What we’ve said about Dissociation

“Any two parts of the mind can be associated. You can link them together. A memory can be linked to words, your ability to talk about it. A behavior can be linked to an emotion. But in disassociation, it's when any two parts of the mind that would or could be normally linked together, connected, become disassociated”

“in a normal memory, you have this integration of the sensations, the emotions, the thoughts that you were having. And it gets integrated into your idea of self and other. When you have a traumatic event, it's almost as if all these different parts don't get integrated”

“some freezing and dissociation can be so subtle that some people might read it as hesitation or just kind of thinking to themselves for some period or not being interested in answering certain questions. You got to be pretty attentive sometimes to catch this kind of thing”

“I think there's a huge spectrum of dissociation from, as you said, just a disconnected... Some small thing disconnected to experiencing someone in a full dissociative state where their mind goes... You can see their face goes blank. It's almost as if they're not present”

“we're definitely worried about dysregulation and we're definitely worried about uh plain disassociation and that can be easy to miss if you're not following the affect”

“there's a patient that I at first didn't know they were dissociating. And when I asked them, like, what did they just experience? They said, like, nothing. I wasn't really thinking about much at all. And it's like, what was different”

“they might forget to tell you. I've had that happen multiple times in multiple cases. It seems to be that part of the memory seems to be dissociated”

“dissociation of memory is very common. And as a result, especially in people with more moderate to severe cases or with other existing comorbidities and vulnerabilities, their ability to either tell you a organized story of what has”

“the more extreme responses and the hyper arousal and the intrusive flashbacks, people commonly have no connection. link to what those experiences are it's not all the time but often they have no idea that it's linked to some past event”

“Don't take this as an invitation, by the way, to get into the camp where you think you can uncover all these memories. Be careful about that. If you look at the research of Elizabeth Loftus, you, the clinician, can absolutely endure”

“a lot of the time, the experiences of hearing apparent voices, noises, or seeing things, even flits of shadows going past that you see in the severe PTSD is a dissociative process and not properly with psychotic features process”

“Those are really just parts of the self that have been split off in terms of an experience, experienced as different or at least separate from the core self. And that does not, in my experience, and I think in the research, actually respond to dopamine blockade”

“OK, don't chase that by pumping up the antipsychotic. Most of the time doesn't work or you're just over sedating them so that they don't have that anymore. It's not dangerous. The treatment target is not zero voices, noises, experiences”

“i notice you're getting a little different there it seems like maybe you're being bothered or this is a lot for you uh let's just go over some things right now can you tell me your name okay where are you right now who am i What's the color of the chair that you're on”

“I probably advise against fighting it. Part of that fighting response seems to pull people into a generalized fear or anxiety response that might make things work”

“a lot of people are also afraid that they're completely out of control. or can't do anything at all, or are almost unconscious during dissociation, which is not generally true”