People who have had trauma in their lives dissociate in therapy sessions often, so therapists who work with trauma are quite familiar with it. The most common way to tell when someone is dissociating is by looking at their eyes, which get defocused, and seem to be “pulled inward.” Other, more extreme, examples of dissociation are: When a woman told me she saw my head off to one side of my neck, or when someone switched alters and when the first alter came back, she/he didn’t know what happened during the time the other alter was in charge of the body – which is an experience of losing time. The last example is of someone with DID, but not everyone who disassociates has DID., People who have experienced trauma often dissociate without intention and often without awareness. It’s an automatic defense that is experienced as “just happening,” and it happens when the person feels threatened or unsafe.
When someone eyes defocus, I bring their attention to what happened so they are aware of it, and help them “come back” : changing the subject that is threatening, asking them to intentionally look around the room and say out loud what they see, ask them what percentage of them is in the present, all of which increases self awareness and normalizes the experience. Sometimes when they are back I might ask if they remember what was threatening and ask them/ help them to stay present while they describe it.
When the dissociation is more extreme, I explain what is happening, or just happened, and we talk about it conversationally. The purpose is to empower the person to not feel so unable to control the dissociative experiences and to explain why it happens and assure them it is not intentional, and that sometimes they aren’t going to be able to consciously decide not to do it. Recognizing what happened, naming it and also recognizing that nothing terrible happened because of it is also reassuring.
If you are worried about maybe disassociating in a therapy session, be sure you choose a therapist who has had experience with trauma and who is someone you can rely on to help you.