Dissociation and Safety | Create Safety with Dr. Dawn Elise Snipes

I don't deal with, I don't deal with needles well, I just don't. So that's one of those times. But there are a lot of people who dissociate frequently because of trauma history. And there are a lot of people who have trauma history. So let's take a look at what dissociation is, what it looks like and what we one, one or two things that we can do about it. So dissociation may occur when you're in physical pain, the current situation is too overwhelming to cope with, or you're reminded of a prior trauma. Think about times when you have been in extreme physical pain and you've just kind of spaced out. You know, whether whatever that situation was, like I told you before, just even thinking about getting a shot, I kind of check out a little bit. The current situation be too over emotionally overwhelming to cope. So you may just check out. There are times maybe you're sitting in a staff meeting and somebody starts raising their voice and it becomes a very toxic situation and very overwhelming and your brain just kind of checks out. It says no, don't want to be here right now. Or if you're in a situation in which you're reminded of a prior trauma, again, let's go back to that staff meeting. Maybe you, you grew up in a household that was abusive and when voices got raised, it meant that bad things were getting ready to happen. So now when people raise their voices, your anxiety goes up and if it continues, then you may feel like you are checking out. Now dissociation is different from daydreaming or highway hypnosis as we're talking about it today. I grew up in Florida and when you drive through the Everglades, it's just miles and miles and miles of flat nothingness. And you can easily just kind of start thinking about other things. That's more monkey mind as opposed to dissociation. What we're talking about here is really having an out of body experience or feeling emotionally numb or detached, and an altered sense of time kind of spacing out in response to distress. That's really what we're talking about today is a response to distress. Emotional or physical distress makes us feel unsafe. We all want to feel safe. That's one of those core needs that Maslow identified in the hierarchy. When we feel a lack of safety, we may dissociate if that sense of unsafeness goes on for too long or is too extreme. One of the things, one of the first things that I encourage people to do when they notice that they do habitually dissociate is to start keeping a log of what's going on before you dissociate it. Obviously, you know, you may be keeping a log of what's going on, then you dissociate, and you've got to go backwards and go, okay, what was happening right before I dissociated? Explore why that moment was so overwhelming to you. Knowing what's going on is half the battle. Once you understand why your body is reacting that way, why your brain is checking out, you can recognize it as a survival and a protective mechanism, and you can alter the situation or your perception of the situation in order to increase your sense of safety. Once you have, you know, kept a log of what was going on and maybe even done some backward chaining, because obviously, a lot of times people dissociate, and then when they. When they come back there, they realize that they lost a period of time and they need to go backwards and think, okay, what's the last thing that I remember? What was going on? Then, of course, explore why that moment was overwhelming and take steps to make that situation less threatening in the future. There was a client that I worked with who had a history of abuse in her family of origin. And when it. As a child, whenever she would make noise, whenever she would do something wrong, whenever she wouldn't clean the dishes correctly, her caregiver would become extremely irate with her and start yelling and sometimes beating her. And that was extraordinarily traumatic for her. Of course, now there are times, for example, for some reason, the kitchen is an area for her that was particularly triggering. When she would be in the kitchen, she would notice that she'd be cooking, and then the next thing she knew, you know, stuff would be burned. She would have sort of checked out, spaced out, lost time. So we started examining that and examining what her experience, experiences in the past were as they relate to being in the kitchen or cooking. And we did start drawing connections between the fact that for her, the kitchen has memories, even though it's not this particular kitchen, any kitchen has memories of severely traumatic situations. For her, we began by starting to help her feel safer in the kitchen. Number one, she would. She read some about feng shui. And one of the things that's interesting, a lot of people don't really realize or think about until I say it. When you're in the kitchen and you're working at the stove, if you've got one of those stoves that, you know you're looking at a wall, it's not one that's in an island, people can come up behind you and you're actually in a vulnerable state at that point in time. And Fun Shui recommends that whenever you're in a situation in which people could sneak up on you or startle you to put mirrors. You know, doesn't have to be big ones. You know, you can put a little mirror on the backsplash, you can put a little mirror on the range hood or something so you can see people before they get to you. You know, I can be sort of immersed in what I'm doing cooking. And if somebody, my daughter doesn't make noise when she walks and she can walk up behind me, I won't even notice she's there. And then she says something and about jump out of my skin. So being aware, having more visual cues can be helpful, but figuring out what things are important to help you feel safer in that environment. For her, the next step started becoming no. Becoming aware of her anxiety when she would be in the kitchen instead of just focusing on her cooking, being more mindful of how she felt physically and emotionally. And if she noticed that she was starting to feel off as she put it, or started to feel anxious, she would start using some of her distress tolerance skills and her emotional grounding skills. A third thing that she did which helped keep her grounded in the present moment some, sometimes if she was having a bad day, would be to narrate what she was doing. She'd, you know, talk to herself. She'd say, okay, I need to get the milk and I'm going to pour a cup of milk in and then I'm going to beat the eggs. You know, she would just talk about what she was doing as she was doing it, and it helped her stay focused in the present moment so her mind didn't go back to some of those traumatic experiences. Now, I'm not saying that's going to work for everybody, but those were three tools that seem to work really well for her. I've worked with other people who