The Experience of Dissociation
Garnet > Lucid Studios
February 15, 2024
Simple Concept
Sustained “uncertainty” can lead to “dissociation”.
Our brain always seeks signal in noise. It tries to “make sense” out of “nonsense”. It looks for patterns to be able to better predict actions and their outcomes. When things “don’t add up”, one survival adaptation technique is to “disconnect” from direct experience and create a distance between subject and object. Between “me” and “it”. It can feel better than the confusing discomfort – the problem is you can’t feel anything else as well.
Dissociation creates a distance from the discomfort.
Definition of Dissociation
The psychiatric definition is separation of some aspects of mental functioning from conscious awareness, leading to a degree of mental dysfunction or to mental conditions including dissociative identity disorder.
Is “zoning out” the same as “dissociation”?
The key comparison between the two lies in the degree of separation from reality. While zoning out is generally a milder, more mundane form of mental wandering, dissociation represents a more profound disconnection and can significantly alter a person's engagement with reality.
Dissociation is a break in how your mind handles information. You may feel disconnected from your thoughts, feelings, memories, and surroundings. It can affect your sense of identity and your perception of time. (2)
The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a false perception of reality as in psychosis. (3)
Many people may experience dissociation (dissociate) during their life. If you dissociate, you may feel disconnected from yourself and the world around you. For example, you may feel detached from your body or feel as though the world around you is not real.
Dissociation is one way the mind copes with too much stress, such as during a traumatic event.
There are also common, everyday experiences of dissociation that you may have. Examples of this are when you become so absorbed in a book or film that you lose awareness of your surroundings. Or when you drive a familiar route and arrive at your destination without any memory of how you got there.
Experiences of dissociation can last for a short time (hours or days) or for much longer (weeks or months).
Dissociation may be something that you experience for a short time while something traumatic is happening. But you also may have learned to dissociate as a way of coping with stressful experiences. This may be something that you’ve done since you were young. (1)
Short-term Dissociation
Brief experiences of dissociation are quite common. They can happen to us all sometimes. For example, during periods of intense stress or when we’re very tired. Some people also find that using drugs like cannabis can cause feelings of derealisation and depersonalisation.
Dissociation is also a normal way of coping during traumatic events. For example, some people may dissociate while experiencing war, kidnapping or during a medical emergency.
In situations we can't physically get away from, dissociation can protect us from distress.
Long-term Dissociation
Dissociation is a natural response to trauma while it's happening. But some of us may still experience dissociation long after the traumatic event has finished. Past experiences of dissociation during traumatic events may mean that you haven't processed these experiences fully.
If you experience trauma in childhood, dissociation may become a way that you cope with this trauma over a long time. Your brain and personality are still developing in childhood, so you may not learn other ways of dealing with other kinds of stress. This may mean you develop a dissociative disorder as an adult. Examples of trauma include:
- Physical abuse
- Sexual abuse
- Severe neglect
- Emotional abuse
Separating Experiences
If you experience dissociation during a traumatic event, you may separate different parts of the experience so you don’t have to deal with them all together. Different aspects of the experience may not feel “joined up”. Your actions, memories, feelings, thoughts, sensations and perceptions may feel separate.
For example, you might store your memories of an experience in a way that you can’t access day-to-day. This is usually called amnesia. You might also remember what happened but not feel the emotions or sensations that were part of it.
If you experience dissociative identity disorder (DID), you might feel as if different memories or sensations happened to different people. This is usually called having different identity states.
This can help you cope if the things that happened would be too much for you to deal with all together as a child. But it may make it hard for you to develop one clear identity as you grow up. (1)
Hypnosis
When you daydream or let your mind wander, you are in a type of “auto-hypnotic state.” You may no longer have a strong awareness of your body.
Other types of hypnosis may put you in a deeper dissociated state. A trained professional may use therapeutic hypnotherapy to help you manage pain, anxiety, addictive behaviors, or posttraumatic stress disorder (PTSD). (2)
Ketamine & Dissociation
One of the most well-known side effects of ketamine is dissociation. Dissociation refers to a temporary mental state in which a person “detaches” from their surroundings, meaning the person becomes less aware of what is actually around them and starts to feel disconnected from their body. (4)
To properly monitor the effects of ketamine, the CADSS looks at dissociative symptoms such as:
- Feeling like things are in slow motion or seem unreal.
