Dissociation is a normal human response to intense emotions or even to boredom.  Everyone dissociates to some extent, but children who have experienced multiple traumas are high risk for dissociative disorders.  As children or adults, they may regularly shut down or space out, or they may become hyper and extremely silly or behave in other ways that appear strange.  In severe cases of dissociation, traumatized individuals (adults or children) may exhibit fast changes in their emotions and behaviors.  Hollywood has dramatized dissociative disorders with movies like Sybil and The Three Faces of Eve.  I believe these dramatic portrayals have increased the stigma and shame around the problem and prevented many people from seeking and receiving proper treatment.

Individuals with dissociative disorders first learned to dissociate as young children, in order to avoid becoming overwhelmed by intense fear or distress.  This is a response that is self-protective and, in a way, sensible.    When dissociation becomes a hard-wired pattern, it serves to help individuals avoid the distress related to feelings and memories.  Such avoidance is problematic, as it can prevent sufferers from being able to work through and resolve traumatic memories.  Over time, dissociation can become a habitual response to any sort of stress, which can lead to problems in functioning in daily life.

Attachment relationships protect us from the effects of stress and trauma.   Individuals with dissociative disorders almost always struggle with feeling safe and secure in their attachment relationships.   Therapy should always include relationship help.  Parents should be guided in increasing emotional attunement and support.  Dissociative disorders in both children and adults should never be dramatized or pathologized.  The focus should always be on the whole person and not on separateness between parts of self.

Guided visualization can assist in developing a sense of safety for younger parts of self and strengthening the “front part” or “most mature” self.   Any “parts work” or dialoguing with parts of self should take place only after making sure the individual has access to feelings of competence and strength, is grounded in the present, and feeling safe.