Dissociation is one of those words that gets tossed around in therapy rooms, but often misunderstood in everyday conversations. It can show up as zoning out in a meeting, driving somewhere and not remembering the route, or feeling completely disconnected from your body during a hard moment. It’s common, it’s complex, and it can be a powerful coping strategy—especially for people with trauma histories.
Let’s break it down a bit: what dissociation actually is, where it comes from, and what we can do to support folks experiencing it.
What Is Dissociation, Really?
At its core, dissociation is the brain’s way of hitting the brakes when something feels too overwhelming (when you can’t physically get away). It’s protective. It allows us to emotionally step away from situations that feel unsafe. And in moments of crisis, that response makes a lot of sense.
But when dissociation becomes chronic or habitual, it can start to get in the way of daily life. Clients might describe feeling foggy, numb, disconnected, or like they’re watching themselves from the outside. Others might not even realize they’re dissociating—they just know something feels off.
What are Common Symptoms of Dissociation?
Dissociation can show up in different ways for everyone. Some common signs include feeling spacey or disconnected, losing chunks of time, or struggling to remember parts of a conversation. You might feel like you’re watching yourself from the outside, or like your emotions are on mute. For some, it looks like “zoning out” or going on autopilot during stressful moments. These symptoms aren’t always obvious, but they’re the brain’s way of creating distance from something that feels too overwhelming to fully process.
What Causes Dissociation?
While trauma is a major contributor, it’s not the only one. Dissociation can also stem from ongoing stress, relational conflict, major life changes, or any situation that overwhelms a person’s nervous system. Trauma-related dissociation, though, often runs deeper. It might include memory gaps, emotional numbing, a strong startle response, or even using substances to stay distant from pain.
Like most things in mental health, dissociation exists on a spectrum. That means treatment needs to be just as flexible and personalized.
How Therapy Can Help
For people who dissociate, traditional talk therapy doesn’t always cut it—especially if the body isn’t feeling safe, even in a therapist’s office. That’s where somatic and brain-based approaches come in.
Amy said in the podcast interview above: “Your body has worked so hard to not realizing, and therapy is a direct call to start realizing.” For this reason, start trauma therapy can sometimes make the dissociation and symptoms worse before it gets better.
Modalities like EMDR (Eye Movement Desensitization and Reprocessing) and DBR (Deep Brain Reorienting) work with the body’s natural responses to perceived threats. Instead of just retelling the story, these therapies help the nervous system release stuck trauma patterns. These modalities help you to build your tolerance while also addressing some of the root issues. Clients often walk away feeling more grounded, connected, and aware of what’s happening internally.
As Amy also noted though, for some people with complex trauma, EMDR can be really activating. It’s helpful to find someone experienced with trauma related dissociation if you are looking for an EMDR practitioner.
Why We Talk About “Parts”
If you work with complex trauma, you’ve likely come across the concept of “parts”—as in, parts of ourselves that formed in response to painful experiences. These aren’t signs of something being broken. They’re adaptive. They helped someone survive.
When we go through trauma—especially as kids—our brains aren’t fully equipped to process it. Instead of integrating the experience, parts of us can get stuck.
Let’s say I experienced something traumatic at age three. A part of me might freeze in that moment, holding onto the beliefs and coping skills I had at that age. Then later, as an adult, something might trigger that same feeling, and that younger part jumps in like, “I’ve got this!” But really, I’m responding from a three-year-old’s lens—without meaning to.
Therapy modalities with parts work (like Internal Family Systems or the structural dissociation model) helps clients understand these different internal voices or roles, reduce inner conflict, and slowly move toward integration. It’s not about “getting rid” of parts—it’s about building relationships with them.
Grounding: Not Just a Buzzword
When someone’s dissociating, we’re often working to bring them back into the present moment. That’s where grounding comes in.
Grounding strategies might be as simple as naming five things you can see, holding a textured object, sipping cold water, eating a sour candy, or repeating the date and time out loud. These small tools help orient the brain and body back to safety. And while they may not fix everything in the moment, they create space—space to feel, process, and reconnect.
Listen to some free grounding exercises on our podcast, After Therapy.
Want to Learn More?
If dissociation is a topic you’re curious about (or you support folks who experience it), here are some go-to resources that Amy Wilkerson, LICSW recommends:
- The Haunted Self by Onno van der Hart, Ellert Nijenhuis, and Kathy Steele
- Trauma and the Struggle to Open Up by Robert T. Muller
- Deep Brain Reorienting by Frank Corrigan
- Trauma Related Dissociation by Suzette Boon, Onno van der Hart Ph.D., and Kathy Steele
Plus: Check out our podcast episode with trauma therapist Amy Wilkerson, LICSW where we explore these concepts in depth.
