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#dissociation – @scriptshrink on Tumblr

Script Shrink

@scriptshrink / scriptshrink.tumblr.com

Writing about mental illness? Ask ScriptShrink!
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So I have a character who spent X years being experimented on because plot reveal later. At the point the story starts, she has received umm let’s call it magical brain damage and is basically catatonic. Then she ‘remembers’ her past life, past life patches up the holes best she can (more magic) and the girl wakes up remembering only her past life. There’s a period of disassociation after she escapes (now she has the experience to do so) but I’m unsure what type I should consider or how long...?

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If I’m interpreting this correctly, your character’s lost memories of their present life and can only remember their past life. For this particular character, I’d emphasize focusing on both depersonalization and derealization. 

For the first one, she might feel like she’s not herself. Why can’t she remember her recent life?  Who is she, really? Which memories are correct? 

For the latter, she might have problems adjusting to the new world. Time has passed her by - is this world even real? It’s so different from what she used to know, can it even be real? Is this just all a bad dream?

No two people experience dissociation the same way, and there’s no set duration. She’s likely to go in and out of episodes for a while. Episodes might be triggered by stress, or being confronted with something from her ‘new’ life that she can no longer remember (for instance, she runs across someone who seems like they know her, but she can’t remember them at all).

Check out my dissociation tag for more details about what it’s like! 

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therapy101

hello! i was just looking through your dissociation tag, came across one anon asking if its possible to live in a dissociative state for most of the time, and i believe you said that it is quite rare to live functionally in an ongoing dissociative state for long periods. and im wondering if the symptoms of depersonalization disorder would match that description?

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no, depersonalization is typically a short-term state vs. a chronic state (even if frequent). I don’t remember the exact ask you’re referring to, but the more I think about it, the more I can’t really imagine a person being able to function reasonably well while being in a dissociative state most of the time. Being in a dissociative state for a long time would most likely be a fugue state*, or something close to it, and fugue states are always or nearly always accompanied by some huge divergence from typical functioning, including amnesia, leaving home, being unable to interpret what’s happening the environment, and so on- it’s a very dangerous state for that person. Dissociation is just not functional in the long term- it only works as a short term solution. Depersonalization is distressing and can cause impairments in functioning, but generally depersonalization disorder isn’t capturing that level of impairment. 

*as an example, I believe (spoiler) Morello experiences a fugue state in the new season of Orange is the New Black. The addition to her backstory makes me reasonably sure she experiences severe and incapacitating dissociation in times of stress and loss. 

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I've been googling around but can't really find anything relevant: are there any outward physical signs of a (not super severe) depersonalization/derealization episode? Like, would the average joe notice anything odd about a person who is currently experiencing depersonalization or derealization? Or are the people experiencing depersonalization/derealization able to function (relatively) normally from an outsider's point of view?

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Anon32

Some people might not notice depending on how well they know the person. I’m usually able to function mostly normally, I think. It’s just all wrong. People that do notice but don’t understand have commented that I’m “in a mood” or “in a funk” or maybe acted like people do when someone daydreams like “snap out of it” or “earth to anon32!” I feel like I don’t get as much done as normal, but I can make myself be somewhat productive.

nothowiplanned

Almost nobody notices when I’m mildly depersonalised - I think I come across as not really paying attention but that’s about it. It’s difficult for people not to notice when I’m very far gone, but when it’s comparatively mild no one seems to notice.

Jellyfish

yeah, if somebody knows you well enough they might say you’re spaced out or distracted, but most people probably won’t notice

barc0de

Yeah! Ive mostly been told i look spaced out and move a bit slower than usual & eyes get unfocused but thats pretty much all i can recall

Charlie

I’ve had complete strangers ask if I’m okay, though that happens very, very rarely.  Usually no one notices, not even friends. If they do then they’ll comment that I’m acting “weird”. The people that tend to notice most are teachers - they will say I look distracted, unfocused, distant, etc.