- Feeling separated from reality.
- Feeling as if looking at things from outside the body.
- Feeling like you are a spectator or like you are observed.
- Objects looking different.
- Colors seeming duller or brighter than usual.
- Time speeding up or slowing down.
- Seeing things through a fog or having tunnel vision.
- Losing track of time or what is happening in the environment.
- Feeling as though your body has changed.
Most people find ketamine infusions to be quite pleasant and relaxing, even if they are experiencing dissociative symptoms. (4)
What is the “K-Hole” Effect?
A k-hole is when high doses of ketamine lead to intense feelings of dissociation. This can cause feelings of being disconnected from or unable to control one's own body, also sometimes affecting the ability to speak and move around easily.
One way to think about a k-hole is as a state between intoxication and coma. Some people refer to a k-hole as an out-of-body or near-death experience.
As the consciousness of the real world diminishes, alterations in the senses during a k-hole may lead to illusions and hallucinations. While usually temporary, some people have shown ongoing dissociative and psychotic symptoms with long-term ketamine misuse. (5)
The Predictive Brain
In neuroscience, predictive coding (also known as predictive processing) is a theory of brain function which postulates that the brain is constantly generating and updating a “mental model” of the environment.
According to the theory, such a mental model is used to predict input signals from the senses that are then compared with the actual input signals from those senses. (7) With the rising popularity of representation learning, the theory is being actively pursued and applied in machine learning and related fields. (8)
This theory assumes that the brain encodes beliefs (probabilistic states) to generate predictions about sensory input, then uses prediction errors to update its beliefs.
Predictive coding theories provide a unified framework explaining how perception is shaped by the integration of beliefs about the world with mismatches resulting from the comparison of these beliefs against sensory input.
The Predictive Brain & Uncertainty
The core idea of predictive processing is that the brain takes into account the uncertainties of its own models and the incoming sensory information, and tries to strike an optimal balance between these two sources of information, the top-down and the bottom-up.
Here, we propose that attention can be understood in terms of this balancing process and inattention as inappropriate balance, from some normative perspective, such as over- or under-confidence in one's predictions in relation to environmental volatility in traffic.
Accordingly, appropriate attention can be recast as reflecting appropriate uncertainty about the situation and its potential outcomes. (9)
Signals related to uncertainty are frequently observed in regions of the cognitive control network, including anterior cingulate/medial prefrontal cortex (ACC/mPFC), dorsolateral prefrontal cortex (dlPFC), and anterior insular cortex.
Uncertainty generally refers to conditions in which decision variables may assume multiple possible values and can arise at multiple points in the perception-action cycle, including sensory input, inferred states of the environment, and the consequences of actions.
These sources of uncertainty are frequently correlated: noisy input can lead to unreliable estimates of the state of the environment, with consequential influences on action selection.
Given this correlation amongst various sources of uncertainty, dissociating the neural structures underlying their estimation presents an ongoing issue: a region associated with uncertainty related to outcomes may estimate outcome uncertainty itself, or it may reflect a cascade effect of state uncertainty on outcome estimates. (6)
Cognitive Impenetrability
Cognitive impenetrability is a property of the basic information processes of cognition. If a process is cognitively impenetrable, then the operation of this process cannot be altered by changing the contents of mental representations (i.e., an agent's beliefs, desires, or goals).
References
- Mind – About Dissociation
- WebMD – Dissociation Overview
- Wikipedia – Dissociation (Psychology)
- Principium Psychiatry – Ketamine and Dissociation
- Strous J, Weeland C, van der Draai F, et al. Brain changes associated with long-term ketamine abuse, a systematic review. Front Neuroanat. 2022;16:795231. doi:10.3389/fnana.2022.795231
- Springer – Uncertainty and Cognitive Control
- Millidge, Beren; Seth, Anil; Buckley, Christopher (2022-01-19). Predictive Coding: a Theoretical and Experimental Review. arXiv:2107.12979
- Ororbia, Alexander G.; Kifer, Daniel (2022-04-19). The Neural Coding Framework for Learning Generative Models. Nature Communications. 13 (1): 2064. doi:10.1038/s41467-022-29632-7. PMC 9018730. PMID 35440589
- Angela, J. Y., and Dayan, P. (2005). Uncertainty, neuromodulation, and attention. Neuron 46, 681–692. doi:10.1016/j.neuron.2005.04.026