Commonly Asked Questions about Dissociation
Can trauma cause dissociation?
Yes—trauma is one of the most common causes of dissociation. When someone goes through something that feels threatening, especially if it’s repeated or happens early in life, the brain sometimes copes by disconnecting. It’s a survival strategy. In the moment, it helps the person get through something scary or painful. Over time, though, that disconnect can stick around and make it harder to feel present or emotionally safe, even when the danger has passed.
How can therapy help with dissociation?
Therapy can be a powerful space to gently reconnect with parts of yourself that may have gone offline. Depending on your experience, a therapist might use tools like EMDR, parts work, or somatic approaches to help your body and brain feel safer. It’s not about forcing you to relive trauma—it’s about helping you build awareness, find regulation, and feel more grounded in the present. Therapy gives you language and tools to understand what’s happening internally and support your nervous system in a more intentional way.
What are grounding techniques for dissociation?
Grounding techniques are simple, practical ways to help you come back to the here and now when you’re feeling disconnected. That might look like naming five things you see around you, holding something textured in your hand, sipping something cold, or saying the date and time out loud. Movement, breath work, or tuning into your senses can also help reorient you. The goal isn’t always to feel calm—it’s to feel regulated and present. These tools create just enough space to stay connected, even when things feel overwhelming.
What’s the difference between dissociation and daydreaming?
Daydreaming is something we all do from time to time—it’s usually intentional or at least benign. You might drift off thinking about your weekend plans or replaying a conversation in your head. It’s a gentle mental break, and you’re still generally aware of your surroundings.
Dissociation, on the other hand, is more of a protective response. It’s not something you consciously choose. It can feel like mentally checking out or disconnecting from your body or emotions, especially in moments that feel stressful or unsafe. Unlike daydreaming, dissociation often happens automatically and might come with a sense of being foggy, numb, or far away from what’s going on around you. It’s your nervous system’s way of saying, “This is too much—I need to pull back.”
The key difference is that daydreaming is more playful or imaginative, while dissociation is usually a sign that something deeper is going on.
Podcast Transcript
Miranda: Welcome to the Therapist Thrival Guide. My name is Miranda, and I’m here with Amy. Today, we’re talking all about dissociation. Amy, would you like to introduce yourself?
Amy: Yeah, thanks so much for having me, Miranda. I’m really excited to be here, and I appreciate the invite. I’m Amy Wilkerson, a licensed independent clinical social worker practicing in the Twin Cities. I’ve been in the field for just over 20 years, which is mind-blowing to say out loud—fireworks are going off in my head! I’ve been in private practice for five years now. I was getting burned out in the field, weighed down by bureaucracy and policies that didn’t align with how I wanted to provide care. So, I took a leap of faith and opened my own practice, where I could be as creative as I wanted. It’s been a great way to connect with clients. I specialize as an attachment trauma therapist, working with complex trauma, especially in adoption and foster care. I also work with military personnel, dissociation, and other aspects of complex trauma.
Miranda: Awesome. I’m so glad you’re here. I first connected with you over Instagram because you share so much great stuff. I’ll be sure to link that in the description. You were also a facilitator in the Permanency and Adoption Certificate Program, which I went through, and you went through it as well. That was a meaningful year-long training for me, and you were one of our guest speakers. I remember one day in particular when we were doing a case consultation, and you shared so many amazing insights on trauma-related dissociation. Ever since then, I’ve been thinking, “You have to come on the podcast and talk about this.” So, let’s dive in. To start, what is dissociation? What are some of its symptoms? I feel like it’s one of those words that people often misunderstand.
Amy: Yeah, dissociation can be a scary word. It’s something people in the clinical world often get freaked out about because it’s tricky and complex. It doesn’t always present the same way as other things, which can be both helpful and challenging. We know some parameters, but we have to stay alert to recognize dissociation when it’s happening. The key thing to understand is that we all dissociate to some degree. It’s not necessarily a sign of severe mental illness—it’s a normal human experience. I like to think of it like the brakes on a car. If we’re about to slam into a wall, we’d press the brakes to mitigate the impact, right? In life, when things come at us too quickly or too strongly, our body hits the brakes to protect us. That’s dissociation in action.
For example, after a super long day, we might binge-watch Netflix to “check out” or disconnect from everything. I’m guilty of this, and I’m sure many listeners can relate. That’s a mild form of dissociation. The problem arises when this becomes a pattern and the primary way we cope. Dissociation is essentially our body’s way of avoiding something that’s too painful or overwhelming for us to process at the moment. It can show up as feeling foggy or spaced out, losing track of time, or even experiencing memory gaps. In cases of trauma-related dissociation, people can experience amnesia. Sometimes it shows up as staying busy all day to avoid feeling anything, which is common.