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Had trouble getting a clear answer on this via Googling. I read once that it is possible to have (via stroke) temporary brain damage that hinders the perception of the body even having boundaries - not "loss of proprioception"; it was described as feeling more like "temporarily one with everything/no separation from anything" so, 1 - Do you know what the technical term for that would be? and 2 - Would my character(s) be correct or incorrect to describe that sensation as a type of "dissociation"?

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That sounds a bit like “depersonalization”, where someone feels that their own bodies / sense of self becomes less real. It is indeed a subset of dissociation, so it would be accurate to describe it as such - it’s just a little less specific.

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therapy101

Memory

What is Memory?

Memory is a process in your brain and body that encodes events, emotions, knowledge, and sensory information into your brain so that it can be recalled later. Memory is a selective and complex process. Not all events you experience will be encoded. Memories that are encoded tend to be more novel (novel meaning new to you, different than other experiences) and relevant or significant to you. 

Although memory uses multiple parts of your brain, it is most located in the hippocampus and related areas. 

Types of Memory

Sensory memory

Sensory memory stores sensory information for a very short period (less than a second in most cases), including taste, touch, smell, hearing, and sight. Sensory memory can store multiple pieces of information but generally a new sensory memory will replace old ones. Example: When you notice that the volume of the TV has changed, you’re using sensory memory. 

Working memory

Working memory temporarily stores information so that you can process it and make decisions or take actions based on it. It can only hold a little bit of information at a time and usually only holds information for 30 seconds or less. Example: When you calculate a tip in your head, you’re using working memory.

Short-term memory 

Short-term memory temporarily stores information so you can access it but does not allow you to manipulate it. There is some controversy about whether short-term memory really exists separately from working memory, and psychological testing typically focuses on working memory and long-term memory only. Example: When you see a phone number and then immediately dial it, you’re using working memory.

Intermediate memory

Intermediate memories are stored for three hours or less. If the memory lasts longer, it has entered into long-term memory. Example: When you drive somewhere for the first time, and then remember how to drive home an hour later using that information, you’re using intermediate memory.  

Long-term memory

Long-term memory stores information for an indefinite period. It can hold as much information as you need, unlike working or short-term memory. Example: When you remember your mother’s birthday is coming up, you’re using long-term memory. 

Types of long-term memory

Implicit memory:

Memories that are stored and recalled unconsciously.

  • Procedural memory: Memory of how to do things, like riding a bike. 
  • Emotional memory: Memory of events that are associated with very strong emotions, like having a fight with a loved one.
  • Priming: Information in your environment you don’t consciously notice but cause you to react differently to something else, either in the present or future, like if you see mold and then immediately see a burger, you’re more likely to be repulsed by the burger. 

Declarative or explicit memory: 

Memories you can consciously recall.

  • Episodic memory: Memories of events, like a specific interaction with another person.
  • Semantic memory: Memories of facts, like important dates.
  • Autobiographical memory: Memories of personally important or impactful events. This includes internal experiences, like realizing you are in love.

Stages of Memory

Encoding

Encoding is the first step to creating a memory, and usually occurs during the working memory or short-term memory phase. When information is encoded, it is translated from the original information to a more “bite size” set of information that prioritizes the aspects of the information that are most important and connects the information to already existing memory structures (creating associative meaning).

Storage 

Storage means placing the information within your cognitive system so that it can be recalled when needed. Different memories will be stored in different places depending on when or how much it needs to be recalled. So for example, if you need to remember a phone number but only long enough to dial the numbers, it’ll be in your short-term memory. But if you need to remember your mom’s birthday every year for the rest of your life, it’ll be in your long-term memory.

Retrieving

Retrieving is remembering- get access to memories that have been previously stored. Recall can happen many ways. It can happen intentionally (you deliberately trying to remember something) or involuntarily (you might recognize something that causes a memory, or be triggered to remember due to your environment).

Cognitive Mapping

Cognitive maps are mental representations of pieces of information. Having a cognitive map helps you remember things, and understand how different pieces of information relate to each other. This helps you understand things faster and prioritize which information to pay attention to.

