Coping with dissociation

1. Become aware of how dissociation works for you

Dissociation can be experienced in many different ways, which varies from person to person. If you want to gain more control over dissociation, the first helpful step is to understand how dissociation works for you. 

Questions that can help gain more insight into dissociation:

• What do you experience when you dissociate? What do you feel or notice then?
• How do you experience the transition from a ‘normal’ state to dissociation? Does that happen gradually or rather quickly?
• Are there specific situations, thoughts, feelings, or sensory experiences (triggers) seem to cause or worsen that dissociation?
• How can you tell that you are starting to dissociate? What are the early signs?
• How can you tell that you are dissociated?
• What can others notice when you are dissociated?
• What do you usually do when you notice you are starting to dissociate?
• Are there things that have helped you to come out of a dissociation?

Answers to these questions can help you better understand yourself and your experiences, learn to recognize signs of dissociation, and gain insight into what helps you, or might help you. 

2. Connect with the here and now

When you are dissociated, you sometimes completely lose touch with the here and now. Consciously focusing your attention and senses on things that are present in the here and now can help you reconnect. 

Ways to connect with the here and now:

• Of 5-4-3-2-1 methodidentify five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste. A different order is of course also fine.
• Dutch Flag exerciselook around you and identify 3 red, 3 white and 3 blue things.
• Make use of tools that stimulate your senses (see also tip 6)
• Focus on you breathingtake a few deep breaths, hold for a moment, and exhale slowly. Try to feel the air fill your lungs and how your chest and abdomen move up and down.
• Speak out loud where you are, what you are doing a which day it is. For example: “I am in my living room, watching television, and it is Friday, October 6, 2023.”Repeat this a few times if necessary.

3. Get moving

Dissociation is often accompanied by shutting down, literally and figuratively. Moving helps to get moving again.

Movement can be large-scale, such as standing up, going for a walk, or throwing something, but also small-scale. Sometimes carefully moving a finger or foot is a first achievable step. If that succeeds, see if you can slowly expand the movement. 

4. Stimulate your senses 

An often very effective way to break through dissociation and return to the here-and-now is by stimulating your senses.

• Sightlook around you and describe out loud or in your thoughts five things that you see. Try to name the details of each object, such as the shape, color, and texture.

• Hearinglisten to sounds around you. Try to identify four different sounds. The ticking of a clock, the singing of birds, the buzzing of a refrigerator or a car driving by. Anything is fine.

• Smellconsciously smell things around you. This can be the air outside, a flower, or a cup of coffee, for example.

• TasteEat or drink something and try to experience the taste very consciously. Describe to yourself or out loud what you taste. Is it sweet, salty, bitter, or sour? Warm or cold?

• Tastetouch different objects and focus on how they feel. Is the surface smooth, rough, cold, warm, soft or hard?

5. Deploy a tool

A weighted blanket or a strong-smelling scent; there are all sorts of handy tools that can help you stay in the here-and-now, or return to it. Often by connecting with tip 4: using and stimulating your senses.

Tip 6: Create a crisis card 

Do you often experience dissociation? If so, it can be helpful to make a crisis card. A crisis card is a personal, foldable card, the size of a bank card. You can easily carry it with you.

On the crisis card, you indicate what your wishes and needs are if you experience a crisis. This can be a situation, for example, in which you are severely dissociated. What should bystanders do or not do? Who can they call? The card also states what agreements have been made with, for example, your practitioner.