ASK DR. LEEDOM: What is dissociation?

A reader asked the following question this week:

Recently, I’ve started doing more research into sociopaths and have run into a condition with which I’m unfamiliar: dissociation. Do you know if sociopaths/psychopaths have been considered to have this disorder, or if it is part of what makes them who they are?

The term dissociation has two distinct meanings in psychology. These two uses of the same word do not necessarily reflect a similar process operating in each.

The first kind of dissociation is a response to stress, and peritraumatic dissociation (dissociation during a traumatic event) appears to be a risk factor for stress-related illness. Symptoms of this kind of dissociation include disturbed experience of reality related to time, memory and nearly every sensation. For example, during trauma, time may stand still and people report that things do not seem real. Male sex hormones or androgens (that women also have in lower levels) protect against this kind of dissociation. For a good but technical article about peritraumatic dissociation read, Symptoms of Dissociation in Humans Experiencing Acute, Uncontrollable Stress: A Prospective Investigation.

The second kind of dissociation relates to the observation that the mind is modular. That means we don’t use our entire brain circuitry all the time, and during different behavioral and emotional states, different circuits are activated. Testosterone is hypothesized to disrupt the connection between the cerebral cortex and the limbic system, and so enhances this kind of dissociation.

This increase in mind modularity has been related to sociopathy/psychopathy by some experts. In a previous blog I reviewed Psychopaths in Everyday Life, a book by Robert Rieber. There is a great quote from the book that relates to your question. It is,

The true psychopath compels the psychiatric observer to ask the perplexing and largely unanswered question: Why doesn’t that person have the common decency to go crazy?

So why don’t psychopaths have the common decency to go crazy? Dr. Rieber explains, “Since psychopaths act as if they were perfectly normal, i.e. sane, they must be skilled in a cunning manner to dissociate any real guilt that they should feel about their antisocial behavior.” He also says that since psychopaths dissociate, they don’t go crazy. He believes dissociation prevents them from experiencing guilt. He also says that many psychopaths do have some level of guilt they are dissociated from.

So there may be a connection between sociopathy/psychopathy and dissociation, but the connection depends on your definition of the word.

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53 Comments on "ASK DR. LEEDOM: What is dissociation?"

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I am having so many aha moments reading these comments, I’m so glad I found this site.

The ex ‘s facial expression was always blank. Eerily blank. I asked him about it several times. He said he had to give bad news to parents a lot about their children (he is a pediatrician dealing with a certain speciality)and so he just must have gotten used to not having an expression. I mulled it over for a while, but never accepted that. When he did smile, it looked painful.

He cried spontaneously and for no apparent reason and my first thought was WTF, then it was ‘those are some pretty amazing crocodile tears’. I found that if I did not acknowledge these odd bursts of tears, they’d stop.

He also ‘locked his keys in his car’ after I stopped seeing him once, and he lives waaaaay far from where he works, and he had his son with him, so he guilted me into driving him all the way home to get his extra key, then all the way back to his car. Locksmith anyone? Boundaries? Anyone? Anyone? Saying no at that particular time would have likely saved me 2 years of utter craziness.

Like others have mentioned, he also fell asleep immediately. So many commonalities!

Disassociation in sociopaths may start as defense mechanism against early childhood abuse and stress.

For example, a boy is physically abused by his step-father. In order to survive the abuse, the child’s mind goes elsewhere in an attempt to block out reality. Some believe, this may be a positive trait when the stress is minimal. However, if the stress is extensive, it may carry on into adulthood and be a part of a dysfunctional personality.

I have dissociated every time I have been in a “life and death” situation from car wrecks where I “saw it coming” to the rape to the airplane crash that killed my husband and burned my friends and my son….so maybe that was why my PTSD symptoms have been in some respects so intense and so enduring.

Once in a car wreck I saw coming, and didn’t think there was any way to survive, I was just so calm and because I was preg I thought to myself “I am so sorry the baby will die with me” and then I just “tuned out” like turning off a TV, The screen went BLANK and I woke up in the back seat of the car (we didn’t have seat belts in those days) upside down at the bottom of a steep hill.

Of course I didn’t know what “dissociation” was in those days, but that event where I “tuned out” was etched in my mind as “odd” and I remembered it vividly to this day.

Other times I have dissociated in other ways, without “blacking out.”

It would be interesting to know WHY some people are more prone to disassociation than others though.

Also the differences in dissociation in “long term high stress” versus “instant high stress” like in a life and death situation versus continual fear/stress.

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