5 Ways to 'Come Back' From a Dissociative Episode
The room evaporates. My body is gone, but also still there. I feel a tingling consuming my body, rolling through my veins, yet I am stuck, like my brain is suddenly unplugged from my appendages. My chest is weighted, tightening, exploding as I strain to breathe. My clothing suddenly becomes irritating, painful, and I want to rip it off. My legs and arms are moving, but not by my choice and definitely not in a way that I seem to have the ability to control. My eyes are open, but I cannot see; my ears are peaked, but I can’t hear. I want to scream, run away in fear…oh yeah, that’s right, my brain has disappeared.
A symptom of my many mental illnesses that I am constantly at battle with is dissociation. Dissociation is a mental disconnect, a “splitting” from the body. When I dissociate, my thoughts and desired actions lose the ability to communicate with my body, meaning my brain might be saying, “run,” but my legs never get the message. I tend to forget where I am, what I am doing, and even sometimes why I started dissociating in the first place. The feelings of dissociation can sometimes linger for hours, leaving me with these difficult sensations and peaked anxiety.
The best way to combat dissociation and return to my body is through what people refer to as “grounding” or mindfulness techniques. These skills are intended to help your body “reconnect” and return to homeostasis. While there are hundreds of different ways to do this, I have found these five work very well and allow me to quickly stabilize so I can remain safe.
1. The “5-4-3-2-1” Technique
This technique can be especially beneficial if you find yourself dissociating while in a group or public setting, like a party or a mall. The idea is to focus your attention within the room or space you are located by using your senses. You begin by simply focusing on your breath, then when able, you acknowledge five things you see, four things you can touch, three things you hear, two things you smell, and one thing you can taste. The process can be repeated or altered as needed until you find that you are able to successfully return to yourself and do what is needed to care for your body and safety.
This is a very simple technique and can also be used pretty much anywhere. To do this, you simply place your hands out in front of you so that your arms are comfortable and place your hands so that your fingertips on the right hand are touching their partner tips on the left hand (you should feel a slight pressure of your fingertips touching). Then, close your eyes and focus on only your breathing and your fingertips, allowing your anxiety, triggered fear, or other thoughts to simply come and go. Continue to do this until you feel calm, can breathe easily and no longer feel dissociation.
3. Use the Carpet
I became a master of this technique during my time in an intensive outpatient program at my local psychiatric hospital. This skill only requires you to lie down on a carpeted surface, stretch your arms out and close your eyes. Then, as you breathe as deeply as possible, you rub your arms back and forth on the carpet, as if making a snow angel. The rubbing of your arms and focus on your breath allows your body to find itself and reconnect, plus you are literally “grounding” yourself.
4. “T.I.P.” Your Body
This is actually a dialectical behavior therapy (DBT) distress tolerance skill, but it works wonders for both emotional dysregulation as well as dissociation if it is mild or you catch yourself when it is just beginning. The letters T-I-P each stand for something you can do to your body to ground yourself. “T” stands for temperature, meaning you do something to alter your body temperature significantly, such as splashing cold water on your face or holding or rubbing ice on your skin. The sudden change in temperature shocks your body back into homeostasis. “I” stands for intense exercise: run around the block, do jumping jacks or sit ups — you can even punch a pillow. Just do something to get your body active. “P” stands for progressive relaxation, meaning you focus on relaxing your body slowly and systematically, one area at a time. I tend to start at the top of my head and work my way to my feet, and have done it while sitting or even when in bed.
5. Keep An Object Handy
If you are going to be out of your home or at work and you are prone to dissociation when anxious, try to keep an object that you can manipulate handy. There are stress balls with textures, fidget cubes, stones or sand, “clicky pens” (not recommended if you work in close proximity to others), a body brush or even toys like a slinky (my go-to item to have in my purse). When you feel anxious or start to dissociate, you can reach for your object and go to town. Everyone will just think you are bored.
The biggest key is to find something healthy to allow you to cope, stabilize and return to status quo. My struggle with dissociation was that I would either reach for items to self-harm, or try to numb myself further with alcohol, both of which were unhealthy and unhelpful. I’ve dealt with dissociation since high school, and although I absolutely hate it, finding ways to ground myself has absolutely made a difference.
Unsplash photo via James Bak