I Feel Numb: How to Cope and Heal from C-PTSD Dissociation.

While Bruce Perry is better known for his Book co-authored with Oprah Winfrey called What Happened To You, I first came across him reading The Boy Who Was Raised as a Dog. It contained a story about a girl who dealt with frequent sexual abuse. She learned to cope through dissociation. She reported she would imagine being "A Raven" and flying through the sky. She would leave her body and brain behind and immerse herself in a fantasy world.

While dissociation gets a bad wrap I've never seen it as a bad thing. Dissociation is a sign of resilience. Someone who dissociates has been through something awful and even though they may not have had the power to leave it physically, their brain took what power it did have and left. Dissociators are survivors. That said, dissociation is hard to control. A child who starts dissociating young may continue dissociating unexpectedly for years to come, long after they are safe and trying to heal. Then they struggle to heal because with trauma the only way to get through is to pass through and you can't pass through difficult emotions if everytime you get close to touching them your mind goes totally blank.

Complex Post-Traumatic Stress Disorder (C-PTSD) is a mental health condition that emerges from prolonged exposure to trauma, particularly in situations where escape or safety was not possible. It often affects individuals who have endured ongoing abuse, neglect, or control, such as those in toxic relationships, prisoners of war, or survivors of prolonged childhood trauma. C-PTSD differs from traditional PTSD in that it involves additional symptoms, including emotional regulation difficulties, a negative self-image, and problems with interpersonal relationships. However, one of the aspects that makes it hardest to treat is dissociation.

The Link Between C-PTSD and Dissociation

Dissociation is a psychological response to overwhelming stress or trauma. It involves a disconnection from the present moment, memory, identity, or surroundings. While dissociation can be a common response to trauma, for those with C-PTSD, it becomes a persistent and debilitating coping strategy.

C-PTSD is not just about flashbacks or nightmares, as often seen in typical PTSD. It also includes emotional numbness, feeling detached from one’s body or surroundings, and a general sense of disconnection from reality. It can cause your memories from childhood to become splintered and confusing. It can also cause someone to be able to say what happened but feel nothing about it then have intense mood swings seemingly at random. Dissociation in C-PTSD can be understood as the mind’s way of protecting itself in the face of overwhelming trauma. The mental and emotional toll of constant stress can cause the mind to "disconnect" from what’s happening to prevent further psychological damage. In essence, dissociation is the mind’s way of protecting itself by disconnecting from the distressing experience at hand.

For many survivors, dissociation is the only way their mind can protect itself from the emotional or physical pain of their traumatic experiences. We can only take so much before we shut down. Over time, this defense mechanism becomes ingrained in the psyche and can become a persistent state of being, often complicating recovery. In some ways dissociation sounds like a great plan. You just shove your trauma in a box and never take it out. A little numbness to avoid the trauma seems fair. However, that's not how it works. Putting the trauma in the box never keeps it there and eventually it always comes spilling out. You get the choice to try to keep it in, or to unpack the box in your way in your own time.

The Types of Dissociation

Dissociation is not a singular experience; it manifests in different forms. Understanding these can help individuals identify how dissociation shows up in their lives:

1. Depersonalization: This occurs when a person feels detached from their own body or thoughts. They may feel like they are observing themselves from the outside, as if they are in a dream or a movie. This can be incredibly disorienting and make it difficult to feel grounded in reality.

2. Derealization: Derealization is the feeling that the world around you is not real, or it may feel distorted or dream-like. People experiencing derealization may have trouble connecting with their surroundings and may feel like they are living in a world that doesn't make sense.

3. Memory Gaps: Individuals with C-PTSD may experience difficulty recalling certain periods of their life, particularly traumatic events. These memory gaps can be frustrating and distressing, as they interfere with understanding one's past and processing it in a healthy way.

4. Out-of-Body Experiences: Sometimes, dissociation can feel like an extreme form of detachment, where individuals may feel as though they are floating outside of their body, unable to reconnect with themselves in a grounded way.

5. Other: People with C-PTSD sometimes don't feel physical pain like they should, they sometimes will drive somewhere and forget how they got there, and they sometimes will be unable to feel parts of their bodies.

Why Does Dissociation Occur in C-PTSD?

In the face of trauma, particularly prolonged trauma, the brain is forced to find ways to cope with the immense stress. Dissociation is the mind's way of protecting itself by creating a psychological buffer. When the body and mind are overwhelmed by ongoing stress, dissociation offers a temporary escape, allowing individuals to disconnect from painful realities.

For survivors of ongoing trauma, dissociation may become a habitual defense mechanism. As the trauma continues, the mind may repeatedly switch into a dissociative state to avoid confronting unbearable feelings. This is particularly true for those who have experienced childhood abuse or neglect, where the experience of helplessness and powerlessness may push the brain to retreat into a dissociative state to cope with feelings of terror or rage that can’t be fully processed. People with C-PTSD may find themselves dissociating every time they go to therapy, when they smell a certain candle, or when someone speaks in a specific tone of voice regardless of the content of their words.

