If your loved one has problems with dissociation, you may not even understand exactly what that means, let alone how best to support them.
What is Dissociation?
It’s a huge topic, with different types and dissociation itself being on a wide continuum. Even now there is much controversy about the issue, and there are many opinions as to its nature and treatment. What I’ll discuss here is the moderate to severe end of the spectrum.
Dissociation can involve a sense of detachment from reality that might affect the person’s connection with their surroundings (derealisation) or their connection to themselves (depersonalisation) or both.
Generally, the more severe the dissociation, the less control the person has over themselves and their environment, and a higher chance of more developed dissociative ‘Parts’ that have been created to cope with past traumas. At the extreme end of the continuum, if the dissociation is severe enough, it may warrant the diagnosis of Dissociative Identity Disorder (formerly Multiple Personality Disorder).
What follows here are a few simple guidelines for people with a loved one who experiences high levels of dissociation. Please remember these are suggestions only; not all of these will work for all people and my list is brief. Also please consider seeing a professional at M1 Psychology Loganholme or Vision Psychology Wishart, with experience in this area, who can journey with you on this complex road.
Guidelines for Helping a Loved One with Dissociation
Educate yourself about dissociation: Seeing a loved one in a dissociative state can be quite scary, and most feel quite powerless to help. So the first step is recognising what is happening to your family member or friend. Once you understand what is happening, you will be much better equipped to help.
Warning: while there is some great material on the internet these days, there is also a lot of rubbish. Please be mindful that just because it’s on the web, it doesn’t necessarily mean it’s true or accurate.
Learn about triggers: Dissociation is designed to protect. All severe dissociation has its origins in trauma. While the original trauma could be many years ago, the mind and brain continue to constantly scan for any further threats and if one is found, or there is a similar cue, your loved one will react automatically.
A trigger could be a sight, sound, smell, colour, texture, a song, a calendar date, a body sensation – it could be literally anything. This makes it very difficult for friends and family to help as there will always be an endless supply of triggers. The key though, is to work out (preferably with a therapist) what specific triggers your loved one experiences themselves. This brings me to my next point.
If possible, modify the environment: Overstimulation in the home, workplace or shopping centre can be a nightmare for dissociative loved ones.
We can’t do much about shopping centres or the workplace, but we can change some things at home. Be mindful of the impact of fluorescent or flashing lighting, strong smells or certain sounds. Some will be soothing; others will be triggering. In some homes, you may need to remove objects that could be used to harm or change some surroundings (a garden may be grounding for the person and help soothe).
Help them learn to reassociate: I remember one lady who was very dissociative found the colour red very triggering. She lined a box with red paper, but put in the box precious items. This helped reassociate the colour red with something good. This can take some time, but can help.
Help them learn to ground themselves: Sometimes some sensory stimulation can really help ‘ground’ them and bring them back to the present. Putty, ‘squishies’, ice, a warm beverage, a weighted blanket or music can help. Be careful using showers or baths to ground them – not recommended unless you can monitor them as well.
In severe situations: If possible, you may need to take your loved one out of the house, or remove them to a calm place if safe to do so. Take them outside in the sun and fresh air (if this helps).
However, if things become unsafe either for yourself or your loved one, you must seek help immediately such as calling a support person, or if necessary, dial 000. If your loved one has a professional contact (therapist or case manager), have their number ready to call. Be mindful of their availability though. Develop a safety plan with contacts and resources should you need them in a hurry.
Finally, take care of yourself!
Please, please, please look after yourself too if you have a loved one who dissociates, and you are their key support person. One of the best things to do is take care of yourself. If you burn out, then there will be two people who will need help!
Dr David Ward is a psychotherapist with over 20 years’ experience, providing therapy to adults, adolescents, children, couples, and families. His areas of professional interest include the use of EMDR therapy to help with recovery from domestic violence, child abuse, PTSD, depression and anxiety; family therapy; and working with victims of spiritual and ritual abuse.
To make an appointment try Online Booking. Alternatively, you can call Vision Psychology Brisbane on (07) 3088 5422.