What Is Dissociation in Borderline Personality Disorder (BPD)? (2022)

What Is Dissociation?

In broad terms, dissociation is a psychological phenomenon that represents a disconnect between your thoughts, emotions, behaviors, perceptions, memories, and identity.

You probably are familiar with the sensation of feeling "zoned out"—the world around you momentarily seems unreal or looks strange or unfamiliar. In these moments, you could be experiencing dissociation.

When it happens occasionally, dissociation is usually not a problem for most people. However, if it happens frequently or is intense, it could be a sign of a mental health condition, such asborderline personality disorder (BPD). Around 75% to 80% of people with BDP report experiencing stress-related dissociation.

Signs and Symptoms of BPD

Symptoms of Dissociation

Dissociation during times of stress is one of the main symptoms of BPD. It's also associated with acute stress disorder and post-traumatic stress disorder (PTSD), both of which can co-occur with BPD.

It's important to note that not everyone with BPD experiences dissociation. Even if you don't experience dissociation frequently or it's not very severe, almost everyone has experienced mild forms of dissociation from time to time.

Examples of Mild Dissociation

  • Daydreaming
  • Getting caught up in a book or movie to the extent that you are unaware of what's going on around you
  • Zoning out (for example, you are driving on the highway and realize that you missed your exit, but you don't remember driving the last few miles)

After years of study, researchers are now able to describe the experiences that go along with dissociation, including depersonalization, derealization, amnesia, identity confusion, and identity alteration. 

Depersonalization

Depersonalization is the feeling of being separate from your body. People who experience depersonalization often say it feels like they are observing their own body from the outside, or as if they're in a dream.

Derealization

Similar to depersonalization, derealization is a feeling of being detached from the external world, which can include other people or objects. Familiar things can look strange, unreal, or unfamiliar.

Derealization and depersonalization often occur at the same time.

An Overview of Depersonalization/Derealization Disorder

Amnesia

Some people experience periods of amnesia or "losing time"—from minutes to hours or even days. Even though they awake during these times, they cannot remember where they were or what they were doing. This type of amnesia is sometimes referred to as a dissociative fugue.

(Video) The 3 Types of Dissociation and Borderline Personality Disorder

What Is Dissociative Fugue?

Identity Confusion

Identity confusion occurs when you experience an inner struggle about who you really are. People might have a hard time figuring out who they are in relation to others.

Sometimes (and particularly for people with BPD), identity issues make it hard for a person to figure out where they end and another person (such as a spouse) begins.

Identity Alteration

Identity alteration is the sense that you are acting like a different person. For example, you see an object in your home that you don't recognize or perform a skill that you don't remember learning. Sometimes, you might become aware of identity alteration because other people in your life say that you are behaving like someone else.

Mild identity alteration is common in the general population (for example, using a different name in different situations). The key difference is that you are aware of your identity or role change in these situations and it doesn't cause problems with your ability to function in your day-to-day life or relationships.

Moderate identity alteration is common in BPD and involves changes in mood or behavior that are not under your control.

Identity Issues in BPD

Causes of Dissociation

The exact cause of dissociation is unknown, but it often affects people who have experienced repetitive, overwhelming trauma, such as severe child abuse or neglect.

Dissociation appears to be the brain's way of coping and separating from trauma, which can make it more bearable. If you learned to dissociate in times of extreme stress as a child, it likely affected the way your concept of yourself developed. It might have even carried over into how you react to stressful situations as an adult.

Trauma doesn't necessarily cause dissociation to develop, nor do you have to have experienced it to have symptoms of dissociation.

What the Research Says

Some early research that is using neuroimaging to examine people with BPD and dissociative symptoms has indicated that there might be actual changes in brain function and communication that contribute to dissociation.

Researchers can use imaging techniques such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) scans to see the brains of people experiencing dissociation.

Brain scans of people with BPD and dissociative symptoms have shown evidence of decreased activity in the limbic temporal areas of the brain, increased activity in the frontal area of the brain, and changes in communication between the two areas.

(Video) "Splitting" In Borderline Personality Disorder: What You Should Know

More research in this area could help researchers determine which brain processes are related to dissociative symptoms, as well as make psychotherapy more targeted and beneficial for people who experience dissociation.

What Causes BPD?

