What Is Dissociation in Borderline Personality Disorder?

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You are likely shocked to learn that those times when you "zone out," feel " unreal," or when things around you look strange or unfamiliar may mean you are experiencing dissociation—a common occurrence for people with borderline personality disorder (BPD).

What Is Dissociation?

Dissociation can be difficult to understand and wrap your head around. That said, in broad terms, dissociation represents a disconnect among a person's thoughts, emotions, behaviors, memories, and identity.

More specifically, after years of study, researchers are now able to describe experiences that go along with dissociation.

These include:

  • Depersonalization. Depersonalization is a feeling of separation from yourself and your body. People who experience depersonalization may say that they feel like they are observing their own body from the outside, or as if they are in a dream.
  • Derealization. Derealization is similar to depersonalization, but it is a feeling of being detached from the external world, such as other people or things. Derealization may cause familiar things to look strange, unreal, or unfamiliar. Derealization and depersonalization often occur at the same time.
  • Amnesia. Some people who experience dissociation have periods of amnesia or "losing time." They may have minutes to hours or days when they were awake but cannot remember where they were or what they were doing.
  • Identity Confusion: This occurs when a person experiences an inner struggle about who they really are, their identity, so to speak. 
  • Identity Alteration: Identity alteration means that a person senses that they act like a different person some of the time. For instance, she may see things in her home she does not recognize, perform a skill that she does not remember learning, or others will say she is acting like a different person. Mild identity alteration is common in the general population and may involve changing one's name. The key is that it does not cause problems with everyday functioning or relationships. In other words, a person is aware of their identity or role change. Moderate identity alteration is common in BPD, and involve changes in mood or behavior that are not under a person's control. 

    If you haven't ever experienced dissociation, you may be puzzled by these descriptions. But even if you do not experience dissociation frequently, most people have experienced mild forms of dissociation from time to time.

    A common example of dissociation in everyday life is zoning out (when you cannot remember what you were thinking or doing) while you were driving on a highway which caused you to miss your exit. 

    Is Dissociation a Disorder?

    There are some disorders that include dissociation as a central feature. For example, dissociative identity disorder (DID) is a disorder that is thought to be the result of very severe dissociation which causes a person to develop different personalities. The vast majority of people with dissociative identity disorder have experienced childhood abuse (for example, physical and/or sexual) and neglect.

    Besides dissociative identity disorder, the other four dissociative disorders are:

    Dissociation is also a symptom of other disorders. For example, one symptom of BPD is dissociation during times of stress.

    Dissociation is also associated with acute stress disorder and post-traumatic stress disorder (PTSD).

    Treatment for Dissociation 

    Treatments for BPD often also include components that are meant to reduce dissociation. Usually, treatment for dissociation is based on building skills that help you to reconnect with yourself, the present moment, and your current surroundings.

    For example "grounding" is one skill that can be used to reduce dissociation. Grounding exercises involve using external stimuli to reconnect. For example, in a visual grounding exercise, you will be instructed to observe small details about the environment around you until you are feeling more connected.

    Some people respond better to grounding exercises that use sensation—for instance, holding on to an ice cube for a few moments can help to bring you back to the present moment.

    A Word From Verywell

    Dissociative symptoms are common in people with BPD, occurring in up to two-thirds of people. Even so, there is certainly a spectrum of severity, meaning some people with BPD experience minimal or mild symptoms of dissociation whereas others experience more severe ones. Research suggests that this severity may be linked to a person's history of abuse and trauma. 

    If you or a loved one is being treated for BPD with dissociative symptoms (or a dissociative disorder), therapy can be challenging and intense, as you or your loved one may have to remember past trauma. But with time and attention, therapy can help a person take back power over dissociative symptoms. 

    Sources:

    American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing; 2013.

    American Psychiatric Association. (January 2016). What Are Dissociative Disorders?

    Dissociative Disorders. (2017). Traumadissociation.com.

    Korzekwa MI, Dell PF, Links PS, Thabane L, Fougere P. Dissociation in borderline personality disorder: a detailed look. J Trauma Dissociation. 2009;10(3):346-67.

    Vermetten E, Spiegel D. Trauma and dissociation: implications for borderline personality disorder. Curr Psychiatry Rep. 2014 Feb;16(2):434.

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