There are also cognitive maps that people create (on paper or electronically) intentionally- this is not what I’m referring to. This type of map is created unconsciously. Here’s an example:

Cognitive maps & bias

Cognitive maps are incredibly useful, but they also lead to bias. Cognitive maps help you process information quickly and come to a decision based on your perception of probabilities. This uses a set of heuristics (meaning, a mental short-cut) to help you decide what you think is happening and how to respond. This is mostly a good thing, but heuristics are imperfect and can lead to bias.

For example, the availability heuristic means making decisions (particularly about probability) based on what examples are most available to you in your memory or cognitive map. So for example, if the most available examples of black men are criminal on the nightly news, you are more likely to decide that a black man walking down your street is a criminal rather than a neighbor.

Forgetting

“Forgetting” means that a memory that was encoded into long-term memory can no longer be retrieved. However, people often refer to “forgetting” when they can’t retrieve a past experience that was never encoded or made into long-term memory. This is not accurate- it’s impossible to “forget” something that was never a part of your memory. For example, I am “forgetting” if I can no longer remember a story I used to tell to my friends often. But I am not “forgetting” if I can’t remember an experience I have never remembered.

“Forgetting” can happen for a number of reasons, and most of these are not a sign of anything negative. Memory pruning is a healthy process in the brain, which works to strengthen aspects of memory that continue to be important for your life and to delete aspects of memory that stop being useful. This is the purpose of cognitive mapping. Essentially, the pathways that continue to get used (College -> Favorite Professor -> Important Experience with Favorite Professor) continue to exist, while pathways that aren’t used often get pruned (College -> Mediocre Professor -> Okay Experience with Mediocre Professor).

However, sometimes “forgetting” occurs due to a medical or mental health problem. Memory impairments don’t work the way the media often portrays them- for example, amnesia most often impacts anterograde memory, not retrograde memory.

Sometimes forgotten memories can return. Usually this occurs due to an environmental trigger. For example, if I return to my undergraduate university and see Mediocre Professor, I may recall my Okay Experience with them. Deliberately attempting to recall forgotten memories rarely works- typically remembering happens spontaneously.

There are medications and behavioral treatments to improve memory impairments. These rarely bring back forgotten memories but rather help you forget less over a longer period of time.

Amnesia

Retrograde amnesia

 Forgetting memories that happened prior to an injury or illness that impacts memory. Not all old memories will be forgotten- typically episodic memory is most highly impacted, but implicit and semantic memory are often fairly intact. Usually, older memories will be easier to remember than more recent ones. New memories can typically still be stored. Retrograde amnesia is typically not permanent and memories can be restored through treatment and exposure to lost memories. This type of amnesia is often caused by a brain injury, serious neurological illness like encephalitis, and other issues like long-term severe alcohol use.

Anterograde amnesia

Loss of ability to make new memories after an injury or illness that impacts memory. This type of amnesia can be caused by brain injuries like loss of oxygen to the brain (anoxia), serious neurological illnesses like encephalitis, and other issues like long-term severe alcohol use. Treatments cannot repair this type of amnesia but behavioral interventions can help people improve their ability to use procedural memory in their daily lives.

Transient amnesia

 Short-term significant impairment in both short-term and long-term memory. This type of amnesia is temporary and has no long-term impacts on people that experience it.  

Post-traumatic amnesia

Amnesia caused by brain trauma (like a severe concussion or stroke). This type of amnesia usually impacts memories related to the injury itself and memories stored around that same time (so for example, all the memories that occurred the morning that a person was in a severe car accident). This type of amnesia can be mild and not cause any long term issues, but for some people it is very serious and indicates that recovery from the injury will be longer and harder.

Dissociative amnesia

Psychologically caused amnesia (all others are medically caused). Typically dissociative amnesia is caused by an unconscious response during a traumatic event or by posttraumatic symptoms, which cause the person to stop encoding information. Sometimes these memories are being stored in long-term but not able to be accessed. Sometimes these memories are only stored implicitly (in emotional memory) but not explicitly (in episodic memory). Memories from dissociative states can sometimes be recalled (if they were encoded) but this typically only happens spontaneously and memories are often incomplete.

Dissociative fugue is a type of dissociative amnesia where a person suddenly but usually temporarily loses access to most memories. They often travel away from their homes and create new identities. This is extremely rare.