Treatment

Treatments for BPD such as dialectical behavioral therapy (DBT) often include components that help reduce dissociation. Treatment for dissociation is usually based on building skills to help you reconnect with yourself, the present moment, and your current surroundings.

Grounding is one skill that can be used to reduce dissociation. Grounding exercises involve using external stimuli and your five senses (sight, hearing, touch, smell, and taste) to reconnect with the present. For example, a visual grounding exercise will have you observe small details in the environment around you until you are feeling more connected.

Some people respond better to grounding exercises that use sensation to bring them back to reality, such as holding an ice cube for a few moments, chewing a piece of minty gum, or smelling a lemon.

Self-Help Strategies for BPD

Dissociative Disorders

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are two other main dissociative disorders:

  • Dissociative amnesia
  • Depersonalization/derealization disorder

Certain mental health disorders have dissociation as a central feature rather than a symptom. For example, dissociative identity disorder (DID) is characterized by severe dissociation that causes a person to develop different personalities.

The vast majority of people with dissociative identity disorder have experienced childhood abuse, including physical and/or sexual abuse, and neglect.

A Word From Verywell

Stress-related dissociative symptoms are common in people with BPD, but there can be a spectrum of severity. Some people with BPD experience minimal or mild symptoms of dissociation whereas others experience severe symptoms.

Research suggests that the severity of a person's symptoms might be linked to an individual's history of abuse and trauma.

Treating dissociative symptoms through therapy can be intense, as it often requires you to remember past abuse. While it can be difficult at times, therapy can help you learn to cope with your symptoms and improve your quality of life.

(Video) WHAT IS DISSOCIATION DISORDER? - bipolar BPD Borderline Personality Disorder

How to Find a DBT Therapist

3 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Krause-Utz A, Elzinga B. Current understanding of the neural mechanisms of dissociation in borderline personality disorder. Curr Behav Neurosci Rep. 2018;5(1):113-123. doi:10.1007/s40473-018-0146-9

  2. Şar V. The many faces of dissociation: opportunities for innovative research in psychiatry. Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171

  3. Dorahy MJ, Middleton W, Seager L, McGurrin P, Williams M, Chambers R. Dissociation, shame, complex PTSD, child maltreatment and intimate relationship self-concept in dissociative disorder, chronic PTSD and mixed psychiatric groups. J Affect Disord. 2015;172:195-203. doi:10.1016/j.jad.2014.10.008

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By Kristalyn Salters-Pedneault, PhD
Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University.

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FAQs

What does dissociation mean in BPD? ›

Dissociation in BPD is closely linked to emotion dysregulation, disturbed identity, and relationship problems. Emotion dysregulation includes a tendency to experience intense overwhelming emotions.

What triggers dissociation in BPD? ›

The exact cause of dissociation is unknown, but it often affects people who have experienced repetitive, overwhelming trauma, such as severe child abuse or neglect. 1 Dissociation appears to be the brain's way of coping and separating from trauma, which can make it more bearable.

Is dissociation normal in BPD? ›

In BPD, stress-related dissociation is one of the core diagnostic features [1]. Up to 80% of patients experience transient dissociative symptoms.

What is an example of dissociation? ›

This is a normal process that everyone has experienced. Examples of mild, common dissociation include daydreaming, highway hypnosis or “getting lost” in a book or movie, all of which involve “losing touch” with awareness of one's immediate surroundings.

How do you know if someone is dissociating? ›

Symptoms
  1. Memory loss (amnesia) of certain time periods, events, people and personal information.
  2. A sense of being detached from yourself and your emotions.
  3. A perception of the people and things around you as distorted and unreal.
  4. A blurred sense of identity.
17 Nov 2017

How do you know if you're dissociating? ›

Symptoms of a dissociative disorder
  1. feeling disconnected from yourself and the world around you.
  2. forgetting about certain time periods, events and personal information.
  3. feeling uncertain about who you are.
  4. having multiple distinct identities.
  5. feeling little or no physical pain.

What does it feel like to dissociate BPD? ›

Dissociative symptoms are common in BPD, including memory loss (amnesia) for certain time periods, events, and people, a sense of being detached from the self, depersonalization, derealization, perception of people and things as distorted and unreal, blurred sense of identity, and hearing voices (which stem from ...

