Rebecca Saunders (00:03.864)
Hello and welcome to the EMDR Doctor podcast. This is a podcast for clients where I share and explore information about all things EMDR.
My name is Dr. Caroline Lloyd. I'm a mental health GP and an EMDR practitioner. And my goal is to demystify EMDR or eye movement desensitization and reprocessing to help you on your EMDR journey. EMDR is a powerful therapy, which helps to reduce the distress from difficult memories. And my goal is to make it accessible to everyone. I hope you enjoy this episode. Hello, and welcome back to the EMDR Doctor podcast. I'm coming
to you from Wurundjeri land and I'd like to pay my respects to the elders past, present and emerging. Today I'm going to be chatting to you about dissociation. Many people might not have heard that term before or they may have heard it in just general terms and they don't know anything very much about it and certainly until I started working in mental health and learning about trauma and learning about EMDR I had very little idea about what it was all about.
In fact, one of my lovely early clients was really the impetus for me to start learning about mental health. And it was really because of their tendencies towards dissociation that I became a little bit interested in it and started to do some learning. The word dissociate is kind of the opposite of associate, which implies a connection or being close to something. So to dissociate is to distance or move away from
or lose connection with something. And in mental health terms, this is losing connection with reality or losing presence from the moment of now. And we can dissociate from thoughts and feelings and memories and identity. And I'll talk a little bit more about all of those things. But the first thing I will say about dissociation is that it is a wonderful thing. It is, in my view, one of the most amazing things that a brain can do.
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It's one way that a person's brain spontaneously protects itself from reality or from further pain and changes the level of the conscious state. And we often learn it as a child when a situation is anxiety provoking or distressing or horrific and we are not able to fight and we are not able to take flight or run away. So in effect, our brain runs away and becomes not present so that the
awful experience is bearable in the short term. Like many things, dissociation has a continuum from a mild dissociative state, which might present with a feeling of slight fogginess or a feeling of not quite being present or not quite here, to complete unawareness of the present or of the self. And at this end of the spectrum, we get dissociation from parts of self.
And this is called DID or dissociative identity disorder, which is when particularly horrible events cause the personality to become fragmented into different identities, which sometimes hold particularly awful memories or experiences and have a distinct and separate identity from each other. Today, I'm not going to talk about DID as it's a big topic and I really can't do it justice just by mentioning it within this episode.
But it is a favorite topic of mine, so I might at some stage do a podcast episode just on DID, but not today. Most people in the world have experienced dissociation. They just might not call it that. So we dissociate from the present when we watch an engrossing movie and we find ourselves caught up in it and we're experiencing the emotions created by the movie. So we are in effect
not present in the current time, we are in the world of the movie. So we have dissociated from the current, the present moment into the world of the movie. And we can experience all the emotions that are created by the movie and not be aware of current time. We can dissociate when we drive home on a familiar route, when we don't have to think about the route. And then when we get home, we can't remember the drive.
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Truck drivers have a name for this, white line fever or highway hypnosis. And this is really, really common. We might dissociate from our emotions when we feel intense emotions, but we have to do something important. For example, we might feel very afraid of speaking on a stage, but we know we just have to do it. So at some point we kind of go numb and go on autopilot and we start our speech.
And then suddenly we're finished and we realise the audience is clapping and we're done and we've dissociated for that period of time where we've given our speech, but we've been able to do it, but we've just dissociated from that feeling of anxiety. We can dissociate from parts of our body, feeling that our feet are numb or our head is floating separate from our body or something similar to that. So dissociation can help us not feel
our emotions, not feel our body, or not remember things that are too distressing to cope with. And these are all amazingly valuable ways that our brains help us cope with daily life and not feel the distress associated with a situation or a memory. So I'll talk a little bit about dissociating memories. So there can be certain times in a person's timeline of their life which is dissociated.
And that means that the memories from that period are lost or unavailable. You could think of those memories as being say behind a dissociative wall, kind of segregated from the main part of our consciousness. So we have the memory, we just can't recognise it, we can't think about it, we can't experience that memory. Many people who come to me have periods of their life from
which the memories are dissociated. So they might not be able to remember any memories, say, from before they were 12 years old. And whilst this is often very protective, it can be disturbing, and people often want to and try to regain those memories. And can we do that? Sometimes. I don't make any promises because we can't really guarantee that kind of memory retrieval, but
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EMDR can be a way to break down the dissociative barrier to those memories. Sometimes we might have flashbacks to a tiny fragment of a memory or a trigger that takes us to an awareness of a previous experience, but we can't remember the memory or the detail of the experience. And we have to be a little bit careful as to when and how we do try and explore that.
as we want to know that we are strong enough to cope with any memories that do come up. And sometimes, usually, there is an excellent reason why those years of memory have been dissociated, why those memories have been locked away and are unavailable. And I do also believe, and I can't say this with any scientific proof, but
There may be a difference between memories that we do have, but they are dissociated and unreachable. And maybe memories that we just didn't lay down at the time when they were happening. So from that period of time when the distress was too high, it didn't actually allow the brain to formulate the memory and make those neural connections. So we may not be able to recover memories because
because they just aren't there. So we may find that in preparing to do EMDR, we do the work of becoming strong enough and mentally resilient enough to go there, but there's actually nothing to find in a way. And when that happens, it can be upsetting, but then the work lies in coming to terms with having blank spaces of life where memories were expected to be, but we can't find them and we can't recognise them.
