Losing the connection with your physical self
Dissociation is when we lose connection with our physical self and from a somatic point of view when we lose contact with the felt sense of what is going on inside our bodies.
Remarkably, we all disassociate every day as a coping mechanism. In those moments when we think, sorry, what did you just say? We might have dissociated, and our mind has wandered somewhere else, or the topic of conversation was a little tricky. Heartache, for example, can be a grief-stricken emotion that can be overwhelming, we can feel our gut tightening and that might be where we hold the emotion. Any avoidance of dealing with these situations as they occur means the emotions won’t be processed and allowed to pass through. Consequently, they can end up held and locked within the body. Given that we all dissociate, probably every day to some extent, the body begins to protest and that is when we need to seek help for the pain or disease that starts to manifest.
It is rather like driving down the road without a speedometer. It is really difficult to know whether you are driving too fast or too slow, or whether you need to use the accelerator or the brake. Without any feedback mechanism and a sensory awareness the whole system falters or breaks.
Assessing a patient with any problem, we are helping them to see their bodies and to understand what they can feel and what they can’t feel. A turning point in my own healing journey from acute episodes of pericarditis was when I realised that I needed to stop thinking my body was the enemy. Pain is communication and it was trying to tell me something.
It would be hugely powerful within general medicine if we could integrate an understanding of dissociation, somatic approaches and nervous system problems. If every GP, every doctor and every physiotherapist understood this we would be seeing the patient very differently when they came in with, for instance, irritable bowel syndrome. We would be thinking, what is going on with their nervous system and why has that become dysregulated? Not everybody with IBS disassociates, but very often they are not feeling the origins of that stressor or disturbance to the body and if they can’t feel it they can’t control it.
Dissociation is very common in trauma. Trauma is probably one of the biggest reasons why we might dissociate because it is an experience of suffering that is: too much, too fast, too long or a need that is not met in the case of neglect.
In those situations, the mind will find a way to find a way to cope and usually that will involve some form of dissociation from the body that is saying this is unbearable and this is painful. However, if the pain isn’t felt, it can’t be healed.
Through a gentle process with a skilful therapist and a mutually agreed therapeutic alliance the patient can start to feel and come back into full contact and relationship with their body. They are not thrown back into feeling the terrible pain, but start to relate to their body, not as the enemy, but as friends with it again.
You can watch my video on this on my YouTube channel. Just click on this link: https://youtu.be/5lp7gMABqKg?si=JZ1XJLv7ywoNXR8j