But dissociation can look different for everyone, so it’s hard to define it with a one-size-fits-all formula. Even substance abuse can be a form of dissociation, as it involves disengaging from the present moment. It’s a spectrum, and that’s why it’s so complex.
Miranda: So, what causes dissociation? Is it always trauma-related?
Amy: Not always. Sometimes dissociation can be triggered by major life transitions or stressors that feel overwhelming. It doesn’t always have to be a “big T” trauma. It can be something like a move, a recent relationship rupture, or just an accumulation of stress. If something in life feels too overwhelming, our system may shut down to protect us from being flooded.
Trauma-related dissociation, though, is when the nervous system is trying to protect itself from something much deeper. It’s a way of avoiding emotions or memories that feel too unsafe to face. That’s when the dissociation becomes more intense and rooted in trauma.
Miranda: So, would you say that trauma-related dissociation tends to have more intense symptoms?
Amy: Yes, typically. That’s often what brings people to therapy in the first place. For example, we all have everyday responsibilities—getting kids up, making breakfast, going to work, etc. But if something significant happens in your life, your nervous system has to decide: Do I process this big, distressing event, or do I just power through because I have to get everything else done? If we’re not able to process it, we might engage in dissociative behaviors like avoiding the issue altogether, burying it under the rug, and pushing through our daily tasks. Over time, though, that avoidance can lead to more symptoms like panic attacks, depression, substance use, or feeling overwhelmed by decisions—these are signs that our body is dissociating.
Miranda: Yeah, that makes sense. I’m thinking of clients who have experienced huge traumas and have buried a lot of their emotions through avoidance. Would you say that, in those cases, dissociation becomes more intense? Or could it manifest in different ways, like panic attacks or dissociation?
Amy: Exactly. When someone has gone through a major trauma, they might use dissociation to cope, and it can show up in different forms, depending on the individual. For some, it might look like dissociation—feeling numb or detached. For others, it might manifest as a panic attack or anxiety. It’s all part of the body’s way of protecting itself from the overwhelming emotions that come with trauma. It can look different from person to person, and sometimes it’s hard to pinpoint exactly how it will show up.
Amy: I think those triggers can definitely push people into deeper dissociation. When we talk about memory, it involves both explicit and implicit memory. Implicit memory is sneaky because it’s not associated with imagery. It’s more of a deeper, felt sense—a knowing that I’m safe, I’m hungry, or my needs are being met. This type of memory is something we experience mostly before the age of 3 or 4.
In the trauma world, you might have heard the saying, “What fires together, wires together.” This means that if two unrelated things happen at the same time, the brain will often pair them together. For example, if every time I ate bacon as a child, my parents were fighting in the next room, I might later eat bacon and suddenly feel anxious without understanding why. It’s the brain’s way of associating these two experiences.
When we’re triggered, it’s often because implicit memory is so powerful that we don’t always understand the connection. That’s why something like texting can feel so overwhelming and random. Someone might be driving, and out of nowhere, feel like they’re going to die—even though nothing happened. It’s because the body has triggered an overwhelming response, and if we don’t have the skills to work through it or don’t realize we’re avoiding deeper pain, it can push us into certain behaviors. These are often protective parts of ourselves that come online to shield us from the underlying pain.
I think understanding parts work is key when it comes to dissociation.
Miranda: Ooh, I’d love to dive into that more. We’ve talked about parts work on this podcast before. I’m not an IFS practitioner, but I’m fascinated by it. I know it translates into different modalities, so tell me more—how does this relate to parts work?
Amy: Yeah, I have training in IFS, but I mostly lean into the structural dissociation model, which also uses parts work. What I love about structural dissociation is that it doesn’t name the parts for clients. Instead, clients identify their own parts, which is a powerful aspect of this modality.
The way I think about parts is this: As we grow, we develop a sense of self, so we recognize that our feelings, thoughts, and experiences are happening to the whole of us. But when we experience trauma, especially at a young age, our ability to integrate that experience is lower. Our brains and coping skills just aren’t developed enough to process the trauma in that moment. So parts of us can become fragmented during that time.
For example, if I experienced trauma at three years old, a part of me may freeze at that age and remain stuck there. Whatever I believed about myself, safety, and coping as a three-year-old might stay frozen in time. So, when my system later comes into contact with a similar feeling or sensation—even something seemingly random—that three-year-old part might come online and say, “Hey, I know how to handle this!” And as an adult, I might not want to be responding from a three-year-old’s perspective, but that’s what’s happening.