The Interaction between Emotion and Memory

Emotions impact memory in two major ways: emotions change how information is prioritized for encoding and storage (often picking the information that is most relevant to the emotions) and can impair ability to encode, store, and recall memory. Stress is one of the clearest examples of this. When you are stressed, your body increases release of stress hormones, which impacts your ability to encode memories. People who are stressed learn less. For example, your memory of a time when you were stressed is likely to be mostly focused on the emotional memory rather than the episodic memory, meaning that you will remember how you felt emotionally and physically better than you will remember the specific events. This often occurs within trauma, causing people to remember the emotions associated with the trauma really well but less able to remember the specifics of the event.

The Interaction between Mental Health Issues and Memory

Mental health issues can negatively impact memory ability in a number of ways. For example, sleep impairment negatively impacts ability to consolidate memories so that they are more integrated into your cognitive map and easier to recall. Attention impairments negatively impact ability to encode- if you are not paying attention, you will not be able to encode the information. Cognitive distractions like worry impact ability to encode, store, and recall. These kinds of memory issues due to mental health issues are typically not permanent, and will improve as the mental health issue is improved or appropriately accommodated.

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Anonymous asked:

Can you describe what it would be like for a character to dissociate? What are the symptoms/ Is it sort of like an experience where they are moving their body but they don't feel they are the ones doing it? Does a character feel emotionless during these experiences? What would it be like for them to dissociate during a traumatic event (such as when they are being raped)? How do they escape a period of dissociation? How long do these periods normally last?

danny

A lot of these are different for everyone, but I’ll chime in for some parts. When I dissociate, it feels like nothing’s real and that I’m not a person. I’ll be physically and emotionally numb. It can be hard for me to see how what’s going on or how my memories connect to me. The best way I can describe that is that it’s like if you repeat a word over and over, it loses all meaning… except in this case, the word is everything. I’ll sometimes feel like I’m just watching whatever’s happening. A lot of the time, I shut down and it’s difficult for me to talk about how I’m doing. If it’s particularly bad, I may not be able to really hear what someone is saying, or I can’t respond at all. When the latter happens, it seems like the words I want to say are just stuck in my head and they won’t come out. 

For me, the length of time I’m dissociated depends how badly I got triggered and how I’m doing in general. Usually, the best way for me to come back is distracting myself by listening to music or a podcast, drawing, reading, etc. If I’m around people, it can help if they talk about something random that’s unrelated to what caused me to dissociate in the first place. Grounding techniques can help as well (focusing on what you can see, hear, smell, and feel or counting objects of a certain color).

nothowiplanned

I usually say it’s a bit like playing a video game. I’m controlling the character’s movements and I know what’s happening to the character, but I have no real sense that the character is me. I did dissociate during rapes and to be honest it was a relief more than anything else. It was a problem when it became my default response to stress or anxiety/fear, but while I was being raped it was just a relief. It was happening to someone who wasn’t me and that was as good as it was going to get. As for how long it lasts it really does vary. For me it usually lasts between 30 minutes and 3 hours, but as danny said grounding techniques can help me to come back. So can sugary food. If I’ve dissociated very far away I can also lose time, and struggle to respond to people.

Anon32

I usually feel a bit back inside my body, like instead of me being my body, it’s a shell around me and I’m looking out like the eyes are windows. Because nothing seems real or I seem like an observer instead of a participant, nothing is interesting or can hold my attention. Before I realized I was dissociating, I would say that I had “the blahs”, being bored and the things that usually are interesting aren’t. For me it can last a few hours or all day. I usually just sit and let it pass unless I have to work and then I just do. It might all be a dream, but dream me has to get this work done so I might as well. I can lose time as well and responding is difficult. Because I’m NB I sometimes get dysphoria related to penetrative sex, so I’ve tried to purposefully dissociate to reduce dysphoria then, but I can’t force dissociation.

Charlie

There’s a lot of talk about what dissociation is like generally, so I’ll just chime in describing my experiences of dissociating at the time of trauma, if that’s alright? 

