Dissociation: What It Means
Dissociation as a nervous system protection mechanism.
Dit artikel hoort bij: Somatic Concepts Explained: A Glossary for Therapists
A Spectrum, Not a Yes-or-No Black and White
Dissociation is a spectrum. Almost everyone dissociates in a mild form daily (missing a highway exit because you were lost in thought). It becomes pathological when it automatically occurs under stress and hinders a person's functioning or relationships. With severe and chronic trauma, dissociation can become a continuous background state.
In Practice
In a session, you can recognize dissociation by: a glazed look, delayed reactions, an inability to recall what was just said, a feeling of 'fading away'. Your response: don't push through it, instead, offer grounding and orienting. Feet on the ground, looking around, touching something, making eye contact. Only continue when the client is present again.
Common Misconception
The mistake is interpreting dissociation as 'uncooperative'. It's an autonomous response, often outside conscious control. Applying pressure intensifies it. Underlying this often lies a layer of trauma that isn't yet safe enough to be touched. Resource work and stabilization comes first.
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Veelgestelde vragen
Can I work with a dissociative client?
With mild dissociation, certainly. For severe dissociative disorders (DID), specialized training is necessary and often a referral is needed. Don't underestimate the work, but don't automatically dismiss it either.
What's the difference between dissociation and freeze?
There is overlap. Freeze is primarily motor (inability to move), dissociation is primarily consciousness-related (splitting off from experience). They can occur together.
What methods work for dissociation?
Trauma-phased treatment according to Janina Fisher or Onno van der Hart. IFS and EMDR (with specialized dissociation protocols) are also used. The pace is slow, and stabilization is paramount.