However, while dissociation may protect the individual in the short term, it can have long-term negative consequences on emotional health, relationships, and overall well-being. Over time, dissociation can interfere with a person’s ability to function in daily life, leading to difficulties in maintaining relationships, holding down a job, or engaging in healthy coping mechanisms.

How Dissociation Affects Daily Life

For those with C-PTSD, dissociation can manifest in ways that disrupt daily functioning:

- Impaired Memory and Concentration Dissociation can make it difficult to focus or recall important details, leading to a feeling of being “foggy” or “out of it.” This can hinder one’s ability to complete tasks or make important decisions. People who dissociate are often diagnosed with or tested for ADHD and often struggle with to do lists and self care tasks.

- Social Isolation: Dissociation may make people feel emotionally disconnected from others. In relationships, they may seem distant or unavailable, even if they are physically present. This can lead to misunderstandings and strain in personal relationships. People who dissociate often feel totally alone.

- Avoidance of Emotional Pain: The act of dissociating can be a coping mechanism to avoid dealing with painful emotions. While this can offer temporary relief, it can lead to emotional numbness, making it hard to experience joy or pleasure.

- Difficulty Feeling Grounded: A person who dissociates may struggle to feel present in their body or environment, leading to a sense of floating or being out of touch with reality. This can make everyday activities feel overwhelming or even unsafe.

How to Cope with C-PTSD Dissociation

While dissociation can feel like an automatic response to stress, there are ways to regain control and work toward healing. How to cope with C-PTSD dissociation involves finding grounding techniques, building emotional resilience, and seeking professional support. Here are some strategies that can help:

1. Grounding Techniques

Grounding techniques are vital for helping individuals reconnect with the present moment. These techniques can break the dissociative cycle and bring the person back into their body and environment.

- Sensory Awareness: Engage the senses to reorient yourself to the present moment. This could involve touching something textured (like a stress ball or piece of fabric), smelling a calming scent, or listening to soothing sounds.

- Five Senses Exercise: Focus on identifying five things you can see, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste. This exercise helps bring your attention back to the present and away from dissociative states.

- Breathing Techniques: Deep breathing exercises can help calm the nervous system and reduce the intensity of dissociation. Try breathing in for four counts, holding for four, and exhaling for four. Repeat several times.

2. Creating a Safe Environment

Having a sense of safety is essential for healing from C-PTSD. Surrounding yourself with supportive people, reducing triggers, and creating a calm environment can help lower the likelihood of dissociation.

- Safety Anchors: These are physical objects or places that provide comfort when dissociation sets in. For example, a comforting blanket, a favorite chair, or a family photo can act as a reminder of safety.

- Predictable Routines: Routines help establish a sense of control and stability. If you’re prone to dissociating, having a predictable schedule can create a grounding structure.

3. Therapy and Support

Therapy plays a critical role in healing from dissociation. C-PTSD is not a disorder that can be managed in a satisfactory way with "coping skills." Life can be pretty dang good, but you have to process your trauma to get there. Process your trauma with a highly skilled trauma informed therapist. This is essential if you want to stop healing and start coping. Look for someone that mentions C-PTSD specifically.

- Trauma-Focused Therapy: Approaches like Internal Family Systems Therapy (IFS) and Eye Movement Desensitization and Reprocessing (EMDR) can help individuals process traumatic memories in a safe, structured way.

- Dialectical Behavior Therapy (DBT): DBT helps individuals manage intense emotions and develop skills to reduce dissociation and other unhealthy coping mechanisms.

- Group Therapy: Joining a support group can provide validation and understanding, as individuals can relate to others who are experiencing similar struggles with dissociation and trauma. You need others who have been through what you're going through to not be alone.

How to Heal C-PTSD Dissociation

Healing C-PTSD dissociation requires patience, self-compassion, and a holistic approach. Here are some key elements to consider:

1. Building Self-Compassion

Healing begins with understanding that dissociation is not a weakness or failure but a survival mechanism. Developing self-compassion helps break the cycle of self-blame and shame that often accompanies C-PTSD. C-PTSD is a disease of shame. Shame drives symptoms and dissociation. It isn't as easy as saying daily affirmations but you can learn to love yourself.

2. Mindfulness Practices

Mindfulness helps to increase awareness of present experiences without judgment. Learning to sit with emotions, even the difficult ones, can reduce the need for dissociation as a coping mechanism. Practicing mindfulness can involve guided meditation, yoga, or massage and is particularly helpful for C-PTSD. Those who dissociate always benefit strongly from mindful eating.

3. Long-Term Commitment to Healing

Healing from C-PTSD and dissociation is a long-term process. It requires ongoing work to process trauma, re-establish connection with the self, and learn new coping mechanisms. It’s important to approach healing with patience and to celebrate small victories along the way.

Conclusion

Dissociation is one of the most challenging symptoms of C-PTSD in treatment, but it is not insurmountable. You've survived so much already that you can survive getting through dissociation. We can only take so much before we shut down, but that doesn’t mean we have to stay shut down forever. With the right treatment and a lot of motivation dissociation can be overcome.