It’s a bit different to dissociating in general, you have the same kind of symptoms but you’re still in a highly emotional situation. You’re aware of what’s happening and you’re still afraid, but it’s almost as if you’ve become so afraid that the fear has lost meaning, you can’t process the feeling. So it becomes numbness and you shut down. There’s really no word for it, you completely freeze.  It’s a bit different in these situations because the dissociation is a direct response to trauma that actually helps the person survive it, so there’s no grounding/escaping until it’s over and the character feels safe again. 

It’s thought that this dissociative/freeze response to trauma is one of the strongest indicators that a person will develop PTSD later on, as it basically results in a lot of unresolved tension and fear that we have tuned out through the dissociation. That’s a bit of a different topic, but it’s something to keep in mind if you’re writing a character experiencing a traumatic event and dissociating during it.

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Is it possible for a character to have both dissociation and aggression/bursts of anger as kind of coping mechanisms and/or responses to stressful/triggering stimuli? (I can give you background info on the character if that would help.)

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Yep, totally possible, but not as likely as having them happen individually.

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reblogged

Hi! One can often hear about charachters "tortured to madness". What does that madness look like? Never ending altered mental state to cope with trauma? What mental functions go away? I'm sure it is varied, but are there archetypes? (Sidenote: thanks for all the answers you have given me before, sorry I often forget to check back to say thanks)

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Well I’d suggest you don’tcall torture victims ‘mad’, they’re likely to take offense.

I think that the answer to this really depends how you definemad.

If it’s any seriousmental illness then I am mad. I personally will not be offended if youthink I’m mad, I am old enough and English enough to take it as a compliment. Othermentally ill people would probably take offense. And I doubt I’m what you’rethinking of when you say ‘mad’, I’m rather too coherent.

If it’s insane theninsane actually has a legal definition and torture victims are generally notinsane. Insane in legal terms means someone isn’t aware of (and therefore isn’tresponsible for) what they do. Very very few torture victims fit this category.

Of those that do- well the main examples that come to mindare Ewen Cameron’s victims who suffered sensory deprivation.

Thiswas an extreme and highly unusual case.

Victims lost memories, for periods up to ten years. Somevictims lost the ability to recognise faces or objects. I’ve never heard of these symptoms at this severity in any other case.(Excepting perhaps, cases of so-called ‘feral children’ raised without humancontact.)

Usually? The symptoms of torture are more ordinary, though noless damaging.

Severe depression. Dissociation. Substance abuse. Posttraumatic stress disorder.

All of those are common after torture and all of those have,in the past, been described as ‘madness’.

But a list of conditions doesn’t necessarily tell you muchabout how someone behaves or what they’re experiencing. People don’t tend tolose mental functions (as you put it), and it isn’t precisely an unendingaltered state, at least not in the way I think you mean that.

Mental illnesses, rather like chronic physical conditions,have a tendency to be slightly better at some times and worse at others. Thesame way that someone with arthritis might get joint aches that change with theweather, mental health problems can be better or worse at certain times. Peoplegenerally also tend to learn to adapt and live with their mental healthproblems.

We may think differently, and I think in the case of torturedescribing someone’s state of mind as ‘altered’ is correct- they’re altered bytorture- but….that means different things to different people at differenttimes. We are not all always at our worst.

I’ll give you a run down of manifestations of depression,dissociation and PTSD that used to be labelled ‘mad’. Keep in mind this doesn’tcover all the symptoms, it’s patterns of symptoms society deems unacceptable.Because we’re often judged differently depending on how our symptoms manifest.

With depression the symptom cluster that tends to be….seen asparticularly ‘bad’ by Western society are the ones that interfere withsomeone’s ability to work.

Irritability, apathy and poor hygiene are all looked down onbut not with the severity reserved for people whose depression literally floorsthem. People who find it difficult to focus, to carry out basic tasks, to remainpunctual and to care about things outside of their own pain. At the lower endof the scale they get labelled lazy. At the higher of the scale people like mygrandmother who was bedridden for months because of her mental health- yeahthat used to be called ‘mad’.

