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Doc says dissociation is a coping mechanism... this confuses me


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I saw my psych last week and, as instructed by my T, told him about several episodes of dissociation I have had recently. I found each incident horrifying but one particular episode occured while I was driving and was extra terrifying.

My psych says that this is a coping tool. My mind's way of escaping an anxiety-filled situation.

The thing is, I have not had many dissociative episodes in the past and, yes, my anxiety is extremely high lately. But, dissociation, to me, is so scary and undesirable I do not understand how, even subconsciously, this would be designed to help me cope???

I have been terribly, terribly depressed lately and dealing with lots and lots of extra stress, both of which put my anxiety into overdrive. And, now I am terrified of having more of these dissociative episodes. HOW can I stop them? And, what am I supposed to do when they are happening.

For example, when driving a couple of weeks ago, my exit was closed. I had to take another route home. A route I had taken thousands of times. But, as I drove, I started panicking and feeling like I didn't know where I was or how I got there. :eek: Nothing looked familiar and I started feeling like I was somehow watching everything without actually being part of it. Does that make sense, at all?

I just do not understand how this could be a coping mechanism, at all????:confused::confused::confused:

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Dissociation is absolutely the worst part of anxiety for me. I live with it for 90% of my day, each day. It starts when I leave my house to drop off my kids and lasts until I pick up my wife at 7pm. It really, REALLY sucks... but, I do understand what it is and how it works, so that has really helped me deal with it. The first time it happened to me I was 7 years old. I was waiting for the bus and all of a sudden I had this wave of terror wash over me and I felt like nothing was real, like I was in some horrible nightmare world where there was no safety and no proof that the world was real. Sounds crazy, right? I was too young to adequately express what was wrong, plus, I didn't want anyone the think I was insane, so I just kept living with it. Long story short, it wasn't until my most recent episode of anxiety and stress that I found some answers. My wife and I just had our 3rd child and for some reason, it pushed me over the edge and back into panic and anxiety mode. I started having panic attacks on the freeway, then at work, then at home, then eventually everywhere I went. It was particularly frustrating because I'd been through all this and thought I was done with anxiety, but it turns out, it's just something I have to be aware of and deal with for the rest of my life. I have been able to deal with all of my symptoms, except for the dissociation... so I kept searching through books and the internet, and eventually found an article that explained the physiology behind this particularly disturbing symptom. I won't bore you with the details, but here's a brief rundown of what happens. When you get anxious, your body goes into defense mode, the fight or flight response, and a whole bunch of systems kick in to get your body prepared to protect itself: The heart beats faster to get blood to your large muscles so you can run away or fight off the danger; Your adrenal glands pump adrenaline into your system to give you more energy, and so on, but the dissociation comes from a couple of systems firing at once. The blood rushing to your large muscle pulls blood away from your brain making you feel light headed and surreal. Also, the blood vessels in your brain constrict which causes those unreal feelings, as if you're out of your body, or not in touch with your mind. It's the same thing that happens during a car accident when people say " it's as if the whole world slowed down and everything felt like a dream ". How is this a defense mechanism you may ask? It is simply a side effect of all the other systems working to protect your body. If you were really in danger, and not simply driving down a different route for example, your logical mind would make sense of those weird feelings by attaching them to an actual danger, such as a car accident, or an attack of some kind, but when they just hit you out of the blue, they produce more feelings of anxiety. You start to think things like "what the hell is wrong with me?" or "why can't I make this go away?". When you think things like that, your mind attaches meaning to the thoughts and they themselves become the danger. Does that make sense? Now, your frightening thoughts, or simply the anticipation of having those feelings again become your threat, and your body reacts to them, even if you aren't aware of it. So as far as what you can do to stop the feelings? Simply start letting them come, knowing full well you are in no danger. I know that sounds counter intuitive, but trust me it works. I've stopped fighting the sensations and in fact have been putting myself into situations that bring them on, because, for me, the only way to get over anxiety is to go through it. Not around it, over it, beyond it, just through it. I found a great website with tons of information about anxiety at paniccure.com. I suggest you look the site over and keep researching dissociation or depersonalizaion. I've also seen it called disassociation, so try several sites based on those titles. Also, take a look at a book by Barlow and Craske called Mastering your Panic and Anxiety ( I'm guessing at the title because it's in my baby's room right now! ). Most importantly, know that dissociation is completely normal, not at all dangerous, and it will go away.

Take care,


Edited by Mark
I misspelled Marlow as Maslow (it's actually Barlow (Mark))
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Wow, Jimmy, you certainly do have amuch better grasp on this phenomenon than me! Thank you for your insight and suggestions. I had read the stuff you wrote about how anxiety affects your body but I had never seen it explain dissociation (or disassociation.)

You definitely have a very good outlook on how to handle it and I intend to give the whole "just let it happen" thing a try and see what happens!

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The just letting it happen thing is tricky, but very effective. It's like using your opponents weight to defeat him. When the feelings come over you, you just let them consume you. The trick is learning to let it just happen, to not listen to your freaky thoughts, just acknowledge them, and let them flow. I think of thoughts like logs in a river. If you just notice the logs and let them flow on down the river, there's no problem. If you grab onto them, because they seem important, they will start to snag on each other and block up the whole river, then you have a flood. Not good... It's kinda zen, or whatever, but it's all about allowing things to flow... For most of us with anxiety, that is very hard, because we've never learned how to "let things go", because to an anxious person, everything we experience seems ultra important.

