Dissociation and PTSD

Dissociation and PTSD symptoms are closely connected. Dissociation, as an essential component of the delayed reaction to the trauma, seems to play an important role in development of the PTSD symptoms.

Dissociation is defined as a term, describing the process (or result), through which a coherent set of actions, thoughts, attitudes or emotions are separated from the other part of the personality and work independently. The main feature of the pathological dissociation is the violation of rational functions of consciousness (the acknowledgement of one’s Ego or motor behavior), in result some of these functions are lost. Dissociation is also defined as the dissociation of relations, an unconscious process, which divides the thinking (or mental processes as a whole) into separate components. Eventually, it leads to the disruption of normal mental relationships.

The dissociative condition is characterized by:

  1. The way of thinking, in which the archaic forms predominate;
  2. Temporal distortion;
  3. A sense of loosing control over the behavior;
  4. Changes in emotional expression;
  5. Changes in body image;
  6. Perceptual distortions;
  7. Changes in the meaning or significance of the actual or past situations;
  8. A sense of “rejuvenation” or age regression;
  9. High susceptibility to the suggestion.

The following are the main forms of dissociation in PTSD: absorption – the specific stressed state of attention; distraction – dreaminess or a day-dream; depersonalization – the loss of reality of one’s own body and the outside world; dissociative identity changes – split personality; amnesia.

Dissociation in PTSD is one of the mechanisms for coping with trauma, when the experience of traumatic situation is accompanied by the emergence of three different phenomena – primary, secondary and tertiary dissociation.

The phenomenon of primary dissociation in PTSD. In the first moments of the traumatic event, many people are unable to accept the holistic picture of what is happening. In this case, the sensory and emotional elements of event remain isolated from the consciousness. Then the experience of traumatic situation is divided into separate somatosensory elements. The primary dissociation largely determines the development of PTSD, the symptoms of which (intrusive memories, nightmares and flashback-effects) can be interpreted, as the dramatic expression of dissociated memories, connected to the trauma.

Secondary dissociation in PTSD often occurs in individuals, undergoing the traumatic situation, and includes the out-of-body phenomena, derealization, analgesia and other. The individual, being in the “traumatic” mental condition, is experiencing further disintegration of the elements of traumatic experience in the face of ongoing threats. Secondary dissociation allows to distance oneself from the unbearable situation, to reduce the level of pain and, ultimately, to protect oneself from the awareness of total impact of the traumatic situation.

A tertiary dissociation in PTSD is taken into account only in case of development of the specific Ego identities, which contain the traumatic experience and consist of complex personal identities with one’s own cognitive, affective and behavioral patterns. An example for the extreme expression of tertiary dissociation can serve a multiple personality disorder.

It should be noted, that dissociation in PTSD is a fundamental psychological attribute and it underlies the large number of the phenomena present both in normal are functioning of the psyche, and in many types of psychopathology, including PTSD. Many forms of dissociative conditions, as well as their prevalence, suggest that they play an important role in the mind functioning and have a great value in relation of adaptation to changing environmental conditions.