And it’s a possible symptom set for torture victims. You losethe will to- do anything really. Get out of bed, wash, eat. Everything feelsdifficult and tiny tasks can feel impossible or like the end of the world.Almost every emotional response is negative.

I can’t speak as well on dissociation and PTSD, I’ve neverexperienced either and I haven’t had regular contact with anyone who has.

In PTSD a combination of regular hallucinations and anenhanced startle response tends to get looked down on. As far as I can tellit’s because someone is visibly reacting to something other people can’tsee/hear/feel.

People who hallucinate regularly have often been labelled‘mad’. Hallucinations are often pointed to as an excuse to institutionalise people,even if they are capable of looking after themselves. It’s a symptom that’soften used to imply diminished capacity, physically and mentally, and it’s alsooften used to incite fear. Western pop culture gives out a near-constantmessage that people who hallucinate are dangerous, untrustworthy and oftenevil.

In the context of PTSD and torture survivors thehallucinations we’re talking about are flashbacks, re-experiencing an elementof a traumatic event. There are a lot of ways this can manifest andScriptTraumaSurvivor has talked about them extensively.

An example might be a survivor ‘hearing’ their torturer’svoice, panicking and running away. When this happens regularly, and inpublic…well you can probably see where that’s going.

The most obvious example of a form of dissociation that waslabelled ‘mad’ and discriminated against is dissociative personality disorder.

This is incredibly rareand manifests almost exclusively in survivors of childhood sexual abuse.

Yet it is often used in fiction to portray a character asfrightening, dangerous, chaotic and evil.

Essentially- what society deems ‘mad’ changes, and it’s oftenmore to do with what symptoms of mental illness society finds offensive then itis capacity. Torture can cause a lot of different psychological symptoms, mostof them severe, but torture survivors are not (for the most part) legally insane.

I hope this helps.

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1/2 My character is 23 years old and in the past 8 months of her life she experience the death of her husband right next to her in the bed, being prisoned and abused by the man that worked there, some injuries and she was sentenced to death, being torn apart from her 5 years old daughter. Could she develope DID from that? Especialy if she shuts down her traumas and tries to ignore them, and in the same time starts training for her revenge, but she is too soft and does not want to kil.

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2/2 She would need to develope a side of her that is more of a fighter not a lover. Would a second personality like in DID help her be that fighter side?

DID forms due to intense / prolonged trauma in early childhood. The window it develops in is roughly between 6 and 9 years old.

Your character can definitely pick up some dissociative symptoms, but they can’t realistically develop DID.

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Anonymous asked:

my character deals with intense physical and sexual abuse. would it be realistic for him to have catatonic episodes or is dissociation more likely?

CW: physical /sexual abuse mention

Dissociation is by FAR more likely, but catatonia is not impossible.

Something to note - catatonia is pretty much entirely treatable. Like, complete remission within hours of being administered a certain medication. Check out my post here for more info.

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If a character experienced a lot of trauma and has panic attacks and disassociation episodes triggered by being in enclosed spaces like cars and elevators, unexpected physical contact (particularly around their face), and unexpected loud noises, what would be some strategies they could try to not just deal with those triggers from day to day but to actually become more comfortable and less anxious about them in general?

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nothowiplanned

So exposure is one (horrible) way of doing this. Taking cars as the example, and depending on at what point the panic kicks in, they could stand touching the car, then sitting in the car with the door open and their legs out of the car, then sitting in the car fully with the door still open, then sitting in the stationary car with the door closed, then sitting in the car for a very short journey, then gradually building up the length of time they stay in the car. This would be extremely emotionally demanding, the character should probably have someone they trust absolutely with them, and they will have panic attacks/dissociate while doing this. It might not progress in a straight line either - one day the character might be able to sit in the car with the door closed but the next day they might really struggle getting in to it.

rarmeowz

Exposure therapy is pretty much the only thing I know of to actually get rid of triggers like that, and depending on the level of fear/panic that the trigger causes it can take a pretty short time to get over it or it can take a very, very long time.

