"I can't remember what I’m doing in the basement – I think I came down to get something" 

"Wow, I'm home already.  But I don't remember driving all this way; the last thing I remember is that stop light half an hour from here!" 

"I can't recall – did I drive to work today…or walk…it is so nice out." 

"Yesterday….yesterday, I think I went to work, but….I can't remember exactly." 

"The dream, it's always the same, bright lights, loud noises, I wake up sweating, my heart pounding." 

"You know, I can't seem to remember anything that happened to me from first grade through fifth grade.  It feels strange?" 

Dissociation is a process of separating one part of your inner self from the others.  The example you have probably heard about most is post-traumatic Stress Disorder – commonly seen in war veterans who suddenly begin to have flashbacks, to waken in the night shaking, sweating, screaming, who avoid certain people or places, who begin to withdraw from their loved ones.  In cases like these, the memory of some wartime event or events which at the time were too terrible for the individual to process spontaneously, have been splintered off, stored in an isolated place in memory – becoming inaccessible to the normal process of thinking about and dealing with stressful events, and eventually becoming intrusive – essentially leaking into daily life in an uncontrolled way.  We call this type of storage "state-dependent memory", and in this extreme case such memories are inaccessible except when your defenses are down or something recalls the conditions under which they were stored. 

We all have instances of state-dependent memory and learning in our daily lives – something we were struggling to recall suddenly comes to us clearly when we are in a location that is similar to where we originally had the experience, or when a similar smell or sound riggers it, or even when we enter a similar mood or chemically altered state!  Memories are stored as a package deal and are associated in our minds with things that happened concurrently.  In the case of trauma, the hugeness of the trauma blocks out anything else, and for some individuals, it causes the memory to be stored immediately and completely in a "safe place" and ostensibly forgotten – until something taps into it.  If the event were processed consciously the way we process most stressful events – by talking it out, by thinking it over, etc., it would remain available for further processing until it began to hurt less.  But when a memory is stored in isolation and never processed, dissociation has occurred and physical and/or psychological symptoms are likely to ensue. 

Dissociation of memory, dissociation of parts of our behavior, dissociation of aspects of personality are all things about which most of us read, but experience only in minor instances – spacing out and not hearing the phone ring when we are engrossed in a novel or not remembering why we walked over and opened the fridge or looking blankly at a familiar face and having no name to put to it.  But for some, the tendency to dissociate is a pattern; they may even be born with that ability to segregate certain thoughts, emotions, and behaviors very effectively from others.  This can be a useful trait if you are in the middle of a trauma and need to act rationally to stay alive or need to distance yourself from the event even to live through it, but it can be a problem later when you suddenly discover that what you had "forgotten" by storing it in isolation from everything else, still exists and affects your behavior.  For most people, a car accident, often a traumatic experience, haunts their minds quite often at first, replaying itself with less and less impact until eventually it can be thought about without a racing heart.  For individuals who have dissociated the crash, though, there is a different experience – that of not remembering much of anything about the event but being haunted by it at random instances always with the same intensity of emotional and physiological arousal.

Less common are instances of dissociation of entire aspects of the self – what was once called "multiple personality disorder" is now more accurately termed "dissociative identity disorder", indicating the similarity with PTSD.  In the case of DID, individuals who have experienced severe trauma split off the aspect of themselves which was traumatized in an attempt to survive.  They may also split off various other aspects over time – aspects developed as coping mechanisms to continued trauma.  The individuals experience amnesia can involve entire personalities or simply voices or thoughts which appear to come from another aspect of the self.  Dissociative symptoms include amnesia, periods of time unaccounted for, feeling unfamiliar with one's surroundings or even one's own body. 

The ability to dissociate is a trait – an aspect of personality.  It can be used adaptively, to survive trauma, or maladaptively, to avoid feelings.  Memories previously dissociated often cause problems in current behavior.  In therapy, these memories are gradually brought to consciousness.  Then they can be processed as they would have been had the dissociation not occurred.  It is important to realize that painful memories are repressed for a reason.  Sometimes they do not surface until a great deal of safety in the therapeutic environment is provided.  Dissociation is one of the mind's many ways of protecting itself, and the work is done with respect for the safety needs of the client.  The experiencing of severe symptoms is one way of determining that the work of uncovering the painful memories needs to be done to stop the problems which are occurring.  Observation of the changing pattern of symptoms guides the client and the therapist as to how much uncovering work is necessary.  Sometimes once begun, the process continues to unfold safely and gradually without further assistance.  Other times professional guidance is necessary for a longer time.  The safety and comfort of the client is primary in planning a course of treatment for dissociative symptoms. 

When we discuss dissociation, the topic of "repressed memory" inevitably arises.  While there continues to be debate even amongst professionals about whether memories can indeed be repressed, the existence of dissociative disorders presents strong evidence that they can.  The more significant issue is whether such repressed memories should be uncovered and if uncovered, what should be done about them.  The short answer is that many repressed memories, though not all, should indeed be uncovered in order to create a more adaptive pattern of functioning in the individual. Some people heal from repressed traumatic memories without recalling them completely.  Others need to remember in greater detail to produce the rethinking process described above which helps decrease the emotional impact of the memory of the event. 

When clients inquire about therapy for depression or anxiety or even for processing trauma, they are not taken into treatment to seek repressed memories.  If during treatment, it becomes clear that there is a memory or dissociation which is interfering with the client's functioning or ability to recover, then and only then will the repressed or dissociated material be sought for active therapeutic intervention.  I am experienced in the safe, effective treatment of dissociative symptoms and I invite you to phone and discuss your options for treatment.