Time out of mind: The unspoken language of dissociation

by ann o'connell

Let’s talk about the intriguing and magical phenomenon of ‘dissociation’, and its younger sibling, ‘day-dreaming’. We all love to sneak out of consciousness whenever our mind’s eye forgets to blink, to dilute the roaring silence of the abyss, and the existential yawning of our cramped inner landscape. We actively seek out the expansive, soul-stretching freedom of delicious day-dreaming by playing hide and seek with ourselves. We all love to flirt with, and associate with our inner dissociates!  

Dissociation is where we go to, and come back from, when we want to explore our creative right brain. Actors would not be able to mesmerise and hypnotise us on the celluloid screen if they could not disavow their sense of self, and inhabit another self-state. Mystics would not be able to traverse the continents of their minds in search of the divine, were it not for the trick of dissociation. Artists would not be able to seduce us with the allure of their work if they could not lean into, and caress those dissociated parts that reside both within and without their many selves. Writers would not be able to weave textured, lived-in characters that compel us to turn the pages, were it not for their ability to divest themselves, and try on the coat of an altered state. Even the rave-apostles of dance culture groove and move to the sound of dub-step, trip-hop, and trance music in a state of psychotic grace - and take dissociative communion wafers such as ketamine, DXM and PCP. “God is a DJ” (Faithless, 1998).  

The Purkinje Shift  

The Czech anatomist Jan Purkinje is credited with identifying that in the most magical hour that we call twilight, the eye shifts away from red, and towards the blue end of the colour spectrum. This is a response to, and part of dark light adaptation (Purkinje, 1823). Likewise, dissociation can be viewed in that same grey-light spectral corridor. We know that dissociation presents particular challenges to the therapeutic work of recovery and healing, both as a transference and a defence mechanism. Indeed, by its very nature, dissociation is the desire to get away from, and ‘not know’, or ‘disconnect’ from the memories/experiences that caused the dissociation in the first place! And yet for therapy to be effective, we need the client to stay in the room with us, so to speak. So, the psychotherapeutic/ trauma informed response to dissociation is to ground the client back in present moment experiences, bring them back to their optimal window of tolerance, and reduce hyper/hypo-arousal.  

Skipping through Dresden  

If we use the city of Dresden during World War II as a metaphor for the destructive impact of chronic childhood trauma, the mindscape would look like it had been aerial bombed with a persistent and casual violence. The heart and soul of the city would be pulled asunder and infrastructure would be wiped out. Buildings would be deemed collateral damage, and their inner walls would be demolished floor by floor, leaving just a skeletal and asphalt shell.  

A child could not survive the implosion of a mind bomb of this magnitude, so the tectonic plates within the child’s internal streetscape would have to undergo a seismic shift to create a split or fault-line in the psyche. This geological re-ordering of the ground would ensure that the child could continue skipping through Dresden. 

   

When there is nobody to soothe a child during ‘The Blitz’, one creative response is to dissociate. When the child is amygdalated, an orchestral manoeuvre in the twilight introduces the parasympathetic strings section, which activates an autonomic arousal response. The symphony conductor then brings in the sympathetic brass and percussion section (enter stage left), flooding the body with opioids in order to ease the crescendo of traumatic pain. However, the contra-indications of these endogenous narcotics inhibit the child’s cry reflex/response, and decreases their mobility. Consequently, traumatic memories are not stored, integrated, or encoded in the brain in the same way as non-traumatic memories because of the extreme arousal of the hippocampus, and the chemical interaction of endogenous opioids. It is a melodic and narcotic overture of the mind!  

Memento Mori  

Dissociation is a structural separation of part of the experience of self. It is a “violent affair” when one part of the psyche attacks other parts, in the process of the severing of the self (Kalsched, 1996). Dissociation moves, transforms, and brings us into shifting worlds of colour and light, like a fractured puzzle that takes flight in the mind. It is a kaleidoscope of ever-changing and complex patterns being nudged and jolted into view, with every twist and turn of the cylinder. So who is the real me? “Will the real slim shady please stand up?” (Eminem, 2000).  

                    

Dissociation is an actor who stops speaking mid-scene and walks off set. Nobody shouts “Cut!”, so the movie reel plays on in the absence of this audience of one. There is no linear or sequential recall of the film script and no prompts from a backstage understudy. I am reminded of a similar but different trauma affect that was beautifully transcribed to celluloid by the director Christopher Nolan in the movie, Memento (Nolan, 2000), based on the short story “Memento Mori”, written by his brother Jonathan (Nolan, 2001). The main character, Leonard Shelby, suffered from anterograde amnesia as a result of a traumatic life event (no spoilers here)! It is similar to dissociation because it is wrapped up in themes of memory and identity.  