Another thing I've realized is how we are the only "animals" on the planet who have extreme anxiety. That is because we've been blessed and cursed with the ability to reason. To think things through. Animals in nature experience every moment fully, without much forethought and certainly without anxiety. Sure, a deer will get tense and hyper vigilant when it is drinking from a watering hole, because of the very real danger of a lion sneaking up behind it and killing it! But, once the danger has passed, it simply goes on with its day. Enjoying each moment. We on the other hand think about all that could have been, all that could happen, all we wished hadn't happend and so on... we are happiest when we just let life flow naturally, experiencing each moment and letting it live in our memory without consuming us. See where I'm going with all this? Your body has a natural "calm center" that it always wants to return to, but thinking can easily get in its way... If you learn to allow thoughts to just happen, you will naturally find that calm center again. It may take some time, and it may feel weird once you actually start feeling that calm center again, because you're so used to either being anxious or anticipating feeling anxious again.

Another thing you might want to look into is something I've found online by looking up "eliciting the relaxation response". I found a great relaxation "tape" on itunes... but look for what works for you.

One last thing, I do alot of "reprogramming" on myself. In other words, when I start feeling odd, or anxious, I repeat something to myself that is the opposite of what I habitually think... for instance, if I'm starting to stress out in traffic I may think " oh crap, I'm gonna freak out and lose control " I remind myself that I've never lost control, or blacked out, or lost touch with reality, and so on... I usually end up just repeating in my mind something like " let it flow, nothing bad is going to happen, I just might feel weird for a while ". Whatever feels right to you. Don't be afraid to experiment... After a while it starts to feel like a game. Like today, for me, I had all this stressful real estate crap to take care of, and instead of waking up dreading my day, I woke up and set my mind to treat the whole day like a game... to see how freaky I could feel and just let myself feel it. The funny thing is, once I adopted that mindset, I never freaked out... I'd get to a spot on the freeway where I usually get super stressed, and instead, since I was "looking forward to practicing letting go" I immediately let it go without even trying...

Be patient with yourself, and trust that it's going to be alright... because it will be.


Edited by jimmyfay2
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  • 5 weeks later...
Guest ASchwartz

Jimmyfay and all,

Yes, Jimmyfay, you seem to have a really good understanding of dissociation and some of the ways to deal with it. In fact, relaxation techniques are extremely worthwhile. Soft and pleasant music is a good way to let go of tension and relax.

Good stuff, Jimmy :)


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Dissociation is a coping mechanism even though it may seem like a weird one because people always thing that coping makes things better - it doesn't - it can be just a means of escape from something terrifying, and even though dissociation is also terrifying for many people, it isn't something chosen, so much as it is just something that happens.

Maybe it helps to think about other sorts of coping mechanisms like self-injury that are also weird in this same way. People do them to cope with something even more frightening, but the outward appearence of these things is that they are themselves frightening.

Derealization and depersonalization are aspects of dissociation. there are different ways it can take place. You can get that feeling like everything is inside-out but you are still more or less having the experience. You can just lose track of time (amnesia) and have no memory for an event. Sometimes dissociation manifests as odd physical symptoms such as that you cannot feel a body part. In severe cases, when dissociation occurs very early on in life you can develop a fragmented sense of self which manifests as dissociative identity disorder (e.g., multiple personality). It's considered a spectrum issue varying from mild to severe impact and intensity.

Dissociation is a means of avoiding having to feel something very painful, but at the same time, avoidance is what maintains anxiety problems. So dissociation helps keep people stuck in anxiety problems. That makes it a dysfunctional coping mechanism (although still a coping mechanism just the same).

anything people can do to bring themselves back to be able to face (and tolerate) whatever it is that they are afraid of is ultimately going to be in the direction of what is therapeutic. So things that help people come back to "earth"; things that feel grounding are helpful. This would be for the more "mild" sorts of dissociation (which believe it or not, derealizationa and depersonalization are categorized as). In the more severe dissociation problems, it's not so much about helping people feel comfortable and relaxed again, as it is to help them function in an integrated fashion.

Oh - that book by Barlow and Craske (mastery of anxiety and panic) is wonderful. We did a podcast interview with Dr. Craske recently - you can listen to that craske interview here

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Thank you, Mark for your detailed reply. I think this helps me understand better what my doc was saying. I still see dissociation (or derealization as a couple of you have referred to it) as extremely frightening but it happened to me again the other day. After reading your explanation, it makes a little more sense why my mind would choose this route. I guess it is an escape of sorts. I do tend to avoid or run from situations I expect to cause me anxiety or which does cause anxiety but some situations you simply cannot walk (or run) away from so I guess this is the caged mind's alternative? I really do not understand why it is happening to me more of late other than I have had a lot of extra anxiety lately. And, I haven't been able to see my T regularly and won't see her again until 12/3 so I do feel quite alone in all of this. :D

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