This is Crazy Talk: An advice column for honest, unapologetic conversations about mental health with advocate Sam Dylan Finch.While he’s not a certified therapist, he has a lifetime of experience living with obsessive-compulsive disorder (OCD). He’s learned things the hard way so that you (hopefully) don’t have to.

Got a question Sam should answer? Reach out and you might be featured in the next Crazy Talk column: sfinch@healthline.com


Hi Sam, I’ve been working with a new therapist to deal with some traumatic events that happened when I was a teenager. We talked a little about dissociation, and how I tend to “check out” emotionally when I’m triggered.

I guess what I’m struggling with most is how to stay present when I’m alone. It’s so much easier to disconnect when I’m by myself and in my own little world. How do you stay present when there’s no one there to snap you out of it?

Wait a minute!

You said that there’s no one to help you “snap out of” dissociating, but I want to remind you (gently!) that that’s not true. You have yourself! And I know that doesn’t always seem like enough, but with practice, you might find that you have more coping tools at your disposal than you realize.

Before we get into what that looks like, though, I want to establish what “dissociation” means so we’re on the same page. I’m not sure how much your therapist filled you in, but since it’s a tricky concept, let’s break it down in simple terms.

Dissociation describes a type of psychological disconnect — so you were right on the money when you described it as “checking out”

But it’s more than just daydreaming! Dissociation can impact your experience of identity, memory, and consciousness, as well as affect your awareness of yourself and your surroundings.

Interestingly, it shows up in different ways for different people. Not knowing about your particular symptoms, I’m going to list out a few different “flavors” of dissociation.

Maybe you’ll recognize yourself in some of the following:

  • flashbacks (re-experiencing a past moment, particularly a traumatic one)
  • losing touch with what’s going on around you (like spacing out)
  • being unable to remember things (or your mind “going blank”)
  • depersonalization (an out-of-body experience, as though you’re watching yourself from a distance)
  • derealization (where things feel unreal, like you’re in a dream or a movie)

This is different from dissociative identity disorder (DID), which describes a particular set of symptoms that include dissociation but also results in a fragmenting of your identity (put another way, your identity “splits” into what most people refer to as “multiple personalities”).

Most people think dissociation is specific to people with DID, but that isn’t the case! As a symptom, it can show up in a number of mental health conditions, including depression and complex PTSD.

Of course, you’ll want to talk to a healthcare provider to pinpoint exactly why you’re experiencing this (but it sounds like your therapist is on the case, so good on you!).

So how do we begin to pivot away from dissociation and work on developing more effective coping skills?

I’m glad you asked — here are some of my tried and true recommendations:

1. Learn to breathe

Dissociation is often triggered by the fight-or-flight response. In order to counteract that, it’s important to know how to self-soothe through breathing.

I recommend learning the box breathing technique, which has been shown to regulate and calm your autonomic nervous system (ANS). This is a way to signal to your body and brain that you’re safe!

2. Try some grounding movements

I hate recommending yoga for people because it can come across as trivializing.

But in this particular instance, body work is so important when we’re talking about dissociation! In order to stay grounded we need to be present in our bodies.

Restorative yoga is my favorite way to get back into my body. It’s a form of gentler, slower-paced yoga that allows me to stretch out, focus on my breathing, and untense my muscles.

The app Down Dog is great if you’re looking to try it out. I take classes in Yin Yoga and they’ve helped immensely, too.

If you’re looking for some simple yoga poses to self-soothe, this article breaks down different poses and shows you how to do them!

3. Find safer ways to check out

Sometimes you do need to turn off your brain for a while. Is there a safer way to do so, though? Is there a television show you can watch, for example? I like to make a cup of tea or hot cocoa and watch Bob Ross paint his “happy trees” on Netflix.

Treat yourself like you would a very freaked out friend. I always tell folks to treat dissociative episodes like you would a panic attack, because they stem from a lot of the same “fight or flight” mechanisms.

The weird thing about dissociation is that you might not feel much of anything at all — but that’s your brain doing its best to protect you.

If it helps to think about it this way, pretend it’s an anxiety attack (except someone took the remote and pressed “mute”), and create a safe space accordingly.

4. Hack your house

I have complex PTSD and having sensory items around my apartment has been a lifesaver.

For example, by my nightstand, I keep lavender essential oils to spray on my pillow for when I lay down to do deep breathing.