Van der Kolk and Fisler (1995) describe dissociation within the context of traumatic experiences that are not integrated into the underdeveloped hippocampus and left brain. Instead, they are stored in the right brain as shards or fragmented images. These gleams of splintered memories can be both known and unknown to the trauma survivor at exactly the same time - a paradoxical double-think, if you will - it was me and yet it wasn’t me – I know and yet I don’t know. So, the person is tethered to that confusing world of not consciously knowing things, yet sensing them in an elusive and inexplicable manner. This is what Ivor Browne called “the unexperienced experience” (Browne, 1990 ).  

Dissociative attunement  

In the world of neuroscience, researchers like Sands, Schore, and Howell & Blizard are taking a curious look at dissociation (Sands 2010; Schore, 2010; Howell & Blizard, 2009). It is a primitive form of communication, and yet despite the best efforts of clients to keep certain self-states out of their own conscious awareness, survivors of trauma feel compelled to show therapists their dissociated aspects of self. The veiled intention of the client is to be seen, understood, and to literally and figuratively show us their original wound. So, when an attuned other can tap into the dissociated aspects of a person’s mind, it transcends communication because dissociation is the silent dialogue of connection.  

These subtle attempts by clients to connect can get lost in translation in traditional talk therapy because survivors with dissociative minds utilise an almost backwards or atypical style of connection. This is the duality of approach and avoidance which comes under the rubric of a disorganised attachment style. This happens when there is a marked absence of an attuned other in the child’s life, so the child learns to withdraw when they are distressed. This pattern continues during maturation because of a consistent and persistent lack of dyadic regulation. This type of relationality must be repaired and revived in order for dissociation to be rendered unnecessary, and for the dissociative states to become known to self and other.  

So maybe we are looking through the wrong end of the telescope when it comes to communicating, connecting and tuning in to the secret language of trauma. The goal of integration of both self and object may require another field of contact for resolution of both experience and memory to take place. So instead of interpreting, we might enter the dissociated space of a client’s mind (Hopenwasser, 2008). This would facilitate the therapist to ‘know’ via their own countertransference what the client is showing us of their fragmented experiences. This is an issue of relatedness, whereby these unformulated experiences become known within the therapeutic alliance, and the attuned other helps the client to regulate.  

See-Saw Margery Daw  

Dissociation is a labyrinth of the mind that is born out of constant hyperarousal and a lack of attunement to the caregiver who did not soothe this flight response. However, the context of therapy can initiate the very same processes of hyperarousal and dissociation that were set in motion by the original trauma! Clients can oscillate on a metronome of extremes like constriction, numbness, deadness, trance-like affect, and detachment from self and therapist, to the other end of the spectrum of overwhelm, flooding, dysregulated affect, intense shame, fear, and aloneness.  

Dissociation comes out to play on the twilight corridor of the therapist’s room. When the temporal lobe shuts down and goes offline, verbal communication cannot be received or processed. However non-verbal and implicit channels are wide open in this two-way street of human traffic. In the relational matrix, when clients move in and out of dissociative states in the in-session experience, the therapist can experience a dissociative countertransference reaction by dissociatively attuning with the client and entering this conceptual space. The therapist attunes to the self-state of the other via their own creative right brain functioning, while firmly keeping the executive functions of their left brain online in order to fully meet the suffering of the other. This facilitates the therapist to decode traumatic experiences, and for the client to form a secure attachment to the other. When we enter the disassociated space of the other, the disassociated space enters us!  

Schore (2001) has indicated in neurobiological research that people remain hyperaroused even when in dissociative states. This means that active mental processes occur during dissociation. Clients can (and do) make veiled attempts to communicate with us in this paralytic grey-zone. The dual function of ‘knowing’ while also keeping a parallel but segregated aspect of ‘not knowing’, is the paradox of the child learning to play dead in order to promote bodily integrity and survival. The client does the same thing in the therapy room when confronted with what appears to be a deadly (relational) encounter!  

When the healthy ego steps aside and clients enter this altered field of contact, this allows dissociated states to step forward into the therapy room. The dissociated mind is not in need of insight in the traditional sense. However, it is in need of a relational dyad in order to integrate self-states, and find expression to unexperienced trauma.  

Peek-a-boo  

Dissociation is the ultimate show and (don’t) tell. It is not a case of ‘move along folks, there’s nothing to see here!’ There’s everything to see here, folks! It’s all on show if we know what we’re looking for. We often say that some traumas are so unspeakable that there are no words (Herman, 2015). Well disassociation is the foreign language of trauma - but there’s no need for subtitles here – we just need to creatively read the room. If dissociation is the royal road to split off experiences and memories, then mutual dissociation and attunement are literally and figuratively straddling the intimate edge, ledge, and precipice of trauma.  

