Dissociation & C-PTSD

Complex Post Traumatic Stress Disorder (C-PTSD) is a serious mental health issue that is the direct result of chronic or reoccurring exposure to extreme stress or traumatic situations. C-PTSD is characterized by a range of symptoms that present after experience with stress, adversity, violence, or abuse including anxiety, heightened emotional states or reactivity, intrusive thoughts or memories related to the traumatic event, and avoidance of triggers connected to the traumatic situation. While many people who experience chronic or persistent stress, adversity, violence or abuse may develop C-PTSD, people who are traumatized are at greater risk for developing other mental health issues like dissociation or dissociative disorders. 

People who suffer from C-PTSD are at greater risk for developing other serious mental health conditions

There is a strong connection between C-PTSD, dissociation, and dissociative disorders. Research suggests that persistent and long term trauma are the root cause of dissociative disorders while the National Center for PTSD identifies a dissociative subtype of PTSD. 

Dissociation is a mental health symptom that is used as a method of coping with the experience of trauma. Dissociation is a psychological defense where an individual feels disconnected from the present moment and may experience a loss of contact with reality. A person who is experiencing dissociation may find themselves feeling less in touch with their personal experiences including their surroundings, thoughts, feelings, behaviors, or memories. Individuals who experience reoccurring or persistent dissociation may also be diagnosed with a dissociative disorder or suffer from C-PTSD: Dissociative Subtype. 

When a person with C-PTSD is experiencing symptoms of dissociation or a dissociative disorder it is commonly referred to as a dissociative state or dissociative episode. Symptoms of dissociation and dissociative disorders manifest in many different ways, occur on  a spectrum, and have several diagnostic presentations. A person with C-PTSD may experience dissociative episodes that last seconds, minutes, hours, or even days. In addition, dissociative states can range from symptoms of inattention to dissociative identity disorder.​

Have you ever “spaced out” or caught yourself day dreaming? You have experienced a form of dissociation.  Although, the experience of dissociation in relation to C-PTSD is more severe and often becomes problematic. Individuals who experience dissociative symptoms associated with C-PTSD often find it difficult to manage their responsibilities or participate in everyday life. 

Dissociative states related to C-PTSD are often induced by increased stress or stress inducing triggers and often find that the experience of dissociative symptoms is unmanageable and interferes with their day to day functioning. While dissociation has been associated with C-PTSD not all people who experience trauma will develop dissociative symptoms. Some people are more prone to the use of dissociation as a method of coping with stress. 

Contrary to what the popular media likes to depict most dissociative episodes do not include dissociative identity disorder (multiple personality disorder) and is rarely experienced as another personality hijacking your body and taking you to random places then waking up confused as to how you got there.

More commonly, dissociative episodes include states of emotional numbness where a person may be disconnected from their feelings or bodily sensations. Emotional numbing is the most chronic form of dissociation which can last for prolonged periods of time, even years. Many people who suffer from emotional numbness as a form of dissociation are disconnected from their bodily experiences and have a hard time identifying how they feel, experience limited emotional reactivity, express emotional blunting, or heightened pain or distress tolerance.

Emotional numbness in C-PTSD can be triggered as a response to avoid being hurt or to help cope in some way. For example, an individual may use emotional numbing to survive an inconsistent or intense environment. Individuals who make themselves emotionally numb may loose interest in pleasurable activities or have difficulty feeling positive (and negative emotions) leading to what looks like depression.

Dissociation and symptoms of dissociative disorder can be difficult to identify due to the variety of presentation. Not only does the spectrum of symptoms complicate the experience of dissociative episodes but many people who experience the symptoms may not be aware they are occurring. In many cases of C-PTSD the severity and frequency of dissociative symptoms is affected by an individual's ability to recognize that they have dissociated. Individuals who are not aware of their dissociative symptoms are more likely to experience prolonged periods of dissociative states or reoccurring dissociative episodes. 

If you or someone you love has experienced complex trauma and are concerned about the presence of dissociation, please visit www.therapywithraquel.com for more information. There’s a whole lot of life you miss when you’re not “here.”

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Raquel Buchanan is a Licensed Marriage and Family Therapist in Palm Springs California. Raquel offers counseling and psychotherapy to individuals who have experienced childhood trauma. She provides both in person and tele-health sessions.