Dissociation is a disconnection between parts of experience that usually work together, such as your thoughts, feelings, memories, body sensations, surroundings, and sense of who you are. It can range from completely ordinary moments, like driving home and not remembering the last few kilometres, to intense experiences of feeling unreal, detached from your body, or unable to remember significant periods of time.
The American Psychiatric Association describes dissociation as a disruption or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behaviour (American Psychiatric Association, 2022). In plain terms, parts of experience that normally feel connected can temporarily come apart.
Dissociation is common, often misunderstood, and highly responsive to the right kind of support. This guide explains what dissociation is, the different forms it can take, what causes it, when it may be a concern, and how it is treated.
Is dissociation normal?
Yes, to a point. Mild dissociation is part of everyday life. Daydreaming, getting so absorbed in a book or film that you lose track of time, or zoning out during a repetitive task are all common forms of what researchers sometimes call normal or non-pathological dissociation.
Dissociation becomes a concern when it is frequent, intense, distressing, difficult to control, or interferes with daily life, relationships, safety, or memory.
What does dissociation feel like?
People describe dissociation in many ways. Common experiences include:
Feeling numb, empty, or emotionally “switched off.”
Feeling as though you are watching yourself from outside your body.
Feeling like your body, hands, or voice do not belong to you.
Feeling that the world around you is foggy, dreamlike, flat, distant, or unreal.
Losing track of time, or “coming to” without being sure how you got somewhere.
Gaps in memory for everyday events, conversations, or periods of time.
Feeling disconnected from your emotions while describing something painful.
A sense of being on autopilot.
Feeling like different parts of you think, feel, or act in conflicting ways.
Many people find dissociation hard to put into words, and some do not realize that what they experience has a name.
Types of dissociation
Depersonalization
Depersonalization involves feeling detached from yourself, your thoughts, your emotions, or your body. People often describe it as feeling like a robot, observing themselves from a distance, or feeling that they are not really there.
Derealization
Derealization involves feeling detached from your surroundings. The world may seem foggy, two-dimensional, artificial, or as though you are behind glass. Familiar places or people may feel strange.
Depersonalization and derealization often occur together. Brief episodes are common, particularly during intense stress, panic, sleep deprivation, or substance use. When they are persistent or recurrent and cause significant distress, a person may meet criteria for depersonalization-derealization disorder. A 2023 systematic review found that this condition affects around 1% of the general population, with much higher rates in people receiving mental health care (Yang et al., 2023).
Dissociative amnesia
Dissociative amnesia involves gaps in memory that go beyond ordinary forgetfulness, often related to stressful or traumatic experiences or to important personal information.
Identity-related dissociation
Some people experience a sense of separate or disconnected parts of self, with shifts in feelings, behaviour, or memory. In its most significant form, this is diagnosed as dissociative identity disorder (DID). DID is a real and recognized condition, although it is often misrepresented in films and on social media.
What causes dissociation?
Dissociation is often understood as a protective response. When an experience feels overwhelming and escape is not possible, the mind may create distance from it. In the moment, this can reduce emotional or physical pain. Over time, however, dissociation can become an automatic response to stress, even when danger has passed.
Common contributors include:
Trauma. Dissociation is strongly associated with traumatic experiences, especially repeated or early trauma such as childhood abuse or neglect. Researchers have described a dissociative subtype of posttraumatic stress disorder, in which people respond to trauma reminders with detachment and numbing rather than only with hyperarousal (Lanius et al., 2010).
Severe stress and anxiety. Panic attacks, extreme stress, and high anxiety can trigger depersonalization or derealization.
Other mental health conditions. Dissociation appears across many conditions. A meta-analysis of studies using a widely used dissociation questionnaire found elevated dissociation in nearly all psychiatric conditions studied, with the highest levels in dissociative identity disorder, PTSD, and borderline personality disorder (Lyssenko et al., 2018).
Sleep deprivation and exhaustion. Lack of sleep can increase feelings of unreality.
Substances. Alcohol, cannabis, ketamine, and other substances can cause or worsen dissociative experiences.
Medical causes. Some neurological conditions, such as certain types of seizures, as well as other medical issues, can cause symptoms that resemble dissociation. It is important to speak with a doctor about new or unexplained symptoms.
Dissociation and trauma: why the link matters
Not everyone who dissociates has experienced trauma, and not everyone who has experienced trauma dissociates. But understanding the link can be validating. Many people who dissociate have spent years believing they are “lazy,” “spacey,” “forgetful,” or “cold,” when in fact their nervous system learned to protect them by disconnecting.
Recognizing dissociation as a survival response, rather than a personal flaw, is often an important first step in healing.
When is dissociation a concern?
It may be worth speaking with a professional if dissociation:
Happens often or lasts for long periods.
Causes distress, fear, or confusion.
