Dissociation in Therapy Sessions

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.

Blessing

Once upon a time along time ago there was a little girl who lived under a tree. That is, she lived in the big hole in the side of the tree where the ground was soft and it was dry and not too very cold even when it was cold outside. She lived there whenever her parents got too crazy with her. Sometimes they did get too crazy and they said crazy things and did crazy things and it wasn’t safe to be near them. But she could run away and be safe in her tree. Her tree loved her and it was alive!
It was very wonderful to have some thing that was alive that loved her and would not hurt her and get crazy. She brought her softest blanket there and a bottle no one would miss that had water in it. Sometimes she brought some food that she could steal from the kitchen in the big house. And -OH ! – she knew the tree was alive because it had little new shoots at the tips of the branches every spring, ever since she could remember. Nobody from the big house ever missed her or went looking for her so whenever she wanted she could go to her loving tree.

Sometimes she wondered why she ever did go back to hang around her parents in the big house.  “I guess” she would say to herself, “maybe one of them would change and be loving like my tree.” But they never did.

One day there was a big storm with lots of rain and windy wind. Very windy wind. She went out to her loving tree and it was lying down with it’s roots showing instead of being in the ground. That was scarey, because it changed. Like her parents changed. That was very scarey. She found out that she could still get into the hole but it didn’t seem so good anymore because the hole was lying down too and there wasn’t as much room in there anymore. She knew she couldn’t get the tree to stand up like it used to. It was too big to even budge.  Now the ground did get wet and it was colder than it used to be when it got cold outside. Besides she was getting bigger herself. There really wasn’t enough room.

So one day she sadly said goodbye to her tree and went walking down the road near by.  She was very startled by a boy who she saw walking down the road too. He asked her where she was going and this she told him: “I’m going where the north wind doesn’t blow down good trees and where the people are as nice as good trees.” “Do you know  where that is?” he wanted to know.  “Not for sure,”  she answered, “but it isn’t behind me so I figured it’s got to be up ahead somewhere. So that’s where I’m looking.”  “That sounds right to me” he said, “I don’t like what’s behind me either. Can I come with you?”

” Well, yeah” she said. “But I’m not used to company.”

“Neither am I,” he answered, “but  we will figure it out.”

“Hmm,” she nodded, and so they kept walking together.

Should repressed memories be remembered?

Question: My therapist says she doesn’t deal with repressed memories and that I can get over my Uncle’s abuse of me with out “doing memories”. I don’t want to have to remember it either, but I keep having these strong images come to me of him raping me and they won’t go away. What does that mean and what should I do?

Some therapists don’t want to help clients recover repressed memories because of recent litigation that has accused therapists of planting “false” memories. While it is true that memories can be unreliable, especial in detail, you seem to be experiencing vivid but incomplete memories and resolving these is an important part of your therapy.

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