Dissociative disorder occurs when a person feels disconnected from themselves in important aspects of their experience, generating a psychological state of dissociation, a concept that is generally defined as “separating something from another thing to which it was attached.”
“We all know a form of everyday dissociation, when our mind and our body are in different places in a specific situation, such as, for example, while reading a book,” explain psychologist Mario C. Salvador and German therapist Peter Bourquin. .
However, “there is another type of dissociation that is considered pathological and occurs when, as a result of a chronic traumatic situation (mistreatment, abandonment, lack of human connection…), “our internal life becomes fragmented and we lose contact with our experience that we are who we are”, as Salvador and Bourquin point out.
In this dissociation “we stop feeling the internal connection with our experiential world of sensations, emotions, desires, fantasies and illusions, to lose ourselves in another self with which we do not feel identified.”
These two specialists highlight that dissociation is a little-known problem, which affects more than 10% of the population, “a percentage that can reach 40% in groups of people with other psychological problems such as depression, post-traumatic stress or eating disorders. ”, as they claim.
As a result of and since the covid19 pandemic, “diagnoses for these dissociative disorders have increased,” point out the authors of the book ‘Who am I? From dissociation to integration’.
Bourquin, of German origin, is a renowned therapist specialized in a psychotherapeutic method called Systemic Constellations (www.peterbourquin.net), while Salvador is a psychologist specializing in clinical psychology and trauma psychotherapy and creator of the Aleceia Model, and is co- director of the Alecés Institute of Psychology and Psychotherapy (www.aleces.com).
TWO ‘SELF’ IN ONE PERSON.
To better understand what dissociation consists of, these therapists describe below a paradigmatic case of this disorder, which they treated in their consultation (changing the patient’s real name and some details of the events, to protect their privacy).
It is about Nina, a 20-year-old girl, who goes to psychological therapy to feel better.
“She spends many days at home, stuck in her room and watching television or surfing the internet. “She goes through seasons in which she sleeps too many hours, and she has no interest in studies or social relationships,” she explains.
Some days she goes to her therapy sessions feeling really bad, with a depressed mood, sad, apathetic, devitalized and with little desire. These days she can complain about life, that nothing makes sense and even express suicidal ideas.
Those days she tells the therapist that she had an unhappy childhood (with the parents of her early years depressed by the loss of another daughter, different from the current ones), and states that she feels that “no one cares about her,” “nobody cares about her.” There is no one who understands her”, “she only has herself” and “she can’t trust anyone because they won’t be there” when she needs them.
Other days, Nina goes to the therapeutic sessions feeling good, with an apparent normality. She says that she is fine now and she doesn’t want to look at the past or talk about the times when she feels bad.
In those moments, he points out that his discomfort “is very far away today and that he is now happy with the family he has.” Somehow, on her “good” days, Nina doesn’t want to know anything about the other Nina that she feels uncomfortable with on her “bad” days.
Nina’s ‘good days’ and ‘bad days’.
And so Nina alternates the days in which she is apparently well, but with a lack of joy in life, sometimes going to the University and doing the minimum, with other days in which she finds herself without desire or strength and locks herself in her home. room, according to the specialists who have treated her.
This mood alternation characterizes his life. There are therefore two parts to Nina: one that leads life with apparent normality, she gets along well with her current parents, who worry about her, attend to her and take care of her. However, she lives a life somewhat numb in her emotions, as if on autopilot.
The young woman lives some days as if she were a normal girl, but other days she enters a state of extreme decay and depression in which she ‘does not feel or suffer’, she has ideas of suicide and lack of courage and sleeps until noon, without want to do anything
Salvador and Bourquin explain that the roots of Nina’s current dissociation lie in her childhood. “When she was four years old, her mother lost a daughter two years younger than Nina, an event that traumatized the family.”
Her mother became depressed, spent days crying and lamenting, and lost interest in everything, focusing only on her own pain.
His father was absent, worried about his wife and was demanding with Nina, with whom he had no patience or sensitivity.
Nina remembers herself as a sad girl. She cried alone in the room and no one came to comfort her. If she seemed apathetic, uninterested or sad, her father reproached her that she had to do things and not cause more problems, because they already had enough, according to the two experts.
They explain that neither of their two parents at the time could see how much Nina missed them and needed them. In reality, she had lost a sister and to some extent she had also lost the presence of her parents.
It is what is known in psychology as attachment trauma, an emotional shock that produces lasting damage to the unconscious and will affect the girl’s survival strategies, “originated by the lack of human connection in the earliest stages of development.” , when care and parental bond are very critical.”
“When Nina is in her days of depression, she reflects the same state she felt in when she was a girl of 4-6 years old, who lived with her absent and depressed mother, and cried in the room and no one came to comfort her, it is say the stage in which his injury occurred due to lack of love and care, specialists point out.
Now, at 20 years old, Nina has different parents, who now care about her and she knows it. However, this does not seem enough for her. What she has today is not enough to close the wound she suffered in her childhood, according to Salvador and Bourquin.
“We can say that both experiences live in separate (dissociated) memory stores and that the resources that Nina has in her current life ‘do not arrive’, and therefore do not affect the pain she experienced in her childhood,” they explain.
In psychotherapy, conditions must be created to restore trust in a human bond that offers affection, security and stability to the person, and that helps them know that we are all interdependent on others, and so that the resources available to them Today in their lives, they can reach and permeate the pain that they experienced alone in their childhood, they point out.
It’s about looking at that pain compassionately instead of burying it or escaping from it, and thus freeing yourself from that trauma, they add.
Healing is a process through which the person integrates their pain to extract a lesson from their experience, they conclude.
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