TRAUMA AND MORE · ARTICLE 09
Dissociation
Disconnection in memory or awareness.
Dissociation describes experiences of disconnection from thoughts, feelings, bodily sensations, memory, identity or surroundings. It can range from brief feelings of unreality to more disruptive episodes involving memory gaps or a sense of being detached from oneself. These experiences can be unsettling, but they are recognised phenomena and can be assessed and supported.
1. What dissociation can feel like
A person may feel as though they are observing themselves from outside their body, that the world is dreamlike or distant, or that periods of time are difficult to recall. Depersonalisation refers to detachment from oneself; derealisation refers to a sense that surroundings are unreal. Some people experience gaps in autobiographical memory. Experiences differ and should not be assumed to indicate one particular diagnosis.
2. Why might it happen?
Dissociation can occur in association with trauma and overwhelming stress, but it can also appear in other mental health conditions or alongside sleep disruption, substance use, medication effects or neurological and physical conditions. It is important not to assume that every episode has a traumatic cause. Assessment considers timing, context, safety and other possible explanations.
3. Impact on daily life
Some people find dissociation interferes with work, relationships, memory or the ability to feel present. Others experience occasional episodes that pass without major disruption. Fear of being judged can make it difficult to describe what is happening. A calm, non-dismissive response can help a person discuss symptoms more clearly.
4. Assessment and treatment
A clinician may explore the form, duration and triggers of episodes, effects on functioning, relevant history, medication and substance use, and whether medical investigation is needed. Treatment depends on the underlying difficulties and may involve psychological therapy, managing co-occurring symptoms and strategies for staying oriented to the present. Trauma-focused work should be appropriately paced and should not be forced.
5. Grounding and support
Some people find it useful to name objects in the room, notice contact with the floor, describe the present date and location, or use a familiar sensory cue. These strategies are not a universal solution; if an exercise increases distress, stop and seek advice. If memory gaps, disorientation or episodes are new, severe or unsafe, arrange prompt professional assessment.
When to seek urgent help
If symptoms are severe, worsening rapidly or make it difficult to remain safe, seek urgent professional support. In England, contact NHS 111 and select the mental health option for urgent support. If there is immediate danger, call 999 or go to A&E.
Further reading and sources