What is BPD favorite person? ›

This is where the term “favorite person” comes from in the borderline community. There is usually one of two people that we absolutely idolize and want to spend all our time with, and if they are busy and can't spend time with us we tend to get angry and feel abandoned.

What does dissociation feel like? ›

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 unreal. Remember, everyone's experience of dissociation is different.

How does a BPD person think? ›

People with BPD also have a tendency to think in extremes, a phenomenon called "dichotomous" or “black-or-white” thinking. 2 People with BPD often struggle to see the complexity in people and situations and are unable to recognize that things are often not either perfect or horrible, but are something in between.

What causes BPD in the brain? ›

Environmental factors

being a victim of emotional, physical or sexual abuse. being exposed to long-term fear or distress as a child. being neglected by 1 or both parents. growing up with another family member who had a serious mental health condition, such as bipolar disorder or a drink or drug misuse problem.

What is it like living with BPD? ›

People living with BPD often have an intense fear of instability and abandonment. As a result, they have problems being alone. The condition is also known for anger, mood swings, and impulsiveness. These qualities can dissuade people from being around someone with BPD.

What happens in the brain when you dissociate? ›

Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia).

What are the 3 main symptoms of dissociative disorder? ›

Symptoms
  • Significant memory loss of specific times, people and events.
  • Out-of-body experiences, such as feeling as though you are watching a movie of yourself.
  • Mental health problems such as depression, anxiety and thoughts of suicide.
  • A sense of detachment from your emotions, or emotional numbness.

How do you help someone who is dissociating? ›

You can: help them find an advocate and support them to meet with different therapists. offer extra support and understanding before and after therapy sessions. help them make a crisis plan if they think it would be helpful.

What do you say to someone dissociating? ›

If your loved one has been triggered, focus on being a safe, kind, compassionate presence, and help your loved one to ground back into the present. Give your loved one space when they ask for it, and nurturing when they ask for it, and ask them what they want and need.

How long does dissociation last? ›

Dissociation and dissociative behaviors may last for hours, days, weeks and even months. Individuals who dissociate over a long time may develop a mental health condition called a dissociative disorder or dissociative identity disorder.

What kind of trauma causes dissociative identity disorder? ›

The main cause of DID is believed to be severe and prolonged trauma experienced during childhood, including emotional, physical or sexual abuse.

What is the difference between dissociation and disassociation? ›

“Dissociate,” Oxford says, means “to cut off from association or society; to sever, disunite, sunder.” And “disassociate” means “to free or detach from association; to dissociate, sever.” Ultimately, the Latin root of both is sociare (to join together or associate), and both have the negative Latin prefix dis-.

What does a mental breakdown look like? ›

feel overwhelmed — unable to concentrate or make decisions. be moody — feeling low or depression; feeling burnt out; emotional outbursts of uncontrollable anger, fear, helplessness or crying. feel depersonalised — not feeling like themselves or feeling detached from situations.

Is BPD caused by trauma? ›

Researchers think that BPD is caused by a combination of factors, including: Stressful or traumatic life events. Genetic factors.

Do people with BPD Gaslight? ›

Certain personality types tend to be more manipulative than others. People with borderline personality disorder, narcissistic personality disorder, and sociopaths are more likely to gaslight those around them.

What does shutdown dissociation look like? ›

Eye contact is broken, the conversation comes to an abrupt halt, and clients can look frightened, “spacey,” or emotionally shut down. Clients often report feeling disconnected from the environment as well as their body sensations and can no longer accurately gauge the passage of time.

Why do borderlines hurt the ones they love? ›

Often, the borderline person is unaware of how they feel when their feelings surface, so they displace their feelings onto others as causing them. They may not realise that their feelings belong within them, so they think that their partner is responsible for hurting them and causing them to feel this way.

How do you make someone with BPD feel loved? ›

To help someone with BPD, first take care of yourself
  1. Avoid the temptation to isolate. ...
  2. You're allowed (and encouraged) to have a life! ...
  3. Join a support group for BPD family members. ...
  4. Don't neglect your physical health. ...
  5. Learn to manage stress. ...
  6. Listen actively and be sympathetic. ...
  7. Focus on the emotions, not the words.
31 Aug 2022

Do borderlines have empathy? ›

Previous research has demonstrated that patients with borderline personality disorder (BPD) are more sensitive to negative emotions and often show poor cognitive empathy, yet preserved or even superior emotional empathy.

