North Star Conversations Transcript: Dissociation vs Avoidance—Tovah Means, LMFT
Brandon Gimbel and Tovah Means clarify the clinical difference between dissociation and avoidance—and why confusing them can misguide treatment:
Brandon Gimbel (00:00)
What is the difference between dissociation and avoidance?
Tovah Means (00:04)
That's a good question. I think avoidance can be felt consciously and unconsciously throughout the day, and it's normal. I think dissociation, it just happens. Someone switches out of the present moment. They don't even know where they've gone and they're off doing something they don't know what it's about or why it's happening.
Brandon Gimbel (00:21)
It’s not avoidance, it's something more.
Tovah Means (00:23)
From a dissociative perspective, they're not actually avoidant. Their nervous system is like, "Why are you doing this? Let's not go back there, that's horrible."