Leads to memory gaps that affect work, school, or relationships.
Makes it hard to stay present during conversations, intimacy, or important tasks.
Occurs in situations where it may be unsafe, such as while driving.
Is connected to past trauma or ongoing stress.
Comes with thoughts of self-harm or suicide.
How is dissociation treated?
Dissociation is treatable. Treatment usually focuses on understanding what triggers dissociation, building a sense of safety in the present, and, when appropriate, addressing underlying trauma or stress.
Approaches may include:
Psychoeducation. Learning what dissociation is and why it happens can reduce fear and shame.
Grounding and stabilization skills. These help people reconnect with the present moment and their body.
Trauma-focused therapy. When dissociation is connected to trauma, therapy approaches that address trauma, often delivered in phases that prioritize safety and stability first, can be helpful.
Treating related conditions. Addressing anxiety, depression, PTSD, sleep problems, or substance use can reduce dissociative symptoms.
Your therapist will work with you to find a pace and approach that feels safe.
Grounding techniques for dissociation
Grounding techniques can help bring your attention back to the here and now. They tend to work best when practised regularly, not only during difficult moments.
Orient to the room. Slowly look around and name what you see: the colour of the walls, the shape of a window, the time on a clock.
5-4-3-2-1. Name five things you can see, four things you can hear, three things you can touch, two things you can smell, and one thing you can taste.
Feel your feet. Press your feet into the floor and notice the support beneath you.
Name the facts. Say quietly or in your head: “My name is ___. I am in ___. Today is ___. I am safe right now.”
Move gently. Stretch, shift your posture, or walk slowly, noticing each step.
Use a comforting object. Hold something with an interesting texture, or notice a familiar, pleasant scent.
Breathe slowly. Gentle, slightly longer exhales can help settle the nervous system.
If grounding does not help, or if dissociation feels overwhelming, reach out to a therapist or trusted person.
Frequently asked questions about dissociation
Is dissociation the same as zoning out?
Zoning out is a mild, common form of dissociation. Dissociation becomes clinically significant when it is frequent, intense, distressing, or disruptive.
Can anxiety cause dissociation?
Yes. High anxiety and panic attacks can trigger depersonalization and derealization. These experiences are frightening but are not dangerous in themselves.
Does dissociation mean I am going crazy?
No. Dissociation is a recognized response of the mind and nervous system, often to stress or overwhelm. Many people fear they are “losing it,” but dissociation is common and treatable.
Is dissociation always caused by trauma?
No. Trauma is a common contributor, but dissociation can also be linked to anxiety, sleep deprivation, substances, and other factors.
How long does dissociation last?
Episodes can last seconds, minutes, hours, or longer. For some people, dissociation is ongoing and persistent.
Can dissociation go away?
Yes. With support, many people experience significantly less dissociation and feel more present and connected.
Reflection questions worth exploring
These prompts are best explored with a professional rather than used to reach conclusions on your own.
When do I tend to feel disconnected or unreal?
What was happening just before I last dissociated?
How do I usually come back to the present?
Are there memories or experiences I find hard to stay present with?
What helps me feel safe in my body?
Support at Vive Wellness Therapy
At Vive Wellness Therapy, we provide trauma-informed support for people who experience dissociation, whether it is occasional depersonalization during stress or a long-standing pattern linked to past experiences. We work at a pace that feels safe, helping you understand your symptoms, build grounding skills, and reconnect with yourself and your life. If you would like support, we would be glad to hear from you whenever you feel ready.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010). Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. American Journal of Psychiatry, 167(6), 640–647. https://doi.org/10.1176/appi.ajp.2009.09081168
Lyssenko, L., Schmahl, C., Bockhacker, L., Vonderlin, R., Bohus, M., & Kleindienst, N. (2018). Dissociation in psychiatric disorders: A meta-analysis of studies using the Dissociative Experiences Scale. American Journal of Psychiatry, 175(1), 37–46. https://doi.org/10.1176/appi.ajp.2017.17010025
Yang, J., Millman, M., David, A. S., & Hunter, E. C. M. (2023). The prevalence of depersonalization-derealization disorder: A systematic review. Journal of Trauma & Dissociation, 24(1), 8–41. https://doi.org/10.1080/15299732.2022.2079796
This article is provided by Vive Wellness Therapy for general informational and educational purposes only. It is intended to be used alongside professional therapy and medical care and is not a substitute for assessment, diagnosis, or treatment by a qualified health professional. New or unexplained symptoms should be assessed by a doctor. Research and clinical guidance evolve over time, and information in this article may become outdated or contain inaccuracies. If you are in crisis or thinking about suicide, call or text 9-8-8 (Suicide Crisis Helpline, available 24/7 across Canada; in Quebec, calls connect to 1-866-APPELLE). If you or someone else is in immediate danger, call 9-1-1 or go to your nearest emergency department.
