Dissociation — a disconnection from thoughts, feelings, body, or environment — is a common moral injury companion, particularly in trauma-related presentations.
Types of Dissociation in Moral Injury
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 moral injury
Memory gaps: Difficulty recalling events during intense moral injury
Why Dissociation Occurs in Moral Injury
Dissociation is the nervous system's protection against overwhelming moral injury experience. It's a survival mechanism that becomes problematic when it persists or interferes with daily functioning.
Managing Dissociation in Moral Injury
- Grounding techniques bring attention back to the body and environment
- Titrated trauma work addresses the moral injury driving dissociation
- Safety planning for when dissociation occurs at high-risk times
- Trauma-informed therapy specifically addresses dissociation in moral injury