabulation: Some individuals create false memories to fill gaps in their recollection. Disorientation: Amnesia can lead to confusion about time, place, or identity.

The causes of amnesia vary and may include trauma, brain inflammation, certain medications, hypoxia, brain tumours, neurodegenerative diseases (like Alzheimer’s), and more. It’s essential to seek medical attention if you or someone you know exhibits symptoms of amnesia.

Dissociative amnesia, specifically, occurs due to severe or long-term trauma, often involving abuse or violence. In this type of amnesia, the mind blocks out distressing or traumatic experiences, leading to memory gaps. Treatment options include occupational therapy, dietary adjustments (such as vitamin B intake), and self-care measures.

Remember that if you ever experience disturbing thoughts about self-harm or suicide, seek emergency care immediately.

Identity Confusion: Specifically related to DID, identity confusion occurs when someone feels uncertain about who they are due to the presence of multiple distinct identities. These identities can “switch” within the person, leading to disrupted self-awareness.

Identity alteration refers to the effect of alters on how individuals with dissociative identity disorder (DID) or other specified dissociative disorder, subtype 1 (OSDD-1), perceive themselves and interact with the outside world. It involves manifestations where different alters express varying opinions, perceptions, and senses of self. At its most extreme, this can lead to switching, where the individual perceives an entirely different person residing within them, taking over their behaviour, or feeling like they’ve become a different person. Alterations may include changes in preferred name, age perception, gender identity, preferences, skills, memories, vocal pitch, body language, and physical reactions to stress. In some cases, there may be time loss or blackouts, where parts of the self are unaware of actions taken by other parts. Less drastically, passive influence occurs when alters influence the individual’s sense of self and behaviour without full executive control Co-consciousness allows multiple alters to be present simultaneously, leading to internal conflict or confusion over one’s true identity. Mild identity alteration is also common in dissociation beyond DID.

If you dissociate, you may feel disconnected from yourself and the world around you. For example, you may feel detached from your body or feel as though the world around you is unreal. Remember, everyone's experience of dissociation is different.

Dissociation can manifest in various ways, and its symptoms can vary. Here are some common signs of dissociation:

Depersonalisation: Feeling detached from yourself, as if you’re observing your actions, feelings, or thoughts from a distance. You might also perceive the world as unreal or “foggy.”

Derealisation: Sensing that people and things around you are distorted or not real.

Memory Gaps: Experiencing periods where you cannot remember information about yourself or events from your past life. These gaps are more severe than normal forgetfulness.

Altered Identities: In cases of Dissociative Identity Disorder (formerly known as multiple personality disorder), individuals may feel uncertain about their identity and experience the presence of distinct identities with their own names, voices, and personal histories.

Physical Symptoms: Feeling little or no physical pain during dissociative episodes.

If you suspect dissociation, consider seeking professional help. A mental health specialist can provide a thorough assessment and guide you toward appropriate support. Remember, everyone’s experience of dissociation is unique, so consult a professional for personalised advice.

Dissociative disorders can cause a range of physical and psychological issues. Here are the main types and their symptoms:

Depersonalisation-derealisation disorder:

Feeling outside yourself, observing actions from a distance.

Sensation that the world is unreal.

May last moments or persist over years.

Dissociative amnesia:

Severe memory gaps about personal information or events.

Not due to another medical condition.

Blank episodes lasting minutes to months.

Dissociative identity disorder (DID):

Formerly known as multiple personality disorder.

Uncertainty about identity.

Presence of distinct identities with separate names, voices, and histories.

Memory gaps about everyday events and personal information.

These disorders often arise from traumatic experiences, and periods of dissociation can vary in duration. If you’re experiencing symptoms, consider seeking professional help. Remember, you’re not alone, and support is available.

Triggers are sensory stimuli connected with a person's trauma, and dissociation is an overload response. Even years after the traumatic event or circumstances have ceased, certain sights, sounds, smells, touches, and even tastes can set off, or trigger, a cascade of unwanted memories and feelings.

Dissociation can be triggered by various factors, especially during times of stress or trauma. Here are some common triggers:

Trauma: Dissociation often develops in response to traumatic experiences. It could be a one-time traumatic event or ongoing trauma and abuse.

Mental Health Conditions: Certain mental health problems, such as post-traumatic stress disorder (PTSD), depression, anxiety, borderline personality disorder, and schizophrenia, may lead to dissociation.

Substances: Alcohol, phencyclidine (PCP), and ketamine can trigger dissociative experiences.

Stress and Anxiety: Acute stress or anxiety can also contribute to dissociation.

Remember that everyone’s experience of dissociation is unique, and triggers can vary from person to person. Seeking professional support is essential if you’re struggling with dissociation.

Dissociation can be challenging, but there are strategies to help you reconnect with the present moment. Here are some tips:

Recognise It: Start by acknowledging when you’re dissociating. Awareness is the first step.

Grounding Techniques: Use grounding techniques to stay present. Focus on your breathing, hold a familiar object, or describe your surroundings.

Journaling: Keep a journal to identify triggers and patterns. Writing about your experiences can be helpful.

Self-Care: Prioritise self-care—get enough sleep, manage stress, and take care of your well-being.

Remember, seeking professional help is essential if you’re struggling with dissociation. You don’t have to face it alone!

A person who is dissociating may look like they're daydreaming, ignoring you, spacing out, or disconnected from the conversation and their surroundings. The person may seem different from their usual self.

If you have the right treatment, there's a good chance you'll recover. This might mean that you stop experiencing dissociative symptoms. For example, the separate parts of your identity can merge to become one sense of self. Not everyone will stop experiencing dissociative symptoms completely.