Why does dissociation happen? ›

Lots of different things can cause you to dissociate. For example, you might dissociate when you are very stressed, or after something traumatic has happened to you. You might also have symptoms of dissociation as part of another mental illness like anxiety.

What does dissociation look like in adults? ›

Dissociation Symptoms

Memory loss surrounding specific events, interactions, or experiences. A sense of detachment from your emotions (aka emotional numbness) and identity. Feeling as if the world is unreal; out-of-body experiences. Mental health problems such as depression, anxiety, and thoughts of suicide.

Is BPD a psychopath? ›

BPD features are highly represented in subjects with psychopathy as well as psychopathic traits are highly prevalent in patients with BPD.

Do people with BPD cry a lot? ›

Compared to non-patients, BPD patients showed the anticipated higher crying frequency despite a similar crying proneness and ways of dealing with tears. They also reported less awareness of the influence of crying on others.

How long does the average BPD relationship last? ›

Results found in a 2014 study found the average length of a BPD relationship between those who either married or living together as partners was 7.3 years. However, there are cases where couples can stay together for 20+ years.

What is the best mood stabilizer for borderline personality disorder? ›

Common anticonvulsants and mood stabilizers for BPD include:
  • Depakote (valproate)
  • Lamictal (lamotrigine)
  • Lithobid (lithium)
  • Tegretol or Carbatrol (carbamazepine)
21 Sept 2022

Are you born with BPD or does it develop? ›

But borderline personality disorder does not develop as a result of those traumas. Instead, it is a combination of genetic factors and childhood experiences (early environmental influences) that cause a person to develop borderline personality disorder.

Does BPD affect memory? ›

BPD patients also suffer from psychotic and dissociative symptoms, with disturbances of perception and of cognition, including memory [2]-[4].

How do doctors test for BPD? ›

There's no specific test for BPD, but a healthcare provider can determine a diagnosis with a comprehensive psychiatric interview and medical exam. After that, you can get appropriate treatment and begin to manage your symptoms better and move forward in your life.

Can borderlines be alone? ›

Borderline personality disorder is characterized by loneliness, social isolation, a fear of abandonment, poor social and communication skills, and unstable, difficult interpersonal relationships. The loneliness of living with this condition can be extremely painful, but treatments can be effective.

What does BPD look like in females? ›

Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety. Ongoing feelings of emptiness. Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights.

What drugs cause dissociation? ›

Agents capable of precipitating dissociative-like states include alcohol, barbiturates and similarly acting hypnotics, benzodiazepines, scopolamine, clioquinol, beta-adrenergic blockers, marijuana and certain psychedelic drugs, general anesthetics, and others.

Can you control dissociation? ›

Steps to reduce dissociation and increase self-awareness.

This can be done anywhere. Mindfulness walk. Notice how your body feels with each step, take your time paying close attention to physical sensations throughout your body. Slow breathing.

Can emotional abuse cause dissociation? ›

Although all types of maltreatment were related to dissociative symptoms, emotional abuse was the strongest and most direct predictor of dissociation in multivariate hierarchical analyses with the influence of other trauma types being confounded by emotional abuse.

How do you stop bpd dissociation? ›

Evidence-based treatments for BPD, such as DBT, Mentalization-Based Treatment (MBT), Schema-Focused Therapy (SFT), and Transference-Focused Psychotherapy (TFP) target emotion dysregulation and identity problems. Thereby, they may either directly or indirectly improve dissociation [100, 101].

What is the most common dissociative disorder? ›

Dissociative amnesia (formerly psychogenic amnesia): the temporary loss of recall memory, specifically episodic memory, due to a traumatic or stressful event. It is considered the most common dissociative disorder amongst those documented.

What medications treat dissociative disorder? ›

Although there are no medications that specifically treat dissociative disorders, your doctor may prescribe antidepressants, anti-anxiety medications or antipsychotic drugs to help control the mental health symptoms associated with dissociative disorders.

What is an example of dissociation? ›

This is a normal process that everyone has experienced. Examples of mild, common dissociation include daydreaming, highway hypnosis or “getting lost” in a book or movie, all of which involve “losing touch” with awareness of one's immediate surroundings.

