Recognising Dissociative Symptoms:
Dissociation is a complex, adaptive response to trauma, often misunderstood or overlooked in professional settings. Individuals who have experienced severe, prolonged trauma—particularly in childhood—may develop dissociative symptoms as a means of psychological survival. This guide provides key indicators of dissociative disorders and offers insights into how professionals can engage with individuals in a supportive, non-pathologising manner.
1. Inconsistent Memory & Gaps in Time
• Reports of lost time or missing details of daily activities.
• Recollections of past events that change over time or appear contradictory.
• Difficulty remembering personal history or significant life events.
Professional Consideration:
Rather than assuming dishonesty or manipulation, recognize that memory fragmentation is a hallmark of trauma-related dissociation. Approach inconsistencies with curiosity, not skepticism.
2. Sudden Shifts in Personality, Mood, or Behavior
• Noticeable changes in tone of voice, posture, facial expressions, or energy levels.
• Episodes of childlike behavior, hyper-maturity, or extreme detachment inconsistent with the person’s usual presentation.
• Switching between different speech patterns or referring to themselves as “we” rather than “I.”
Professional Consideration:
Instead of questioning the authenticity of these changes, focus on understanding what environmental or internal triggers may be activating these shifts.
3. Depersonalization & Derealization
• Expresses feeling disconnected from their body or emotions (“I don’t feel real”).
• Reports feeling as though they are watching themselves from the outside.
• Describes the world as distant, foggy, or dreamlike.
Professional Consideration:
Grounding techniques, such as sensory awareness exercises, can help reorient individuals experiencing dissociation. Avoid forcing immediate engagement, as this can increase distress.
4. Identity Confusion & Fragmentation
• Struggles with defining personal identity, preferences, or sense of self.
• Confusion about age, name, or aspects of their own history.
• Distress over conflicting thoughts, emotions, or behaviors they don’t recognize as their own.
Professional Consideration:
Validate their experiences without pressure to “explain” them. A sense of internal conflict is common and should be approached with patience and acceptance.
5. Physical Symptoms Without Clear Medical Cause
• Chronic pain, headaches, or fatigue with no identifiable medical explanation.
• Unexplained injuries or self-inflicted harm with no memory of how they occurred.
• Reports of feeling physically different at times (e.g., different handwriting, altered perceptions of body size).
Professional Consideration:
Recognize that dissociation can extend to the body, sometimes leading to pain insensitivity or altered physical awareness. Be mindful of this when assessing medical complaints.
6. Automatic Responses to Stress & Triggers
• Freezing, shutting down, or zoning out mid-conversation.
• Non-responsiveness or delayed reactions when asked direct questions.
• Expressions of fear or distress without an apparent immediate cause.
Professional Consideration:
Instead of pushing for immediate answers, use a calm, gentle approach. Give individuals space to regain a sense of safety before expecting engagement.
7. Trauma-Informed Engagement: Do’s & Don’ts
✔ Do:
✅ Build trust through consistency and non-judgmental interactions.
✅ Use grounding techniques to help bring individuals back to the present.
✅ Offer choice and control, as dissociation is often linked to past powerlessness.
✅ Validate experiences without requiring immediate explanations.
❌ Don’t:
🚫 Assume inconsistencies are intentional deception.
🚫 Force eye contact or immediate verbal responses.
🚫 Use confrontational questioning that may trigger further dissociation.
🚫 Treat dissociation as a sign of non-compliance or avoidance.
Final Thoughts
Dissociation is not a disorder of deception—it is a disorder
By Jen Grace