PTSD and Dissociation?

By Kristina Randle, Ph.D., LCSW

Q. I’m having a lot of trouble understanding my own behavior and how certain things go together. I have had constant trauma until I was 17 and left my home. Since then, I’ve struggled with certain triggers – things that sound like my mom’s laugh and anything that reminds me of what happened for so long. The triggers make logical sense to me. However, I have a lot of trouble seeing myself in the past as an actual person and I swing between feelings of being completely overwhelmed by fear of danger and feelings that there’s no way any of my past could have happened because it doesn’t make sense that someone could have survived it so well. I know in my logical mind that my past had to have happened, but I still feel that it didn’t really happen to me. I’ve been trying to work on this in therapy but it is difficult because sometimes my thoughts slow down so much that I can’t finish a sentence or understand what’s happening around me. It’s not that I’m lost in thought, it’s that my thoughts actually stop. I also occasionally have trouble remembering how old I am or what year it is. One behavior that freaks me out is that as a child, I pretended to be other people and some of the time it didn’t seem like pretend, and I spent about half my waking time in an imaginary place with an imaginary family. But this stopped once I got into middle school.

I know I just listed a bunch of information, and I know that no one can diagnose anything over the internet, but what I am trying to understand is if these behaviors all fall within the realm of PTSD, or if I could have a dissociation problem. Do you have any insight into why I have these symptoms? Is there a specific kind of therapy that might work for me? Thanks.

A. It may be that you have PTSD and a dissociation disorder. PTSD and dissociation disorders can occur comorbidly. To what degree you are suffering from both, or either disorder, is not something that I can accurately determine based on a short letter.

You may never come to know what is causing your behavior and if you did I suspect that information would be of little assistance to you. Knowing “why” the behavior is occurring is less essential than finding treatment for the dissociation events (i.e. the times when you have difficulty remembering how old you are or what year it is or having to stop midstream in your speech because your thoughts have “stopped”). These issues seem to affect your daily life.

I would recommend that you search for a therapist who specializes in PTSD, helping victims of trauma or who has expert knowledge of dissociative disorders. There may possibly be treatment programs related to trauma in your area. You should try to research them. There are also therapists who utilize treatments such as hypnosis and Eye Movement Desensitization and Reprocessing (EMDR) that may be beneficial to you. Research has shown that EMDR in particular can be an effective treatment for trauma. If you’d like to read more about EMDR, click here to be connected with the EMDR Institute, Inc.
Thanks for writing. I wish you luck.

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Last reviewed: By John M. Grohol, Psy.D. on 22 Sep 2008

APA Reference
Randle, K. (2008). PTSD and Dissociation?. Psych Central. Retrieved on October 21, 2014, from http://psychcentral.com/ask-the-therapist/2008/09/22/ptsd-and-dissociation/