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Dissociation Record

Worksheet

Dissociation is a set of physical and behavioral adaptations (‘skills’) that human beings have developed because they can help us to survive extreme events. Our bodies and minds have the ability to respond quickly, powerfully, and automatically in response to signs of danger – even if those responses are not what we would choose to happen in a particular situation. Dissociation can also be experienced after traumatic events have finished. The Dissociation Record worksheet is designed to help clients to learn more about how they dissociate. Once triggers have been identified strategies can be developed to avoid them, or respond to the resulting dissociation using grounding strategies. Therapists will find the data collected on a Dissociation Record regarding the type of dissociation a client experiences helpful when planning trauma-focused treatment.

Dissociation Record Dissociation Record

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Description

Psychologists think that dissociation is a set of physical and behavioral adaptations (‘skills’) that human beings have developed because they can help us to survive extreme events (Schauer & Elbert, 2010). This means that our bodies and minds have the ability to respond quickly, powerfully, and automatically in response to signs of danger – even if those responses are not what we would choose to happen in a particular situation. Dissociation can also be experienced after traumatic events have finished. These types of dissociation may persist, even many years afterwards.

Dissociation during trauma

There are some situations where in order to have the best chance of staying alive:

  • Your body might not want ‘you’ to feel pain because you might do something that could endanger you – such as trying to get away from the source of the pain.
  • Your body might not want you to feel some types of emotion, such as anger, in case they prompt you to act in ways that could result in you getting killed (e.g. provoking a stronger opponent, trying to escape).
  • Your body might not want the ‘conscious you’ to be too aware of what is happening in case you make a rash decision to act in a way that could jeopardize your survival.
  • Your body might not want you to move in case you worsen an injury.

Clients often find it helpful to understand that dissociation happens during traumatic events because your body has decided that it is important for the ‘conscious you’ not to feel certain things during a terrifying situation from which you can’t escape. In traumatic situations you might:

  • Feel less of particular emotions (because emotion could make you react in ways that would endanger you).
  • Not be able to move your body (because moving could endanger your life).
  • Feel separate from your body, or like you are watching events from the outside (an ‘out of body’ experience).
  • Feel hopeless / submissive / completely defeated because feeling this way means that you are less likely to fight back (which your body has decided could be a dangerous thing to do).

Dissociation after trauma

People who survive traumatic events often experience forms of dissociation. These can include:

  • Intrusive memories and ‘flashbacks’ of events from the trauma.
  • Your body or mind ‘replaying’ the emotions and body feelings that you felt at the time of the trauma. This can include strong feelings or ‘numbing’ (absence of feeling).
  • Feeling ‘detached’ or ‘disconnected’ from the real world when you have post-traumatic flashbacks or intrusive memories.
  • A general sense of feeling ‘spacey’ or ‘detached’ in the absence of conscious intrusive memories.

The Dissociation Record worksheet is designed to help clients to learn more about how they dissociate. Clients who dissociate can be advised to carry a copy of the Dissociation Record with them and record details of their dissociation for at least a week, filling it in as soon as possible after each episode of dissociation. Once triggers have been identified strategies can be developed to avoid them, or respond to the resulting dissociation using grounding strategies. Therapists will find the data collected on a Dissociation Record regarding the type of dissociation a client experiences helpful when planning trauma-focused treatment.

Instructions

“Dissociation is frustrating because it can happen unexpectedly and make you feel out of control. A good strategy is to understand what your triggers are, and to learn more about the ways that you dissociate. Once you know what your triggers are you can develop strategies to manage them: in the short-term it can be helpful to avoid them; and in the long-term you can retrain your brain to understand that these triggers are no longer signs of danger and that there is no need to dissociate.”

Step 1: Identify triggers for your dissociation

The first step of a dissociation record is to identify the triggers for your dissociation. Helpful questions to ask yourself include:

  • What was happening just before you dissociated?
  • Describe the situation. Who were you with? What were you doing, remembering, or thinking about? When was this? Where were you?
  • What do you think triggered your dissociation?
  • Were there any sensory triggers that you were aware of: sight, sound, touch, smell, or taste?

Step 2: Describe the kind of dissociation you experience

People can experience many different kinds of dissociation. Some people experience dissociation that affects what they experience in their mind, others that affects what they feel (or don’t feel) in their bodies. Helpful questions to ask yourself include:

  • What kind of dissociation did you experience?
  • Did you have an unwanted memory of an event from your past?
  • Did you experience a ‘replay’ in your body of something from your past?
  • Did you ‘zone out’ or feel ‘spacey’, unreal, or disconnected?

Step 3: Describe how the dissociation made you feel

Dissociation can be an extremely powerful feeling. You might have had thoughts or emotions about your dissociation at the time you dissociated, or later on. Helpful questions to ask yourself include:

  • How did you feel emotionally?
  • How did the dissociation make you feel (during and after)?
  • What did you notice (or not notice) in your body?
  • What did you think that experience was?
  • What did you think of yourself for dissociating like that?

Step 4: Describe what you did to cope

Some people make strong efforts to manage their dissociation, and other people report “nothing I do affects it, so I don’t bother trying”. Record what you do to cope with each episode of dissociation. This form can also be used to record your progress as you practice using different strategies your therapist may teach you, such as grounding or distraction. Helpful questions to ask yourself here include:

  • What did you do to cope in that moment?
  • What helped the dissociation to stop?
  • What helped you to ‘ground’ yourself back in the present moment?

References

Schauer, M., & Elbert, T. (2010). Dissociation following traumatic stress. Journal of Psychology, 218, 109-127.

Psychology Tools (2020). Trauma, Dissociation, and Grounding. Retrieved from: https://www.psychologytools.com/resource/trauma-dissociation-and-grounding/