A therapist knows you're dissociating by noticing behavioral shifts like spacing out, sudden silence, blank stares, emotional flatness, or talking with gaps (lost time); they observe physical signs like shallow breathing or a vacant expression, and note discrepancies between your words and emotions, feeling detached or numb; sometimes they even notice their own mental fog or confusion, indicating you've "checked out" to cope with overwhelming feelings or trauma.
The DSS is a 20-item self-report instrument that assesses past-week symptoms of dissociation that are clinically relevant and moderately severe (i.e., not types of dissociation common only among either non-clinical populations or those with dissociative disorders).
The condition typically involves the coexistence of two or more personality states within the same person. While the different personality states influence the person's behaviour, the person is usually not aware of these personality states and experiences them as memory lapses.
Talking therapy. Talking therapies are the recommended treatment for dissociative disorders. Counselling or psychotherapy can help you to feel safer in yourself. A therapist can help you to explore and process traumatic events from the past, which can help you understand why you dissociate.
Recognising the signs of dissociation
When a person experiences dissociation, it may look like: Daydreaming, spacing out, or eyes glazed over. Acting different, or using a different tone of voice or different gestures. Suddenly switching between emotions or reactions to an event, such as appearing frightened and timid, then becoming bombastic and violent.
People who have experienced physical and sexual abuse in childhood are at increased risk of dissociative identity disorder. The vast majority of people who develop dissociative disorders have experienced repetitive, overwhelming trauma in childhood.
Findings revealed that therapists have strong emotional and behavioral responses to a patient's dissociation in session, which include anxiety, feelings of aloneness, retreat into one's own subjectivity and alternating patterns of hyperarousal and mutual dissociation.
Any kind of trauma can cause dissociation. This could be assault, abuse (physical, emotional, or sexual), natural disasters, military combat, war, kidnapping, invasive medical procedures, neglect, or any other stressful experience.
You might: Switch between different parts of your personality. Speak in a different voice or voices.
Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia).
How to Identify a Dissociative State. From an outside perspective, dissociation may look like daydreaming: someone with glazed eyes, inattentive demeanor, or deep in thought. Other times, it might manifest as heightened emotional responses, such as appearing frightened without an apparent threat.
Positive symptoms: derealization; (the mind detaches from one's environment), fragmentation of identity; , and depersonalization (the mind detaches from one's self) Negative symptoms: amnesia, altered consciousness (e.g., narrowed awareness, trance), altered behavior.
We can notice if a client may be dissociated if we look out for the following cues: If the client feels in a fog. The client consistently asks therapist to repeat the questions. The client feels as though they are a long way away.
[1] The result in such extreme cases is often a highly fragmented sense of life and self-identity that can lead to mental health problems such as depression, anxiety and suicidal thoughts.
Key Signs a Client is Dissociating in Therapy. Emotional Numbness: One of the foremost indicators is when clients become emotionally detached. This is not a mere distraction; they might feel as if they're observing themselves from afar. It's as if their feelings have been muted or switched off.
Dissociation can feel frightening because it often involves feeling detached from your body, thoughts, or surroundings. This can be sudden and unsettling, making it hard to feel in control. But it's important to remember that support is out there.
Unhealed trauma often appears as chronic people-pleasing, relationship struggles, anxiety, self-destructive coping, or persistent shame and emptiness. Trauma rewires the hippocampus, amygdala, and prefrontal cortex, affecting memory, emotion regulation, decision-making, and social interactions.
Also called psychotherapy, talk therapy is the main treatment for dissociative disorders. This form of therapy involves talking about your disorder and related issues with a mental health professional. Look for a therapist with advanced training or experience in working with people who have had trauma.
Any request for personal favors, suggestive remarks, inappropriate physical contact, or attempts to socialize outside of the professional context are not just therapist red flags—they are definitive breaches of ethics and trust. This relationship is singular, devoted solely to your mental health.
Your therapist will be willing to listen to your feelings and help you work through them, so don't feel ashamed about your emotions towards them. They understand transference is an essential phenomenon in therapy, and addressing it is vital for your healing journey.
Effective termination involves preparing the client, reviewing progress & consolidating gains to ensure they are equipped for the future. Encouraging reflection on successes & discussing potential future challenges helps clients maintain wellbeing & apply what they've learned beyond therapy.
Borderline personality disorder (BPD) and antisocial personality disorder are the most frequently diagnosed personality disorders.
Dissociation often feels good because it serves as the brain's natural defense mechanism against overwhelming stress, trauma, or emotional pain.
Focusing on the details of their environment can help pull their attention away from the feelings of dissociation. Ask them to pick an object and describe it in detail, using all of their senses. This can be a useful technique to help someone if you are on the phone with them while they are dissociating.