have difficulty with raised voices, again, because of prior traumatic situations or. Well, generally it's. It's prior experiences where people have been extremely loud and it has been intimidating in some way. And sometimes. And I've been in staff meetings that have gotten loud. Sometimes when you're in those types of staff meetings, you can start to feel anxious. You can start to feel like you're back in that prior situation in which you were vulnerable. It's important to be able to recognize, stay grounded in where you are, but also recognize how Safe you are now. When you were six and your caregivers started fighting, you know, you may have felt very vulnerable. And there's, you know, a lot of good reasons for that. A six year old can't take care of themselves. They can't just up and leave. There's 6 year olds are much more vulnerable than 26 year olds that are sitting in a staff meeting. Developing mantras that you can tell yourself if you start to feel stressed in a situation is also important to, to help you stay grounded. Reminding yourself that I am safe, I am not in danger in this situation. They are being loud, but, you know, and figuring out a dialogue to talk back to those internal voices that are saying you're in danger. Another client I worked with had a really bad experience in, with a car accident on the interstate. And whenever that person would be in heavy traffic and start smelling the smells of exhaust fumes, it would trigger memories, it would trigger dissociative experiences and flashbacks. It was important for him to be able to recognize going into the situation whenever he got into his car, recognizing, okay, there's a possibility that this could happen. So if it does, what is my plan? To stay grounded and to stay safe for, for him. Obviously there are also options sometimes of not driving during high traffic times and not taking the interstate, which is where the car accident occurred. You know, there are things that people can do and it's important. Remember we've talked repeatedly about how trauma erodes people's sense of safety and personal power. And it's important in order to address dissociation, which is a response to feeling powerless and unsafe, to help people start feeling safe and more empowered. So what can you do in this situation to help yourself feel safer and to stay grounded in the present moment instead of going back to whatever that traumatic experience or those traumatic experiences were. What can you do to help yourself deal with the current situation? If it's physical pain, you know, what can you do to help yourself stay focused in the present moment if you need to? You know, sometimes if you know you've got a compound fracture of both legs, you may not want to stay focused at that point in time. And, and that's okay too. Recognizing that dissociation is one way that our brain responds to keep the brain environment from becoming too toxic, from becoming running too hot. If you want to think about it that way, Dissociation in and of itself is not a bad thing. Like I said, it is a protective mechanism that our brains create in order to protect us from being overwhelmed, from experiencing excruciating pain. So dissociation in and of itself is not necessarily a bad thing. When it happens, repeatedly when it happens, and you've got these periods of time that you just lose minutes or even hours. That's when it become. Starts becoming more problematic and potentially more dangerous. Because, you know, if you're. If you've dissociated, you may not be aware as much of what you're doing. You may not be as cognizant. So it is important, like the person I was working with who would regularly dissociate while she was cooking. You know, it's important to be able to stay focused so you don't start a fire. And those are all important things to remember. There are a lot of different techniques for addressing dissociation. EMDR can be really helpful for some of the symptoms of post traumatic stress, such as flashbacks and dissociation. But again, there are a lot of cognitive, behavioral, and environmental things that you can do. Are there questions you have about dissociation or creating safety? If you have children that dissociate or you're working, you know, maybe you're in a classroom and you're. You work with children and you notice that occasionally one of them sort of drifts off. There can be a lot of reasons for that. For example, adhd, the inattentiveness part may look like drifting off or daydreaming. But for some children, you know, being in the classroom can be like, right before a test or when you're getting your tests back. Or, you know, there can be a lot of different triggers that I could just spitball for a while. But there can be things in the classroom that are triggering or for that child, which may cause them to dissociate. And it's important if you are working with children or you have children that are dissociating to help them recognize what they're doing and develop skills and tools to deal with it. I remember when I was in fourth grade, we used to be in this school, and we didn't have walls between our classrooms. This was back in the 70s. There were pods. So we had, like, bookshelves that separated all the different classrooms. And there was a fifth grade teacher that would pull students aside and scream at them until he was like, literally turning purple. I was terrified of this man, absolutely terrified of this man. And, you know, lo and behold, guess who I got assigned when, you know, I graduated fourth grade and went up to fifth grade, I got assigned to his class. And, you know, that sort of situation was extremely intimidating and. And threatening. For me now, I don't remember dissociating at that point, but had I been from a household where there was a lot of domestic violence or a lot of verbal abuse, then that could trigger a dissociative episode. So we do want to pay attention to environmental triggers that might cue dissociation for children and recognize dissociation as what it is, protective mechanism instead of addressing the child as misbehaving, for example, or not paying attention intentionally. Rwanda. Are there particular issues relevant to dissociation that you think that I could address during this presentation? You've identified that you think it's a relevant topic for right now. Alrighty. You. You can't speak today. Y' all are really quiet today. But that's okay. You know, if you have other questions or you think of things, remember, I will be back here on Thursday with another live presentation. So you can always, you know, ask follow up questions in those meetings. If there are no other questions, I am going to go ahead and sign off for today and I will see you guys on Thursday. And Katie, I can do some. I can do another presentation on dissociative memories. There's a lot of debate and discussion about what those look like and how to deal with them.