To better understand how to respond to someone who has dissociated, it is helpful to know what dissociation looks like and how to assist someone in that state. The following responses are examples of dissociation:
- Staring vacantly into the distance,
- Spacing out or being uninvolved with the present,
- Being unable to focus, concentrate, and respond to instructions, and/or
- Being unable to speak.
After being triggered into a dissociative state, an individual may seem confused or vague and ask questions such as: “Where was I?” “What did I say?” or “What just happened?” Some survivors only discover as adults that they dissociate under stressful circumstances.
To support survivors who have been triggered and ensure that they do not leave when they are feeling disoriented or embarrassed, it is best to:
- Orient survivors to the present by reminding them where they are and what was happening when they began to have trouble staying present.
- Encourage slow breathing (inhale to the count of four and exhale to the count of six), and if possible, do this sitting up with their feet flat on the floor.
- Remind survivors to keep their eyes open and to look around the room.
- Encourage survivors to notice physical sensations (e.g., the feeling of their back on the chair and their feet touching the floor, or sensation of air on their face).
As survivors become more oriented and responsive:
- Do not touch them.
- Offer verbal reassurance in a calm voice.
- Avoid asking complicated questions or giving complex instructions. Instead, ask simple questions to try to connect with the person (e.g., “Are you with me?” “Are you following me?” “Can you stay present with me?”)
- Allow them the necessary time and space to regain their equilibrium (a quiet room may be helpful).
- Normalize the experience. If the survivor has disclosed abuse prior to this incident, let him/her know that some settings may trigger flashbacks or emotional responses, but it is best not to ask for details of past abuse that may have contributed to being triggered. If prior abuse has not been disclosed, frame the normalizing comments in terms of anxiety that many people feel when in stressful situations.
- Ask if someone else can help such a friend whom you can call.
The more we can de-mystify the manifestations of abuse and understand the mind and body’s response to trauma, the more we can assist survivors in their recovery.
Schachter, C.L., Stalker, C.A., Teram, E., Lasiuk, G.C., Danilkewich, A. (2009), Handbook on sensitive practice for health care practitioners: Lessons from adult survivors of childhood sexual abuse. Ottawa: Public Health Agency of Canada, http://www.integration.samhsa.gov/clinical-practice/handbook-sensitivve-practices4healthcare.pdf