Do weighted blankets help with dissociation? ›

Many people with PTSD have problems to receive physical comfort when sad. Severe symptoms like losing awareness for the body (dissociation) can be stopped with weights on the body. Finding out about this changed my life. Truly amazing.

What does dissociation feel like? ›

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 unreal. Remember, everyone's experience of dissociation is different.

Is dissociation the same as zoning out? ›

Zoning out is considered a form of dissociation, but it typically falls at the mild end of the spectrum.

What is BPD favorite person? ›

This is where the term “favorite person” comes from in the borderline community. There is usually one of two people that we absolutely idolize and want to spend all our time with, and if they are busy and can't spend time with us we tend to get angry and feel abandoned.

What is a BPD episode called? ›

BPD is a mental health disorder characterized by extremes in the way a person thinks, feels, and acts. Many people with BPD form extreme characterizations about themselves, others, objects, beliefs, and situations during episodes called splitting.

What happens to your brain when you dissociate? ›

Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia).

What does your therapist do when you dissociate? ›

Thus, therapy for dissociation generally focuses on acknowledging and processing the painful emotions that are being avoided. By changing how a person responds emotionally to a trauma, therapy can help reduce the frequency of dissociative episodes. A therapist may also teach coping skills for use during dissociation.

How do you help someone who is dissociating? ›

You can: help them find an advocate and support them to meet with different therapists. offer extra support and understanding before and after therapy sessions. help them make a crisis plan if they think it would be helpful.

What does shutdown dissociation look like? ›

Eye contact is broken, the conversation comes to an abrupt halt, and clients can look frightened, “spacey,” or emotionally shut down. Clients often report feeling disconnected from the environment as well as their body sensations and can no longer accurately gauge the passage of time.

Can you be aware of dissociation? ›

The difference from active avoidance (on purpose avoiding thinking about or doing something) is that dissociation tends to happen without planning or even awareness. Many times, people who are dissociating are not even aware that it is happening, other people notice it.

What is shutdown dissociation? ›

Shutdown dissociation includes partial or complete functional sensory deafferentiation, classified as negative dissociative symptoms (see Nijenhuis, 2014; Van Der Hart et al., 2004). The Shut-D focuses exclusively on symptoms according to the evolutionary-based concept of shutdown dissociative responding.

How does a BPD show love? ›

The Science of Falling in Love

Affection – People with BPD are either extremely affectionate or withdrawn, which may be confusing for those who don't have the disorder. Abandonment – Lots of people are scared that their partner isn't happy; but when you have BPD, you may be in constant worry that they will leave.

Why do borderlines hurt the ones they love? ›

Often, the borderline person is unaware of how they feel when their feelings surface, so they displace their feelings onto others as causing them. They may not realise that their feelings belong within them, so they think that their partner is responsible for hurting them and causing them to feel this way.

How do you make someone with BPD feel loved? ›

To help someone with BPD, first take care of yourself
  1. Avoid the temptation to isolate. ...
  2. You're allowed (and encouraged) to have a life! ...
  3. Join a support group for BPD family members. ...
  4. Don't neglect your physical health. ...
  5. Learn to manage stress. ...
  6. Listen actively and be sympathetic. ...
  7. Focus on the emotions, not the words.
31 Aug 2022

What do people with BPD struggle with? ›

People with BPD are often on edge. They have high distress and anger levels, so they may be easily offended. They struggle with beliefs and thoughts about themselves and others, which can cause distress in many areas of their lives. People living with BPD often have an intense fear of instability and abandonment.

What does BPD rage look like? ›

People with BPD usually experience symptoms like drastic mood swings, unstable emotions, poor impulse control, and a distorted sense of self. These challenges tend to manifest in tumultuous relationships, self-harming/suicidal behaviors, and strong emotional reactions to stressors.

Do people with BPD cry a lot? ›

Compared to non-patients, BPD patients showed the anticipated higher crying frequency despite a similar crying proneness and ways of dealing with tears. They also reported less awareness of the influence of crying on others.

Videos

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2. Dissociation & BPD | What Is It? | Borderline Personality Disorder
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4. Trauma and Disassociation in Borderline Personality Disorder
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