Dealing with Dissociation in Therapy Sessions: Techniques and Strategies

As therapists, we understand that dissociation can often be a challenging phenomenon during therapy sessions. While it can sometimes be a natural protective mechanism, it can also disrupt the therapeutic process. It's essential to equip yourself with the right tools and techniques to ensure that your clients feel safe and supported during these moments. This article aims to provide you with a comprehensive guide on how to handle dissociation effectively and support your clients in reconnecting with the present moment.

Understanding Dissociation in Therapy

During a therapy session, a client may experience dissociation, a state where they feel disconnected from their body, thoughts, emotions, and surroundings. Dissociation can manifest in various ways, including:

Staring blankly or appearing unresponsive Difficulty recalling what was just discussed Changes in demeanor, such as becoming emotionally flat Physical signs, like fidgeting or changes in posture

Therapists Response: Techniques and Strategies

When a client shows signs of dissociation, it's crucial to respond in a way that promotes safety and facilitates reconnection. Here are some strategies that therapists can use:

Stay Calm and Grounded

The therapist should maintain a calm demeanor to help the client feel safe and protected. This approach can be particularly effective in reducing anxiety and creating a secure environment for the client.

Use Grounding Techniques

To help the client reconnect with the present moment, grounding techniques can be employed. These include:

Encouraging deep breathing: Ask the client to take slow, deep breaths, which can help them regain a sense of control. Using sensory awareness: Guide the client to focus on physical sensations, such as feeling their feet on the ground or noticing the texture of an object. Engaging in dialogue: Gently ask the client questions to redirect their focus, such as, “What do you see in the room?”

Offer Reassurance

Reassure the client that they are safe and that it's okay to take their time to return to the present moment. This acknowledgment can help them feel more comfortable and supported during the session.

Assess and Process

Once the client has been reconnected with the present moment, take the opportunity to explore the dissociative episode. This can help in understanding its triggers and addressing underlying issues. This exploration can provide valuable insights into the client's experiences and emotions.

Personal Insights and Experiences

Some therapists, like myself, may personally experience dissociation during therapy sessions. However, this doesn't negate the value of the therapy. Instead, it can provide unique insights into the client's experiences. As mentioned in the case study, my psychologist continuously monitors my state while I dissociate and uses this to facilitate a deeper and more insightful therapy session. The dissociative state can often bring information that is otherwise blocked, making it a valuable tool in the therapeutic process.

It's important to note that the level of dissociation and the presence of the client must be carefully managed. If the state is too deep, it might be necessary to guide the client back to the present. On the other hand, if the client is feeling safe, the dissociative state can be directed towards insights or grounding techniques.

Conclusion

The goal when dealing with dissociation in therapy is to provide a safe and supportive environment for the client to process their feelings and experiences without judgment. Each therapist may have their own preferred techniques based on their training and the specific needs of the client. With the right approach, we can make the most of these moments to enhance the therapeutic process and deepen our understanding of our clients.