The 7 Types of Dissociation & How Somatic Experiencing® Helps
Dissociation has become quite the buzzword on social media and within the mental health community. Often deemed a negative quality, dissociation, is actually quite adaptive; it is a natural coping mechanism where the mind and body separate from overwhelming thoughts, feelings, sensations, or memories to protect against trauma, stress, or physical pain. A lesser known fact is that dissociation can take many forms, from feeling detached from oneself to forgetting key details of one’s life. Here, we’ll explore the seven types of dissociation and the way that Somatic Experiencing® (SE) conceptualizes each. These concepts can be a bit tricky to grasp, which is why I’ve also included examples that help illustrate what each type can look like in real-life.
1. Depersonalization
Depersonalization occurs when someone feels detached from their body or sense of self, almost as if watching themselves from outside. It can feel like a surreal experience where one is simply observing life pass by. This type of dissociation is most common in people who have experienced sudden, acute trauma, such as a near-death experience, or physical or sexual assault, which can cause the mind to detach from the body to protect against intense sensations and instead causing an emotional “numbing” effect.
Sarah always felt pressured to be “perfect” in her family. Her parents, who were highly critical, expected her to achieve top grades and excel in everything she did. In order to manage her parents' expectations and avoid conflict, Sarah learned to emotionally disconnect, numbing herself to her own needs and feelings. As an adult, she works as a nurse in a high-stress emergency department, where she finds herself feeling emotionally numb and detached from her body during intense moments, almost as if watching herself perform her duties from above. This sense of detachment helps her stay focused in the moment but leaves her feeling disconnected and out of touch with herself after her shifts.
If left untreated, depersonalization can lead to long-term emotional numbness, reduced capacity for intimacy, difficulty connecting with oneself and others, and feelings of chronic isolation or emptiness. Somatic Experiencing® (informed by Polyvagal theory) views depersonalization as the nervous system’s protective mechanism to buffer against intense stress by going into “dorsal vagal shutdown.” SE therapists like myself help clients like Sarah reconnect with their bodies through gentle grounding techniques, focusing on safe, incremental embodiment practices to slowly restore a sense of presence and connection to self.
2. Derealization
Derealization involves feeling that the world around is distant, dreamlike, or unreal. This type of dissociation can make a person feel as if they’re seeing life through a fog or filter, and familiar surroundings might feel strange. If you’ve ever experimented with psychedelics (especially Ketamine, Psilocybin, or Ayahuasca), you might have experienced this kind of dissociation. Derealization is most common in people who have experienced complex trauma, like ongoing childhood abuse or neglect, where the environment felt persistently threatening or unsafe.
Throughout his childhood, James was constantly subjected to verbal and emotional abuse from a critical and controlling parent. He learned to survive by disconnecting from his emotions and surroundings. As an adult, after years of enduring similar verbal and emotional abuse in his relationship, James starts to feel as though he’s been living in a bad dream that he’ll soon wake up from. Looking in the mirror, he barely recognizes the person staring back at him. Moving through the world, he experiences his surroundings as surreal; people seem distant and even a little fuzzy, as if he’s drifting through a dream. This sense of unreality leaves him feeling disconnected, disoriented, and struggling to feel grounded in his own life and body.
Untreated derealization can make it challenging to engage fully with life, affecting social relationships, work (performance and pleasure), and enjoyment of daily experiences. It can lead to chronic disorientation, anxiety, and a sense of disconnection from reality, causing long-term struggles with focus and presence. Somatic Experiencing® understands derealization as the nervous system’s way of creating distance from overwhelming surroundings. SE encourages clients like James to re-orient themselves in the environment gradually, often through grounding exercises like noticing colors, sounds, and surroundings while also noticing physical sensations to feel safer and more present in the real world. Orienting sending cues to the nervous system that it’s safe to return to and be inside the body.
3. Dissociative Amnesia
Dissociative amnesia refers to gaps in memory, typically around overwhelming, traumatic, or highly stressful events. These blocks in memory prevent us from fully recalling specific experiences, even when trying our best. These memory blocks arise as the body’s way to protect against painful memories. Dissociative amnesia is often associated with childhood trauma or long-term abuse, where forgetting helps the individual distance themselves from painful memories or experiences.
