Dissociation in BPD is a stress-related defense mechanism involving temporary detachment from reality, self, or memories, often manifesting as feeling "in a fog," out-of-body experiences (depersonalization), viewing the world as unreal (derealization), gaps in memory (amnesia), or identity confusion.
For someone with BPD, dissociation can feel like slipping into a fog, losing touch with who they are, or even feeling disconnected from their body. This experience reflects a deeper struggle: the lack of an integrated sense of self.
Dissociative symptoms are a criterion of BPD; features may include 'psychotic-like symptoms (e.g., hallucinations, body-image distortions, ideas of reference, hypnagogic phenomena) during times of stress' and 'self-mutilation may occur during dissociative experiences' (American Psychiatric Association, 2013).
Whether you're dissociating depends on your experiences, but it often involves feeling detached from yourself, your emotions, or reality (like being in a dream or movie), experiencing memory gaps, or feeling like you're outside your body, often as a stress response to trauma or overwhelming situations. Mild dissociation can be daydreaming, while severe forms involve identity confusion or amnesia; seeing a professional for diagnosis is key if you're concerned.
During a BPD episode, a person may display signs such as extreme anger, paranoia, or overwhelming sadness. They might lash out emotionally or withdraw completely. Episodes can also include impulsive behaviors, such as self-harm, reckless spending, or substance use, as a way to cope with their intense feelings.
Adult patients with BPD experience a wide range of other psychotic symptoms in addition to AVH, including hallucinations (11% visual hallucinations, 8% gustatory hallucinations, 17% olfactory hallucinations, 15% tactile hallucinations [19]), thought insertion (100%), thought blocking (90%), being influenced by another ...
BPD Meltdown
During a meltdown, people may experience extreme mood swings, impulsivity, and difficulty calming down. Understanding how BPD contributes to meltdowns is crucial for developing coping strategies and providing support to manage and navigate these overwhelming emotional experiences.
Symptoms of dissociative disorders
Symptoms and signs of dissociative disorders depend on the type and severity, but may include: feeling disconnected from yourself. problems with handling intense emotions. sudden and unexpected shifts in mood – for example, feeling very sad for no reason.
Therapists notice things like blank stares, vacant looks, or repeated movements that signal dissociation. You'll describe how it feels, maybe like watching yourself from outside or feeling emotionally numb. Together, you explore what emotions, thoughts, or situations spark these episodes.
If you have DID, you might feel or experience the following:
Here are some examples:
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.
How can I help myself in the longer term?
Examples of Mild Dissociation
Recent qualitative analyses led to a more elaborated definitions of emptiness including: “a sense of going through life mechanically, purposelessly and numbly, with a psychological and bodily felt inner void, together with a sense of disconnectedness from others” (Herron and Sani, 2022, p. 193).
You might: Switch between different parts of your personality. Speak in a different voice or voices.
Because therapy is such a personal thing, what you tell a therapist must remain confidential. This includes things like affairs, past crimes, and "bad behavior" that isn't necessarily criminal behavior. You can talk to a therapist about how you were abused in the past, and they will not share that information.
Clients often dissociate from their physical state (as being in the body can be extremely difficult for survivors of trauma). It is helpful for the therapist to bring the client back to their body, so that the client can connect with their embodied experience of the trauma.
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.
Focus on Your Senses
Engage your senses to come back to the here and now. Hold a cold ice cube, feel the texture of an orange peel, or listen to your favorite song. These sensory experiences can help bring you back to reality.
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.
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.
People with borderline personality disorder have a strong fear of abandonment or being left alone. Even though they want to have loving and lasting relationships, the fear of being abandoned often leads to mood swings and anger. It also leads to impulsiveness and self-injury that may push others away.
Common symptoms of BPD psychosis include: Visual hallucinations. Gustatory hallucinations (strange or unpleasant tastes) Olfactory hallucinations (smells and aromas that aren't actually present) Tactile hallucinations (feeling someone or something touching a person's skin or beneath the skin)
These thoughts may spiral into thought patterns like, "She probably hates me," or "I'll never have a friend who sticks by my side." With these spiraling thoughts come spiraling symptoms, such as intense emotions, anger, and urges to self-harm.