The Interconnections of Trauma, PTSD, and Dissociation

Trauma, particularly during childhood, is strongly associated with dissociative disorders, with this relationship being bidirectional. Trauma can induce dissociative disorders, and dissociation can impede recovery from trauma. Dissociation often serves as a coping mechanism in cases of post-traumatic stress disorder (PTSD).

These conditions' connections are further explained by changes in brain function resulting from trauma.

Dissociation and Dissociative Disorders

• Dissociation: A disconnect between thoughts, feelings, memories, behavior, perception, and sense of identity.
• Dissociative Disorders: Dissociation significantly impairing daily functioning.
  • Dissociative amnesia: Loss of memory concerning critical events.
  • Dissociative fugue: Wandering off with no memory of the event.
  • Depersonalization/Derealization: Feeling detached from oneself and/or surroundings.
  • Dissociative identity disorder: Identity confusion and alteration.

Trauma and Dissociation

• Trauma, especially ongoing childhood abuse and neglect, is a considerable risk factor for dissociative disorders.
  • 90% of individuals with dissociative disorders have experienced childhood mistreatment.
• A single traumatic experience, such as natural disasters or violent crimes, can also lead to dissociative disorders.

Dissociation as a Coping Strategy

• Faced with trauma, dissociation can serve as a self-protective survival technique, allowing individuals to escape overwhelming experiences.
• Children, especially, may use dissociation to cope with helplessness and emotional pain.

Long-Term Negative Effects of Dissociation

• Dissociation, when persisting outside real danger, can disrupt relationships, work, and daily functioning.
• It may impede recovery from trauma and encourage the tolerance of situations that necessitate change.

Age of Trauma and Dissociative Disorders

• Children at certain ages, such as preschool (4-5 years) and pre-adolescence (8-9 years), appear more prone to developing dissociative disorders in response to trauma.
• Ongoing severe trauma before age nine is strongly associated with dissociative disorders.

Brain Changes in Trauma and Dissociation

• Research indicates that trauma and dissociation are linked to changes in brain function and neural connections.
• Decreased limbic activity, heightened frontal lobe activity, and altered communication between these regions are observed.

PTSD and Dissociation

• Dissociation and PTSD are closely related and often co-occur.
• A dissociative subtype of PTSD in the DSM-5 includes depersonalization and/or derealization symptoms.
• Dissociation in PTSD can intensify symptoms but is usually transient.

Treatment for Dissociation

• Seeking help for dissociation is crucial, as it can lead to various complications if left untreated.
• Treatment may include psychotherapy, such as cognitive behavioral therapy and dialectical behavior therapy, along with medications.
• The International Society for the Study of Trauma and Dissociation provides resources and therapist connections.

Coping with Dissociation

• Strategies to cope with dissociation include:
  • Getting enough sleep.
  • Engaging in regular physical activity.
  • Maintaining a balanced diet.
  • Practicing relaxation techniques.
  • Writing in a journal to identify triggers.

Conclusion

Childhood abuse and neglect are particularly linked to dissociation, which can hinder recovery from trauma. PTSD and dissociation are closely intertwined, with a dissociative subtype of PTSD recognized in the DSM-5. Proper treatment can help manage PTSD symptoms and cope with stressors that trigger dissociative symptoms. Seeking assistance from a trained professional is vital for healing and improving quality of life.