Emma grew up in a chaotic and often frightening home environment, where she witnessed intense conflict and unpredictability between her parents. To cope, she learned to “forget” many of these painful experiences, distancing herself from the emotional weight of her childhood. As an adult, she finds it difficult to recall details of her school life and friendships from that period. These blank spots in her memory leave her feeling as though parts of her life are missing, and she struggles to understand who she is without these pieces of her past. She feels frustrated by the big black hole that sits in her memory where her childhood experiences should be.
Untreated dissociative amnesia can interfere with a person’s sense of self, as large parts of their personal history remain unknown or unclear and triggers seem to come out of nowhere. This can contribute to issues with identity, cause difficulty forming meaningful relationships, and create emotional distress if memories resurface unexpectedly. Somatic Experiencing® sees amnesia as the body “holding back” certain memories to prevent overwhelming the nervous system. Even though cognitive memory may be blocked, the body and the nervous system were still present to the event and can therefore recall pieces of the experience through fragments of memory that come through as sensation, images, behaviors, emotions, and meaning-making. SE therapists like myself use a technique called titration, allowing these memories to emerge slowly and safely, so clients like Emma can process the memories without feeling overwhelmed, integrating these experiences as part of their narrative, rather than becoming re-traumatized by them.
4. Identity Confusion
Identity confusion involves uncertainty about one’s own values, beliefs, and sense of self. It can occur when trauma or high stress disrupts identity development, and can lead someone to question or distance themselves from their own identity. Identity confusion is often seen in individuals who experienced emotional abuse, neglect, or invalidation during their formative years, leaving them uncertain about who they are or should be.
From a young age, Alex felt as though he was walking on eggshells at home. Growing up with parents who imposed strict expectations and dismissed his feelings, Alex learned to suppress his true thoughts and desires to avoid conflict. His accomplishments were never quite enough, and his interests were often deemed impractical or unimportant. This constant invalidation made it difficult for Alex to develop a strong sense of self. As an adult, Alex now struggles to make decisions about his career and relationships. He’s torn between pursuing a path that aligns with his authentic interests or choosing one that meets the approval of others. After the end of a turbulent relationship that echoed the dynamics of his childhood, he finds himself questioning who he truly is. Each choice he faces seems to deepen a profound sense of doubt and confusion, leaving Alex feeling adrift without a clear identity or direction in life.
Identity confusion can lead to chronic self-doubt, difficulties in relationships, and challenges in making life decisions. It can prevent individuals from pursuing their true goals, leaving them feeling unfulfilled or directionless. Somatic Experiencing® views identity confusion as a fragmented sense of self due to unresolved trauma. SE helps clients like Alex reconnect with their inner sense of self by working through sensations and emotions associated with confusion. This gradual integration leads to a more cohesive sense of identity, anchored in the body’s sensations and awareness.
5. Identity Alteration
Identity alteration is an intense form of dissociation where individuals may feel as though they have multiple, distinct identities within them, each with different memories, behaviors, or emotions. This can be a characteristic of conditions like Dissociative Identity Disorder (DID). Identity alteration is commonly linked to severe, repeated trauma in early childhood, such as prolonged physical, emotional, or sexual abuse, which the mind compartmentalizes in order to cope.
Growing up, Tara often felt like she had to be a different person to meet the varying demands of her family. She learned to adapt her behavior, switching between the “caretaker” with her mother and the “obedient child” with her father, creating a fragmented sense of self. Now, as an adult, Tara sometimes feels as if she has distinct personalities, each one surfacing depending on the situation. She can be outgoing and assertive in one moment, but suddenly shift to feeling small, quiet, and submissive in another. These shifts often happen without her control, leaving her and others feeling confused and struggling to explain or understand her actions. Each identity feels like a separate part of her, each carrying its own set of emotions and memories.
Left untreated, identity alteration can lead to confusion, impaired functioning, and difficulty maintaining consistent relationships and employment. The individual may feel out of control and struggle to maintain a stable sense of self. Somatic Experiencing® sees identity alteration as a survival response to trauma, creating parts to contain different aspects of traumatic memories. SE helps clients like Tara bring safe awareness to each part, allowing for gradual integration by working within the body’s capacity, supporting a unified and regulated self.
