Dissociation – when it’s more than zoning out

Dissociation is a process where your mind disconnects from your thoughts, feelings, memories, or your sense of self and your surroundings. We all experience it from time to time, a good example is when you’ve driven somewhere but can’t recall how you got there. 

More severe dissociation can however be a symptom of PTSD. It can be triggered by a reminder of something from the past and can feel frightening and intense when it occurs. A veteran may feel detached from their body, time may seem to slow down, or the world may appear unreal.   Dissociation isn’t a choice, it’s an automatic response the brain develops to help mentally escape from overwhelming or traumatic experiences and the memories linked to them.

A veteran experiencing dissociation may become unresponsive or silent. This can be very distressing to both them and the family and friends around them as they may struggle to know what to do or how to help.

But there are some straightforward steps anyone can take. 

Grounding techniques are simple strategies that help to keep the veteran in the present moment and connected with their surroundings when their brain is trying to pull them back into past trauma.

Many grounding techniques involve using the mind, body and behaviour to hook the person’s attention and interrupt the trauma memory.  The 5-4-3-2-1 strategy can be one way to manage difficult emotions.  To use this strategy you need to gently talk to the person experiencing dissociation and ask:

• What 5 things can you see?
• What 4 things can you feel or touch?
• What 3 things can you hear?
• What 2 things can you smell?
• What 1 thing can you taste?

“Experiencing dissociation can be frightening and confusing. To help a veteran, the best thing you can do is to keep everything simple. Speak calmly, slowly and clearly and avoid any sudden movement.  The 5-4-3-2-1 strategy can help bring someone back into the present but it may then take some time for them to return to ‘normal’,” says Dr Vicky Aldridge, Principal Clinical Psychologist and Clinical Lead for Learning and Development at Combat Stress. 

If you’re a friend or family member of a veteran and want to learn more about how to support them, the Combat Stress Learning platform may be able to help. This free resource provides reliable, evidence-based information to increase knowledge and understanding of veteran mental health. Visit combatstress.org.uk/combat-stress-learning to find out more.