It is said that when clients dissociate, ‘the work’ stops until therapists bring them back to their optimal window of tolerance (Ogden & Fisher, 2015). But what if dissociation is the work? What if grounding the client should happen at the end of the session instead of at the moment they dissociate? Clients are clearly trying to orientate themselves towards their own true north (their aurora borealis) by treading close to the margins of their unconsciousness with us. What if the path to healing lies within the four corners of this profound presentation that our clients honour us with every time they lift the veil and show us their time out of mind and mind out of time?  

Dissociation is the gold, frankincense, and myrrh that gifts us a half-open door to this split in the human psyche. When we step into the crumbling world of the client, we are spectators to their present moment disintegration, as we observe their war-torn child. We watch as they leave the scene of the crime and glimpse images of past infractions committed by those who trespassed against them.  

Dissociation is like living in width instead of length. It is the pull of the infinite into a finite and fractured world. It is like wandering unmoored around the fringes of the empty rooms in the mind. As therapists, we can make an enchanting and elegant enquiry, while standing in the face of the client’s ambiguity and cognitive dissonance. Dissociation is not a meaningless trance designed as a defensive wall to keep intruders out. It is intuitively designed to let us in! Clients help us to hit upon the right password that grants unfiltered access to the gossamer threads of harrowing memories that are ordinarily inaccessible to therapists.  

Dissociation is experienced as a fragmentary, piercing meditation of time. The past and the present merge in concentric circles, as we look past ourselves and lean forward into the next moment. There is a stillness that can be felt in the middle of each moment and is part of the vertigo of dissociation. It is here that clients experience the spiritual doldrums because they cannot open the door to the magical gateway of the self. It takes immense courage for both therapist and client to contemplate stretching further than the mind’s comfortable reach, into the ultra-dazzling blankness of dissociated paralysis. This is where tenses and worlds collide as we can skate across the icy surface of their many selves, and take a peek inside without breaking each layer.  

Last call for Dresden  

The psychotherapist, writer, and podcaster Jimmy Judge, with three decades of experience of working creatively with the aftermath of childhood trauma has this to say on the subject:  

The iconic, late, and very great David Bowie was the master chameleon, by creating and developing a cast of characters that spanned his six decades as a singer, songwriter, producer, actor, and performer. Even ‘David Bowie’ was the alter ego of David Jones, his birth name. Here’s where it gets intriguing, an arc within an arc, which is synonymous with the dissociation associated with psychological trauma: Whether it was Aladinsane, Major Tom, or The White Duke, his most compelling alter ego was Ziggy Stardust. This androgynous, sexy human/alien hybrid had a powerful impact on 1970s society and remains highly influential to this day. Did Jones know Bowie? Did Bowie know Ziggy or vice versa? The answer is both yes and no simultaneously – to know and not know, and yet exist and desire expression and recognition. Welcome to the mystical, magical, painful, confusing, and transformative world of dissociation, or as this article names and introduces us to, “Time out of mind”. More often than not, the C-PTSD sufferer is concerned and gauging how you will receive them - can you hear me? Will you believe me? Will it be too much for you? Will I blow your mind because it sure as hell is blowing mine!  

Judge continues:  

At a basic level, dissociation or ‘time out of mind’, is quite simply a no-brainer. Who would want to ‘associate’ with the awful people who treated you horrendously with ‘unspeakable’ abuse? Of course, you would want to disconnect or dissociate from such awful, uncomfortable memories/ experiences. This is our most natural and healthy instinct. So far so good, right? Okay but what if those despicable acts were perpetrated by our loved ones? And what if we were far too young to process such violent onslaughts? What if our nervous systems had not developed sufficiently to manage and integrate such horrors? Enter the amazing, creative, and miraculous world of time out of mind where the Dresden children play hide and seek in the burnt-out debris of the traumatised mind. Their hope now as adults in the therapy room is that the therapist doesn’t give up on them, keeps looking and listening to them, watching for signs, prompts and clues. Be patient. Ya just have to let your client show you where they are. The adult/child client is in fact trying to teach us how to find them. So, when you feel lost, inadequate, and powerless as the therapist, watch and listen very carefully. Ya hear that? Ya see them.  

(Judge, 2021).  

