Dissociation in therapy can manifest in various ways, depending on the severity of the dissociative experiences and the specific dissociative disorder present. Here are some common signs of dissociation that therapists may observe during therapy sessions:
Spacing out or blanking out: The client may appear to be mentally absent, have a distant gaze, or seem unresponsive. They may lose track of the conversation or appear to be daydreaming.
Memory lapses: The client may have difficulty recalling important information or events, even those that occurred recently.
Alterations in identity or sense of self: In dissociative disorders like DID or OSDD, different identity states or "alters" may emerge during therapy, leading to shifts in behavior, thoughts, emotions, and even speech patterns.
Amnesia: The client may experience gaps in memory, particularly related to traumatic events or periods of high distress.
Emotional numbing: The client may appear emotionally detached, unable to feel or express emotions, or express emotional experiences in a detached, matter-of-fact manner.
Depersonalization: Clients may describe feelings of detachment from their own body or a sense that they are observing themselves from a distance.
Derealization: Clients may describe a sense of unreality or detachment from their surroundings, as if the world around them is not real.
Self-harm or self-destructive behaviors: Some clients with dissociative disorders may engage in self-harming behaviors as a way to cope with overwhelming emotions or to "ground" themselves when they feel disconnected.
Abrupt changes in mood: Sudden shifts in mood or affect may occur as different identity states emerge and experience emotions differently.
Switching between alters: In cases of DID, a client may experience switches between different identity states (alters) during therapy sessions.
Loss of time: Clients with dissociative disorders may lose track of time or feel as if time has passed more quickly or slowly than it actually has.
Confusion or disorientation: The client may appear confused, disoriented, or unsure of their surroundings.
Therapists who work with clients experiencing dissociation are trained to recognize these signs and may use various therapeutic techniques to help clients cope with dissociative symptoms. Techniques such as grounding exercises, containment strategies, and helping clients build awareness of their dissociative experiences can be essential components of therapy. For individuals with dissociative disorders, therapy often focuses on creating safety, processing past traumas, improving communication between identity states, and fostering integration and cohesiveness.