North Star Conversations Transcript: Dissociation Defined—Tovah Means, LMFT

Brandon Gimbel (00:00)

We'll start with a big one: What is dissociation?

Tovah Means (00:02)

Yeah, that is a big one. It's very complicated, but what I tend to tell people is that when our experience starts to get very overwhelming, and then when our bodies start to read some element of terror, dissociation is the system inside of us that starts to come online. And it takes the parts of us that are present and experiencing things in a present way offline, so that we can get through the moment.

When we're talking about dissociation in children where the threat is active every day, the overwhelm is active every day, the terror is activated every day, then you're really looking at a dissociation becoming a part of who you are inside of yourself. It's the place that children go when they can't cope in any other way. And so my simplest answer is: it takes us away in the moment from what we just can't tolerate until it's safe enough to process it.

Brandon Gimbel (00:51)

That's very helpful. I talk to my patients about defenses. Anna Freud really details all the different defenses for the self, and they all, to my mind, have a common thread: There's an element of denial in all of it, denial of reality from the simplest, "oh no!" to the most significant, this actual dissociation. We go to dissociation when there's nothing else available. None of the other defenses can protect the self sufficiently enough. So the mind says, "I'm out. I'm out. I'm separating. I'm putting a wall up."

Tovah Means (01:14)

Dissociation is unconscious. Dissociation happens without our permission, awareness, or consciousness. And so it makes it much harder to track and to work with in terms of defenses.