6. Absorption
Absorption is a deeply focused state where individuals may become so engaged in activities or their imagination that they lose track of time and become disconnected from the present moment. While it can be positive when it happens in safe, creative states (flow states) in dissociative contexts, it becomes a habitual disconnection from reality and a maladaptive coping mechanism. Absorption as a dissociative response is common in people with a history of neglect or emotional trauma, where they may have turned to their inner world for comfort, leading to a habit of disconnection from the external world.
Growing up in a chaotic household where conflict was frequent and intense, Jake found solace in his imagination. He learned to escape from the tension at home by losing himself in books, movies, and, eventually, his writing. This focus on his inner world helped him feel safe and protected, even if it meant disconnecting from the present moment. As he became older, this pattern continued; he could spend hours absorbed in his work or hobbies, often losing track of time and forgetting to eat or sleep. As an adult, Jake now struggles to balance his creative work with everyday life. His tendency to immerse himself so deeply often leaves him isolated and disconnected from friends and family, even when he’s physically with them. While he values his creativity, he sometimes feels as if he’s using it to avoid confronting the outside world, leading to a sense of loneliness and detachment.
Untreated absorption can lead to social isolation, poor self-care, and a weakened connection to reality. It may also contribute to procrastination and avoidance behaviors, affecting productivity and relationships. Somatic Experiencing® recognizes absorption as a dissociative response when it disconnects individuals from their immediate surroundings and body awareness. SE supports clients like Jake in maintaining grounding and present-moment awareness, using techniques to stay connected to their bodies while engaging in activities, creating a balance between focus and presence.
7. Dissociative Fugue
A dissociative fugue (pronounced "fyoog") is a rare and extreme form of dissociation where an individual may suddenly leave their environment, travel, and adopt a new identity without recollection of their past. This temporary state is often triggered by trauma, complex trauma, or extreme stress, especially in cases where a person feels they have no means of escape from an overwhelming situation or environment.
Throughout Kate’s childhood, her parents frequently moved, driven by her father’s unstable job situation and her mother’s volatile relationships. Kate learned early on to adapt to new environments quickly, but she also never had a true sense of home or stability. With each move, she’d leave behind friends, routines, and any sense of permanence, building an identity around constant change. Her childhood left her feeling rootless and unsure of who she truly was, as every move disrupted her ability to form lasting connections. Years later, following the breakdown of a high-stress marriage, Kate finds herself in another city with no memory of how she got there or even who she is. This sudden shift leaves her feeling scared and confused, and it’s not until hours later that her memory returns, but the experience leaves her shaken, uncertain, and more traumatized than before.
Untreated fugue states can result in repeated episodes, loss of relationships, and issues with identity and self-esteem. People may struggle to trust themselves, as they may fear unexpectedly “losing” parts of their memory or life again. Somatic Experiencing® interprets fugue states as the body’s “flight” response taken to the extreme, allowing escape from distressing circumstances. SE therapists work with clients like Kate to create a strong sense of safety and grounding in familiar environments, helping build resilience so the nervous system feels less need to “escape” in this way, ultimately reducing the likelihood of future fugue states.
How Somatic Experiencing® Gradually Heals Dissociation
Somatic Experiencing® therapy is all about increasing body awareness through grounding and gentle reintegration techniques. By engaging the body and gently releasing stored trauma, SE helps create a more cohesive sense of self, supporting clients in feeling safe within their bodies and in the world around them. Dissociation is a survival mechanism that, unfortunately, stays with us until we can reconnect safely with our experiences and reintegrate the fragmented parts of our mind and body. Through SE, clients can learn to reclaim their sense of presence, grounding, and wholeness one step at a time.
If you’re ready to explore healing and reconnect with yourself in a safe, supportive environment, Somatic Experiencing® could be the next step in your journey. Reach out today to learn how SE can help you gently work through past trauma, restore a sense of safety, and start living fully in the present. Your path to wholeness begins with one small step—let’s take it together!
Ready to become more embodied ? Explore how Somatic Experiencing® therapy can help!
SOMATIC EXPERIENCING® • THERAPEUTIC TOUCH • REIKI ENERGY HEALING
TRAUMA THERAPY • THERAPY FOR WOMEN IN THEIR 20s • PSYCHEDELIC INTEGRATION THERAPY
IN-PERSON THERAPY IN PASADENA, CA | VIRTUAL THERAPY IN CALIFORNIA