A couple of medical terms for types of dissociation include depersonalization and derealization. There's a little bit of a difference between the two. Sometimes they are just clumped together, but there is a difference. Depersonalization is when we don't feel that we are real. We might feel like we're a pretend person or a ghost or an illusion, or we might feel that we are looking at ourselves or we don't feel
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within ourselves, we don't feel we are ourselves. And this can be pretty distressing the first few times it happens if we don't know what it is. So the other version of this real versus not real feeling can be derealization, when we don't feel that the world is real. So depersonalization is not feeling like we are real.
Derealization is when we don't feel that the world is real. So people often describe derealization as a feeling like they are real, but they're living in a video game, or they might feel like they're in a Matrix world, or sometimes another way I've heard it described is that people feel like they're living on a set of a movie. So we feel real, but the world we are in doesn't feel real. So these states are often quite temporary.
Sometimes just momentary, sometimes they last all day, but they are temporary. They happen in periods of increased stress or if we get overwhelmed with too many difficult things. So especially if that's the first time that it happens to us, the sensation of not being real or the world not being real can be quite disturbing. And what we need to know right then.
is that it's just our brain altering our perception of reality in order to help us. It's a kind of a protective mechanism and it won't last and that we can help ourselves manage it with some simple strategies which I'll just mention now. So if dissociation is getting in the way of daily life and it's bothersome then it probably is a good idea to work with a therapist to find some good ways that
are personalised to you to help manage it. And everyone's individual so people just like different things. So in general, stress reduction is great. Make sure that you're getting enough sleep, make sure that you're getting some good exercise. And lots of people do find that strenuous exercise really does help to decrease the adrenaline levels and lower the cortisol levels and lower levels of stress.
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or maybe meditation or relaxation exercises or self-hypnosis, both as part of your daily routine and also as a kind of a rescue strategy for relaxation. So some of these rescue strategies include things like box breathing, short visualizations, VU breathing. And if you're curious about that one, have a look on YouTube. There's lots of...
lots of demonstrations of VU breathing, that's V00. EFT or tapping can be really great. All of these things are really easily learned and they help you to reduce stress in just minutes. So in the moment when you are experiencing dissociation, grounding exercises help us feel more present. And some examples of grounding exercise include
Holding ice in your hand or drinking iced water. Splashing your face with cold water. Holding a stone or one of those little sort of prickly fidget toys. Patting a pet. A strong hug from a friend or you can hug yourself. Just wrap your arms around your upper arms and hug yourself strongly. Smelling aromatherapy scents.
singing out loud, tossing a ball, doing little mathematical sums like seven times nine or something like that. Spelling words backwards can be a great way to get the thinking brain back online. So you can try some or all of these strategies and I'd really encourage you to have a few favorites that you practice regularly so that you can try a few and see what works for you in the moment.
Sometimes one will work one day and another is great the next day. But sometimes it's hard to think of strategies in the moment when you need them most. So keeping a list on your phone can be a really great way to have them available to you when you need them. And now I just want to talk briefly about dissociation during EMDR. Some people are really worried that they'll dissociate during an EMDR session. And yes, this does sometimes happen because with EMDR we
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do go towards those difficult memories. And sometimes that can feel a bit much and dissociation is there and present for some people. So it does happen. Most EMDR practitioners are very familiar with dissociation and how to manage it. And sometimes a little bit of dissociation within a session is just fine and we can proceed with the processing. And sometimes we need to take a little pause.
and we just need to allow the brain to gently rest for a minute. And when the dissociation passes, then we can just gently reevaluate where we are and what direction to go to from there. And we might use some grounding techniques to give the brain a chance to divert from that major area of distress and to regroup and to recover. And all of that is absolutely fine. Sometimes we don't.
expect dissociation in an EMDR session and then there it is. And sometimes we expect it and it doesn't arrive. And any way that happens is absolutely fine. So dissociation is definitely not a reason that you can't do EMDR. If it comes along, we cope with it. We use our strategies. It can be a really great learning experience and
reinforcing that our brains are capable of doing hard things and sometimes dissociation is really helpful. So if you would like more information about dissociation, there is a great Australian website, di.org.au that has some lovely explanations about dissociation or origin.org.au which is one of our local
youth focused organisations in Australia. Or if you really want to do a deep dive with a really good book, then there's a book called Dissociation Made Simple by Jamie Merrick and it has lots of examples and it's a really easy read with some really great information and that does go into quite a lot of detail about DID and the more pronounced forms of dissociation. So it has great information for
Rebecca Saunders (16:10.417)
all ends of the spectrum. So I hope that this has been interesting or helpful for you. If you want to contact me, feel free to do so via my email admin at therapyness.com.au or reach out to me via my website emdrdoctor.com.au. I hope this has been helpful. I will chat to you again next week. Have a great week. Bye for now.