I keep soft blankets on every couch, an ice tray in the freezer (squeezing ice cubes helps snap me out of my episodes), lollipops to focus on tasting something, citrus body wash to wake me up a little in the shower, and more.

You can keep all these items in a “rescue box” for safe keeping, or keep them within reach in different areas of your home. The key is to make sure they engage the senses!

5. Build out a support team

This includes clinicians (like a therapist and psychiatrist), but also loved ones that you can call if you need someone to talk to. I like to keep a list of three to five people I can call on an index card and I “favorite” them in my phone contacts for easy access.

If you don’t have folks around you who “get it,” I’ve connected with a lot of lovely and supportive people in PTSD support groups. Are there resources in your community that can help you build up that safety net?

6. Keep a journal and start identifying your triggers

Dissociation happens for a reason. You may not know what that reason is right now, and that’s okay! But if it’s having an impact on your life, it’s crucial to make sure you’re working with a mental health professional to learn better coping tools and identify your triggers.

Keeping a journal can be helpful for illuminating what some of your triggers might be.

When you have a dissociative episode, take some time to retrace your steps and look at the moments leading up to it. This can be crucial to better understanding how to manage dissociation.

Because dissociation can impact your memory, writing it down also ensures that when you meet with your therapist you’ll have reference points that you can go back to, to build a clearer picture of what’s been going on for you.

If you aren’t sure where to start, this No BS Guide to Organizing Your Feelings can give you a template to work with!

7. Get an emotional support animal

I’m not saying run to the nearest animal shelter and bring home a puppy — because bringing a furry friend home can be a trigger in itself (potty training a pup is a nightmare that will likely have the opposite effect on your mental health).

I can tell you from experience, though, that my cat Pancake has completely changed my life. He’s an older cat that’s incredibly cuddly, intuitive, and loves being hugged — and he’s my registered ESA for a reason.

Any time I’m having a mental health issue, you’ll find him perched on my chest, purring away until my breathing slows down.

So when I tell you to get a support animal, it should be something you put a lot of thought into. Consider how much responsibility you can take on, the personality of the critter, the space you have available, and contact a shelter to see if you can get some help finding your perfect match.

You might be thinking, “Okay, Sam, but WHY would our brains do this dissociation thing when it’s so unhelpful in the first place?”

That’s a valid question. The answer? It probably was helpful at one time. It just isn’t anymore.

That’s because dissociation, at its core, is a protective response to trauma.

It allows our brains to take a break from something it perceives as threatening. It’s probably a safe bet that, at some point or another, dissociation helped you deal with some very tough stuff in life.

But it’s not helping you now, hence the predicament you’re in. That’s because it’s not a coping mechanism with a whole lot of usefulness in the long-term.

While it can (and often does) serve us when we’re in immediate danger, it can begin to interfere with our lives when we’re no longer in a threatening situation.

If it’s helpful, just picture your brain as an overcautious lifeguard who blows their whistle literally anytime you’re close to water — even if the pool is empty, or it’s just a kiddie pool in someone’s backyard… or it’s your kitchen sink.

Those traumatic events have (hopefully) passed, but your body is still reacting as though they haven’t! The dissociation, in that way, has sort of overstayed its welcome.

So our goal here is to get that neurotic lifeguard to chill the eff out, and to retrain them to recognize what situations are and aren’t unsafe.

Just try to remember this: Your brain is doing the very best it can to keep you safe.

Dissociation is not something to be ashamed of, and it doesn’t mean that you’re “broken.” In fact, it indicates that your brain is working really, really hard to take good care of you!

Now you have the opportunity to learn some new coping methods, and with time, your brain won’t need to rely on the old mechanisms that aren’t serving you now.

I know it can be scary to experience dissociation. But the good news is, you aren’t powerless. The brain is an amazingly adaptable organ — and each time you discover a new way of creating a sense of safety for yourself, your brain is taking notes.

Pass along my thanks to that amazing brain of yours, by the way! I’m really glad you’re still here.

Sam


Sam Dylan Finch is a leading advocate in LGBTQ+ mental health, having gained international recognition for his blog, Let’s Queer Things Up!, which first went viral in 2014. As a journalist and media strategist, Sam has published extensively on topics like mental health, transgender identity, disability, politics and law, and much more. Bringing his combined expertise in public health and digital media, Sam currently works as social editor at Healthline.