“He’d like to come and meet us, But he thinks he’d blow our minds”  

(Bowie, 1972)  

War baby 

 

Darkness belongs to that class of blessings that are vital to the human spirit. There is an allure to the dark that delivers us both to and from our inner children when we wrap ourselves up in the pitch black. As we dig past the surface of dissociation, there is an absurdity and pernicious tenet that runs through the epicentre of our sense of identity and who we think we are.  

Therapists are the issuers of open invitations to clients, but in this case, the clients are inviting us into their world. The question is, can we RSVP in a timely fashion, so that we might have a different conversation with them than the ones we have been having up until now? The mind’s capacity for freedom is infinite, but it can default to the imprisonment of repeating patterns if we are not listening with our third ear when we traverse the wreckage and spectacle of childhood trauma.  

If we strive to live out of the mantra that the client is the expert in the room, then let them lead us by the hand to the nexus of their woundedness. The magic of mutual dissociative attunement can take us on that journey with them to their promised land! Let’s celebrate this extraordinary non-verbal language. This complex architectural puzzle was constructed by the children of Dresden when they were all alone in the trenches. Nobody came to their rescue so they had to find a way to play hopscotch on crumbling streets, listening to a discordant, internal beat that had its own tone and colour. This was not 4/4 time. This was a disjointed jazz harmony with syncopated rhythms, and a heavy emphasis on improvisation.  

So maybe our gift to clients is to sit with them under a strung out, battle-scarred sky, and help them to rescue their inner refugee who is caught between the synaptic cracks of their cerebral cortex. There may be more than one inner war-child who needs to grab a winch from our psychological helicopter and be pulled to freedom and safety. We can assist them to introduce themselves to themselves and say, “Hi Ann, it’s nice to meet you. My name is Ann. The war is over baby... It’s time to come home” 

Ann O’Connell is a psychotherapist in the HSE. She co-authored a number of training manuals on the subjects of addiction and trauma, including Reduce the use and Trauma informed care in Ireland. She just completed Level 9 MSc. Psychotherapy with DCTC and wrote her thesis on the subject of How client traumatic experiences, including dissociation, impact on the therapist within the therapeutic relationship. Contact Ann at aoconnell911@gmail.com  

References

Bowie, D. (1972). Starman [Song]. On The rise and fall of Ziggy Stardust and the spiders from Mars. RCA Records.  

Browne, I. (1990). Psychological trauma, or unexperienced experience. Revision 12 (4), 21-34.  

Dylan, B. (1975). Time out of mind [Song]. On Time out of mind. Columbia Records.  

Eminem (2000). The real Slim Shady [Song]. On The Marshall Mathers LP. Aftermath Records.  

Faithless (1998). God is a DJ [Song]. On Sunday 8pm. Arista Records.  

Herman, J. (2015). Trauma & recovery: The aftermath of violence – from domestic abuse to political terror. Basic Books.  

Hopenwasser, K. (2008). Being in rhythm: Dissociative attunement in therapeutic process. Journal of trauma and dissociation. 9 (3), 349 - 367.  

Howell, E. F. & Blizard, R.A. (2009). Chronic relational trauma disorder: A new diagnostic scheme for borderline personality and the spectrum of dissociative disorders. In P.F. Dell & J.A. O’Neil (Eds.), Dissociation and the dissociative disorders: DSM-V and beyond. 495-510. Routledge.  

Judge, J. (2021). The many faces of dissociation. Unpublished essay.  

Kalsched, D. (1996). The inner world of trauma. Routledge.  

Nolan, C. (Director). (2000). Memento. [Film]. Summit Entertainment.  

Nolan, J. (2001, March). Memento Mori. Esquire Magazine.  

Ogden, P, & Fisher, J. (2015). Sensorimotor psychotherapy: Interventions for trauma and attachment. W.W. Norton & Co. Purkinje, J. (1823). Commentatio de examine physiologicoorganivisus et systematiscutanei. University of Breslau Press.  

Sands, S. (2010). On the royal road together: The analytical functioning of dreams in activating dissociative unconscious communication. Psychoanalytical dialogues, 20, 357-373.  

Schore, A.N. (2001). The effect of early relational trauma on the right brain development, affect regulation and infant mental health. Infant mental health Journal, 22, (1-2), 201-219. Schore, A.N. (2010). The right brain implicit self: A central mechanism of the psychotherapy change process. In Petrucelli (Ed.), Knowing, not-knowing, and sort-of-knowing: Psychoanalysis and the experience of uncertainty. Karnac Books.  

Van der Kolk, B.A., & Fisler, R. (1995). Dissociation and the fragmentary nature of traumatic memories: An overview and exploratory study. Journal of traumatic stress, 8, 505-525.  

IAHIP 2022 - INSIDE OUT 96 - Spring 2022