Explaining Dissociation Part 4: How to Help People

Now we know what dissociation is, and some ways in which it can be treated. But the non borderline may be wondering, “What can I do?” Or the borderline patient might be looking to give suggestions to their loved ones about what they can do. Well, the best way to help a sufferer of dissociation is first know how to NOT help them.

Things That Don’t Help People with Dissociation–

Minimizing our problem. This includes statements like “it’s not a big deal” “just relax” “others have it worse” and “everybody goes through the same thing.” This is damaging to the person with dissociation, because we need to feel like our experiences matter.  Chances are, the person is already trying hard to put perspective on their problem, and being preached at to try harder will make them feel incompetent.

Commanding us to be normal. Statements like, “just calm down” “come back to earth” “snap out of it” “just be happy” “just think about it rationally” are completely pointless. The borderline is mostly  incapable of being rational when in a severe dissociated state, and if they could just act normal again, they would! So don’t waste your time telling them things they cannot currently do.

Shaming Us. “Be strong for your family” “this isn’t the real you” “strong people don’t act like this” and “toughen up” are examples of making the dissociated person feel ashamed. Again, this will not help— if  the patient could snap out of it, they already would have. Shaming will make them feel worse and may prolong the episode.

Strong emotional reactions. When a borderline is in temporary psychosis, anger, or dissociation, it is best to avoid strong reactions, so long as the borderline is not being violent. Try not to act horribly shocked or disappointed, as this make the borderline feel extremely guilty and even more helpless than ever.

Saying it’s a character problem. If you think borderline is a character problem, you are scientifically incorrect. More on that later. The dissociation is likely a result of brain abnormalities, so don’t reject the person for their neurobiology unless you would reject a person based on their skin color, height, sex, or weight.

Helpful Tips—

When a friend is in a dissociated state, the key is to remain calm, and remain present. Dissociation and temporary psychosis fade away quickly in borderlines. No matter how crazy they sound, how distant they seem, or what important things they have forgotten, it’s critical that you calmly listen. Instead of trying to offer  advice, offer your presence. Tell them/us you will stay with us for as long as we need.

Brain Abnormality

Dissociated people are often accused of being stupid, slow, or too careless due to amnesia and derealization. They may also be accused of faking when they feel their identity has been split. However, none of these accusations are true. People like me with dissociation don’t have any more or less “character problem” than you do– it’s a brain thing. Dissociation has been linked to brain abnormalities. It’s not something we can just will away by trying to be better people.

For example.  The hippocampus, a brain center that helps memory, is smaller in patients with some dissociative disorders. The right prefrontal cortex, which helps with memory and processing, is under-active in dissociative amnesia. So, it’s a brain thing, not a character thing!

Closing Words

Dissociation is a defense mechanism that went wrong. Sometimes, it works. Severe detachment from the world, and/or from the self, means you are protected from trauma that is happening. You essentially are not there. But the brain overcompensates, and victims of dissociation may start to dissociate at the smallest triggers, or over nothing, during random conversations. Life gets very difficult as you constantly live in a cloud, separated from the world, forgetting important details, forgetting who you are, thinking that the world is a puppet show or a hazy dream. Unfortunately, there’s no known cure for dissociation, but improvement has been shown through professional therapy techniques. And everyone would be better served to learn something about dissociation.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3233754/

http://stantatkin.com/wp…/uploads/2012/09/Brand2009.pdf

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