In much of the work I do with parts and dissociation, we explore these different parts of self. The more complex the trauma, the more complex the parts. The goal is to get them into alignment with a more present, time-oriented perspective so that we can say, “I no longer need to rely on this strategy I once had to stay away from the pain.” Does that make sense?
Miranda: Yeah, that makes sense. How do you think parts work targets dissociation? I can see how it helps reintegrate trauma and a sense of self, but how does it specifically target dissociation?
Amy: Dissociation is essentially when we’re not fully aware of what’s happening for us in the moment. It prevents us from being present and keeps us disconnected from a time-oriented perspective, which is necessary for making clear, balanced decisions. When we function from a part of self that’s not grounded in the present, it often means that part is operating from a time in the past, and its strategy is designed to keep us from confronting the pain.
For example, in my work with adoptees, I often see a deep fear around romantic relationships. For the first time, the nervous system is experiencing that level of vulnerability again—something it hasn’t felt since being with biological family. This intimacy triggers a part of the self that believes, “I’m not safe here.” So, to avoid the pain of that vulnerability, a protective part might come online and try to control the situation. If I can control how close I get to someone or how I behave in a relationship, I believe I can avoid the pain of rejection or abandonment.
This behavior keeps me from feeling the deep, underlying fear of being abandoned or rejected, and it distracts me from the painful emotions driving it. This is where parts work comes in—by helping clients recognize these patterns, we can target dissociation and reintegrate the parts in a more present, healthy way.
Miranda: That makes a lot of sense. So, for people who have these implicit memories or fragmented parts from a young age, how can they start to recognize these patterns? Is it more about identifying the symptoms and reflecting on past trauma?
Amy: In therapy, I think it’s often a combination of creative support. Talk therapy for dissociation isn’t always the best approach because it can flood the system quickly. Then the body goes into resistance. Many times, when I work with complex trauma, my clients will say, “I thought I was going to come to therapy and just start feeling better,” but instead, it feels worse. And I’m like, “I know, it’s hard.” They don’t always understand why, but I explain to them, “Your body has worked so hard at not realizing. Therapy is a direct call to start realizing, and if you don’t have the tolerance for that, it’s going to feel overwhelming.”
I try to give that disclaimer up front—this might feel harder before it gets better because of the dissociation. To answer your question, there are some modalities like EMDR and DBR that pair really well with parts work. They help build skills to notice what’s happening in real time and guide the system toward full presence. This helps not only develop new skills but also builds tolerance to face what we’re discussing, so clients don’t continue dissociating.
Miranda: That’s the part I was trying to make sense of! With dissociation, there are the in-the-moment skills, but you also have to deal with what’s underneath—those underlying issues and fragmented pieces of self. I could teach my clients all the grounding skills in the world, but unless we address those underlying pieces, the dissociation will continue.
But wait, what’s DBR? I didn’t catch that one.
Amy: Oh, sorry! DBR stands for Deep Brain Reorienting. It’s a newer modality that was developed by Dr. Frank Corrigan. It’s brilliant, and I’m really excited for it to get more recognition. I encourage clinicians working with trauma, dissociation, or attachment wounding to look into this modality. For adult adoptees and those with attachment wounding, it’s a game changer. DBR focuses on how our system first orients to a threat before it even becomes a cognition. A lot of other modalities, like EMDR, focus on cognition, but DBR works with the initial shock entering the system—before we even have the thought “Oh, I’m scared.”
It’s especially brilliant for attachment wounding because it helps release shock from the system, allowing us to process vulnerable experiences with much more tolerance.
Miranda: How does it work? I think a lot of people are familiar with EMDR, but how does DBR operate before cognition even sets in?
Amy: Let me explain. DBR is one of the most aggressive modalities I’ve encountered, but I don’t mean that in an activating way—it’s just very quick. It works through trauma faster than any modality I’ve seen, yet it’s also the gentlest. People with dissociation or complex trauma often struggle with EMDR because it can be too activating. DBR, on the other hand, helps the body process the trauma much more gently.
Let’s say I’m sitting in my office and a dog barks outside my window. My nervous system is constantly asking, “Am I safe? Am I safe?” If I hear something like a dog barking, my system orients to the sound, and I recognize it as harmless. The moment of impact—when my system first orients to a potential threat—is where DBR comes in. If, during a conversation, someone gives me a facial expression that implicitly triggers my nervous system, I might feel like I’m in danger, even though nothing overtly happened. That shock from the implicit nervous system is what DBR targets.
In DBR, the therapist helps recall that activating stimulus and coaches the shock out of the system, which brings a lot of relief.
