The most common trait we think of when discussing PTSD is dissociation. Whether through flashbacks, or disconnections from the present, dissociation primarily seen as a pathological left over from a traumatic event, most seen with combat veterans. Within this imagery, one sees a firecracker or backfire from a car that sends a military veteran into a flashback of a past war scene. While this is accurately captures PTSD, this is only one minor aspect of dissociation and only illustrates its pathological symptoms instead of its overall necessity within the protective and defense mechanisms of the human body against extrema trauma. It is important to remember according to Contreras, that some dissociative behaviors are also part of the human experience and not necessarily pathological symptoms (2024, P, 181). In this blog, we will shortly look at dissociation in a broader scope and see how it exists not only during the trauma, but after the trauma as well, and how it manifests in multiple different ways.
Please also review AIHCP’s Healthcare certifications, especially AIHCP’s Trauma Informed Care and Spiritual Trauma Informed Care programs.
Peritraumatic Dissociation
During extreme stress or trauma, or life or death situations, the body’s autonomic nervous system responds through its sympathetic or parasympathetic branches. As discussed in previous blogs, this can lead to fight, flight, freeze, fawn, or even fade. Since dissociation deals with fade or immobility, it is part of the parasympathetic response during a traumatic event. In its peritraumatic state, the survival mechanism is natural and looks to help the person disconnect, detach, or compartmentalize the event. This is shutdown is is to spare the mind the horrible nature of the event and other emotional and mental damages, albeit, it also shuts the person’s physical abilities to continue resistance. During this moment of detachment, the Prefrontal Cortex’s emotional processing is inhibited and the sympathetic activity is reduced. In turn, the parasympathetic response increases and the activity of the cortico limbic brain creates algesics to skip the process of storing memories, or recalling memories, especially painful ones. In addition, analgesics are produced to reduce pain and numb the body from the event (Contreras, 2024, p. 176-177). This process can leave gaps in memory as well as other cognitive and emotional related issues. The more traumatic event, the more traumatic the dissociation and due to this the higher possibility to dissociate later (Contreras, 2024, p. 173).
What to remember is this natural defense and survival response is normal in its hope of protecting the mind and body.
Posttraumatic Dissociation
Dissociation becomes pathological when it continues to haunt the mind after the actual event. The mind can be easily triggered due to similar scents, surroundings or signs that evoke the survival response. For many, they are already existing in a constant survival strategy mode, keeping systems on red alert. Within dissociation, individuals may experience psychological and functional alterations of memory and identity. Others may sense physiological symptoms such as temperature loss in the limbs, or a lowered heart rate. Others may sense a detachment from surroundings or disconnect from bodily sensations. Others may experience less pathological experiences with temporary states of day dreaming or disengagement with life (Contreras, 2024, p. 174). Various aspects are also affected by dissociation such as loss of time, disconnect from body, disconnect from identity of self, lack of motivation, amnesia and memory loss, or loss of capacity to recognize emotions and their affect, meaning and range (Contreras, 2024, p. 175). All of these issues represent true significant issues for a person who has not returned to homostatis or baseline due to the traumatic event. Since the body remains in a state of survival mode, mechanisms that are meant to be temporary instead are becoming permanent states of being for the individual.
Dissociation can become especially dangerous when in its extreme form it can cause individuals to become invert and thoughtless to their surroundings or what is happening. When amnesia is present, it can disconnect a person from their true self which forces the person to create new schemas or behaviors that are extreme in nature (Contreras, 2024, p, 182).
Dissociation according to the DSM-5 can also be experienced as a DPDR disorder (Depersonalization-Derealization disorder), as a Dissociative Identity disorder (multiple personality) or a amnesia based disorder. Due to these more extreme cases, it is critical to find help if these issues grow worst or persist. With personalization, the person feels detached, or even as an outside observer of one’s mental processes. With derealization where one experiences a type of unreality about one’s surroundings, as if dreamlike, distant or distorted (Contreras, 2024, p,. 319).
Finding Help
Therapists, especially those trained in trauma informed care, are especially equipped to help a person again find baseline or homostasis. They can help the individual again deactivate the autonomous nervous system and turn off survival mechanisms that have hijacked the overall person’s life. This involves not only learning to regulate emotions, but also instructing others in grounding techniques that can limit the dissociation. In many cases, exposure therapy and reframing is necessary to help the person move beyond the traumatic event. It involves helping the brain properly store the memory and process it. In doing so, the brain can eventually reset without being alerted to non threats.
Please also review AIHCP’s blog on grounding techniques for those suffering from PTSD. Click here
Conclusion
Dissociation is a natural response of the parasympathetic nervous system that involves detachment during a traumatic event. It shuts down many centers of the brain for memory by effecting encoding , storage and retrieval. Instead the memory becomes emotional and tied to the amygdala. Additionally, the hippocampus has a difficult time differentiating the past memory and event with the present moment and associates everything as imminent. This in turn leads to triggers and continued detachment from non existent threats. Since the body remains in a state of red alert, dissociation as a survival mechanism instead becomes a survival strategy that persists until the person is finally able to resolve the past trauma.
Please also review AIHCP’s healthcare certifications as well as its Trauma Informed Care and Spiritual Trauma Informed Care programs.
Resource
Contreras, A (2024). “Traumatization and Its Aftermath: A Sympathetic Approach to Understanding and Treating Trauma Disorders”
Additional Resources
Tull, M. (2025). “What Is Dissociation?. Very Well Mind. Access here
“Dissociation”. Psychology Today. Access here
“Dissociative Disorders”. Mayo Clinic. Access here
Guy Evans, O. (2025). “What Is Dissociation? Types, Causes, Symptoms & Treatment”. Simply Psychology. Access here