Dissociation — a disconnection from thoughts, feelings, body, or environment — is a common chronic pain companion, particularly in trauma-related presentations.
Types of Dissociation in Chronic Pain
Depersonalization: Feeling detached from yourself — like watching yourself from outside
Derealization: Environment feels unreal, dreamlike, or distant
Emotional numbing: Feeling cut off from emotions that are part of chronic pain
Memory gaps: Difficulty recalling events during intense chronic pain
Why Dissociation Occurs in Chronic Pain
Dissociation is the nervous system's protection against overwhelming chronic pain experience. It's a survival mechanism that becomes problematic when it persists or interferes with daily functioning.
Managing Dissociation in Chronic Pain
- Grounding techniques bring attention back to the body and environment
- Titrated trauma work addresses the chronic pain driving dissociation
- Safety planning for when dissociation occurs at high-risk times
- Trauma-informed therapy specifically addresses dissociation in chronic pain