Miranda: That’s fascinating. I need to look into this. Many of my clients have connections to adoption or foster care. I’ve thought about getting EMDR trained or looking into other modalities, but as you said, EMDR isn’t always the best fit for people with attachment ruptures or preverbal trauma. Are you EMDR trained?
Amy: Yes, I’m EMDR trained, but I use DBR more now. I find it reaches deeper into the brain and is more gentle. From both a clinician’s and a client’s perspective, I think it’s much more soothing. The activation doesn’t linger between sessions as much as with EMDR. It’s not always easy or comfortable, but it’s gentler in the long run.
Miranda: That makes sense. I’ve definitely heard that EMDR can be harder for people with attachment issues or preverbal trauma. It sounds like DBR might be a better option for some of my clients.
Miranda: Oh, that’s so interesting! Very cool. Okay, so this leads to my next question. What other modalities or skills have you found helpful for dissociative disorders or people experiencing dissociation?
Amy: Yeah, I love parts work. Structural dissociation is a really fascinating modality, and I would definitely recommend getting trained in it, especially if you’re working with complex trauma. I also really like IFS. Personally, I love structural dissociation, EMDR, DBR, and somatic work—all of these are great and really enhance the therapeutic process. Things that ground us and bring us back to the present moment are especially important.
A lot of times, people believe that the goal is to be calm and “zen,” but I don’t think that’s the real goal. I think the goal is regulation, which is very different from calm. Regulation is a neutral state where, despite what’s going on around me—whether it’s chaos or stress—I don’t lose connection to myself. When I’m regulated, I can stay connected to what I need, even in stressful moments. When I’m dysregulated, everything goes out the window. Grounding skills can help us feel more present and embodied.
The challenge with dissociation is that many people have a “phobia” of being calm or present because they associate it with something bad happening. So, strengthening the ability to be present without getting overwhelmed when our nervous systems start aligning is important. Sometimes, when people feel more aligned or notice happiness or joy, their anxiety spikes because they believe that joy leads to bad things happening.
Miranda: I just had a client a couple of weeks ago who said the same thing. She felt great, but was waiting for the other shoe to drop—expecting something bad to happen. Her nervous system was just so used to dysregulation. I like how you described it as a phobia of regulation. There’s definitely a fear that it isn’t safe or manageable.
Amy: Yeah, my mentor always used that word, and it really resonated with me because it’s exactly what it feels like— a true phobia. For many, being calm feels threatening to their survival. The myth I like to dispel in therapy is that the goal isn’t necessarily to be calm; the goal is regulation. Calm is great, but being regulated, where we can stay connected to ourselves no matter the chaos around us, is the real goal.
Miranda: That’s powerful. What grounding skills do you recommend when clients are experiencing dissociation?
Amy: First, I always remind myself that what works for me might not work for everyone. It depends on how activated someone is. One helpful reminder for me is to check the date and time. I’ll remind myself that I’m no longer seven years old, and I’m living in 2025. Just this small reminder can help ground me.
Another technique involves working with parts. Sometimes, parts present as younger versions of ourselves, so I might ask a client to look in the mirror and say, “Do you recognize that the person you’re looking at is no longer a child?” This can help ground parts of the self back into the present moment.
Somatic techniques are also helpful—things like rubbing lotion on your hands or paying attention to sensory details. One great trick is to use a super sour or spicy candy to stimulate taste and smell. It’s a quick way to orient the system to the present moment: “Do I recognize the flavor in my mouth right now?” This helps check if all parts of the self are present.
If not, it opens a conversation about why certain parts are having a hard time being in the moment, helping us explore their perspectives and how we can create safety for those parts.
Miranda: This has been so helpful. I’ve gone through all of my questions, and I’m learning so much. What resources would you recommend for further reading? I remember you recommending a book on trauma-related dissociation last time, but I can’t remember the title.
Amy: Yes, “Trauma-Related Dissociation” is a great book. There’s a workbook version too, which I highly recommend. I also just got my hands on the first official book about Deep Brain Reorienting (DBR), which explains its neuroscience and how it works with trauma and attachment wounding. It’s an exciting resource if you’re curious about DBR.
Another great resource is The Haunted Self, which explores structural dissociation. Interesting Education is another good one for understanding dissociation and trauma. If people want to dive deeper into complex trauma and dissociation, I’d be happy to share more books.
Miranda: That would be awesome! Thank you so much for joining, Amy. This has been so informative. There are so many modalities I’ve never heard of before, and I’m definitely looking into structural dissociation theory.
Amy: Glad to hear it! I think you’ll find it fascinating.
Miranda: Thanks again, and thank you for listening. We’ll see you next week!