[[Post continued after the jump]]

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Psych Terminology: Dissociation

Dissociation is the psychological process of becoming distant or detached from reality. While it can occur as a symptom in many different mental illnesses, it is also a very common reaction to a traumatic event - a character might feel like they’re floating above their body, or that the trauma is happening to someone else, etc. 

Dissociation can be a symptom of many different mental illnesses, and in fact has its own category of dissociative disorders, which includes:

The most well known of these is Dissociative Identity Disorder (DID) (see here), where a person dissociates to the degree that alternate personality states are created. 

Note - One thing that kinda bothers me is when people use or say “disAsociation.”

There’s no “A” in between “dis” and “sociation”. It’s simply “dis-sociation.” 

The same goes for “dissociative” - it’s not “disAsociative identity disorder,” it’s “dissociative identity disorder.”

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okay can we just one last thing

spreading the idea that one is only triggered when having a full blown, system-shut-down panic attack is damaging and delegitimizing to people who have physiologically and emotionally different reactions to triggers.

like slow burning, long lasting unease and fear.

that’s a trigger reaction too.

please stop.

Some other trigger reactions (not an exhaustive list at all, some I’ve experienced, some I’ve known people who’ve experienced):

  • Feeling disconnected from yourself or the world.
  • Having any emotional or psychiatric symptom that you’re prone to but don’t always have (depression, hallucinations, delusions, etc.)
  • Physical symptoms made worse by severe stress or anxiety (I just got diagnosed with adrenal insufficiency, now I know why a sufficiently stressful interaction once left me barely able to breathe without a bipap, lots of chronic illnesses are susceptible to stress, some even have their onset triggered by stress)
  • Sudden distrust of everyone you interact with or are close to.
  • Disorientation.
  • A sense that the bottom has fallen out of the world and you don’t know where things stand anymore, everything seems alien and strange and impossible to navigate.
  • Inability to identify anything in your surroundings anymore (as in, what’s a chair, what’s a desk, etc.), everything reduced to sensory information only.
  • Emotional exhaustion.
  • Feeling keyed up or nervous all the time.

And that’s just off the top of my head.  There’s lots more triggers.  And a trigger can set off a short-term reaction, or a long-term reaction.  The long-term reactions can last for far longer than you’d imagine.  And if a person has the wrong physical illness, a sufficiently strong trigger can even be dangerous to their life — even if it’s not in the form of a total emotional breakdown.

So triggers don’t just come in one form, and they don’t just have one set of effects on the person, or one obvious severity.

this post is incredibly validating thank you

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scriptshrink

Things to keep in mind while writing triggers!

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I'm writing an apocalypse. Society essentially ends. One of my protagonists is bipolar (as I am). Part of his struggle for survival involves trying to get hold of medication. Personally, I am not sure how I'd do at world's end if I was also unmedicated. My personal experience does not really include extreme tragedy and threats to my survival. So the question: do people in life-threatening situations find that their illness sort of takes a backseat for a while, or do they make things worse?

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(part 2) Would having bipolar disorder make my character more susceptible to PTSD or other issues? Would his learned coping skills or meds kind of insulate him? What are some withdrawal risks if he can’t get the meds?

The Scriptshrink consultants answer after the jump!

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Anonymous asked:

Can a character going through a traumatic experience (for instance, being kidnapped and kept prisoner) somehow compartmentalize so that they don't really feel the trauma while they're experiencing it, but once they're safe, they feel everything they were keeping down during the traumatic experience? Thanks!!

Yes. This is actually one of the more common reactions to a trauma - the character dissociates, mentally distancing themselves from their surroundings, themselves, or both.

These two kinds of distancing are:

  • Depersonalization - which is often described as an “out of body experience.” The character would feel like the trauma isn’t actually happening to them; instead, they’re observing what’s happening rather than feeling it.
  • Derealization - a character would feel like reality itself isn’t real - everything around them feels disconnected and dreamlike. This makes the character feel like “this isn’t really happening.”

As to the second part of your question, PTSD (and acute stress disorder) itself is an extended emotional, physical, and cognitive reaction to experiencing a traumatic event that often involves re-experiencing the emotions felt during the trauma.

For more information, check out my tags on these subjects:

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