Dissociative Disorders and the Disintegration of the Present

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The clock ticks as my mind is frozen in time. People pass by, words lose their meaning, and everything around me becomes gradually less meaningful. I cannot keep up with the pace of time. One minute per minute is all too fast for my broken mind. I am perpetually trapped in the perfect tense, never able to reach the present and 'live in the moment' because my mind is afraid of the present.

This is what a dissociative experience resembles: an inability to catch up to the one minute per minute pace of time. Dissociation is a coping mechanism, typically for trauma or experiences of loss, wherein the patient cannot collect themselves in the present moment and respond to external stimuli. Rather, the patient responds to internal stimuli: a dangerous prospect. The patient will seem "zoned out," or perhaps not, during these episodes. Of course, dissociation exists on various spectrums, so it can be episodic or ever-present. In my case, however, it is episodic.

My Story

I recently resigned my position as a prep school teacher due to an inability to control these episodes and function well in spite of them. It is simply not a good idea to entrust a dissociative patient with children if their dissociation is not under control. I would oft find myself 'zoned' in the classroom with no real ability to address the students and control the classroom environment. Dissociation causes a generalized lack of engagement in daily tasks. This makes it particularly difficult to hold any job and meet basic performance standards. 

A year and a half ago, I was institutionalized for a few days due to suicidality and severe depression. A psychiatrist in Loma Linda agreed to take on my case due to its peculiar nature. Together, we realized that I had Borderline Personality Disorder (BPD) with dissociative features, and Major Depressive Disorder (MDD). This diagnosis was extremely helpful, as it led me to a different path than the general depression and anxiety therapeutic regiment that my university psychiatrist prescribed (sleep well, eat well, and take this hard-hitting depression and anxiety med). There are some illnesses that sleep and diet cannot solve. 

Thankfully there are therapeutic tactics and strategies to cope with dissociation; I am writing this post to explore these tactics.

Positive Coping Mechanisms

One positive coping mechanism is mindfulness meditation and acceptance and commitment therapy, as well as Dialectical Behavioral Therapy (DBT) and Cognitive Behavioral Therapy (CBT). 

Grounding Exercises

Let's face it: the present can be scary and full of stressors. First, before we begin meditation, we must ground ourselves in our present space. This is called grounding. Note three objects you see in the room and pay attention to their details (shape, color, size, etc.). Let your eyes linger. Now notice three sounds that you hear in the present (do this slowly and attentively) and again note their character. Now touch three objects and describe (out-loud) how they feel. 

The point here is to engage the senses as dissociation disengages the senses. This prevents a dissociative episode during the subsequent meditative exercises and creates a safe space for your mind to rest. Time distortions (the experience of time passing too slow or too fast) will also cease during these exercises. 

Mindfulness Meditation 

Mindfulness meditation is effective for some due to its ability to force the patient to focus on the present moment via their breath. Breath is something that is always present. We are always presently inhaling an exhaling, so breath is a key to understanding the present. 

Begin by just noticing your breath. Do not try to control it, just notice it. Rest your attention on it, gently. Then, let your thoughts pass by your attention as if you were sitting on a river bank and your thoughts were floating down the river, passing by you. Do not judge the thoughts or memories that come to your mind. Just let them pass. 

This will undoubtedly increase awareness of the present and loosen the grip of anxiety and dissociation on your experience of time. 

Theology of the Present

The present moment is where God seeks to meet us. It is God's "No" to the determinative grasp of the past; it is his assurance of hope in light of a seemingly uncertain future. Mindfulness meditation, grounding, and DBT/CBT are all theologically significant ways of reorienting the self toward a space wherein we encounter God.