Dissociation with PTSD
My PTSD comes from childhood sexual abuse, which as you can see from the graph below, is very common. I cannot stress enough that I honestly had no idea I suffered Dissociation or PTSD, until I started seeking help of a professional therapist. I’m certainly not an expert but I know what I feel and how I feel, and I’m doing more research to try and understand it, along with my regular weekly sessions with my therapist. Learning and writing about these conditions is helping me desensitize myself to it, but it’s not a quick process by any stretch, so that’s why I started this website. In some weird way, learning more about it is helping me deal with it, and also reaffirms that what I feel is real and common among many people. That in itself helps me deal, knowing I’m not alone in what I’ve been through and how I have to work through dealing with it to heal and survive.
So, when I have a flashback, my mind immediately goes into Dissociation and tries to protect me from feeling too much of the traumatic experiences. While I can feel some of it, and embrace some of it, I actually go into a Dissociative State while Dissociating. Yeah I’m still trying to figure that one out! It’s like my brain is telling me, ok this flashback is here, but I’m going to let you only go so far before I pull you back in to protect you.” That’s the reason, we think at least (my therapist and I), that I can actually go on and function throughout the day and not be a complete wreck for lack of a better term. The flashbacks are real, there is no doubt, but the way I Dissociated at the time of the events when I was a kid, affects how the flashbacks hit me now.
The following graphic gives a nice, easy to understand scale of the causes of PTSD. Source – Post Traumatic Stress Disorder – TraumaDissociation.com – which as I’ve stated in other posts is a very good resource, with easy to understand graphs and information on Trauma & Dissociative Disorders.
Dissociative PTSD sub-type There are three key groups of symptoms in PTSD, intrusion symptoms (such as flashbacks) and emotional numbing, are dissociative in nature. Emotional numbing is often referred to as “psychic numbing” or “emotional anesthesia”. Dissociative symptoms which occur which occur within PTSD do not necessarily mean a Dissociative Disorder is present since the additional criteria for Dissociative Disorders are often not be met; however, PTSD is a common additional diagnosis for people with complex Dissociative Disorders including dissociative identity disorder. Dissociative symptoms, such as subjective sense of numbing or detachment, reduced awareness of an individuals surroundings, derealization, depersonalization, and dissociative amnesia, are cardinal features of posttraumatic stress disorder. PTSD with dissociative features The DSM-5 manual describes this at the bottom of (but within) the PTSD diagnostic criteria: With dissociative symptoms (with either depersonalization or derealization). This is commonly referred to as the dissociative sub-type of PTSD, although it is actually a specifier in the DSM-5, and as described above all PTSD involves some dissociative features, so there is not a “non-dissociative PTSD”. The dissociative sub-type involves depersonalization or derealization rather than just additional dissociation, and is clinically different from severe PTSD. The criteria were summarized by Friedman (2013):28 as follows: All the PTSD criteria are met “High levels of depersonalization or derealization” are also present Dissociative symptoms are not linked to substance use or another medical condition it is found in both children and adults.