If you are friends with someone who dissociates, you might want to learn how to help them, in case it happens while you are around. Here are different interventions you can use to interrupt dissociation and support grounding.
Tell them that they are dissociating. People often don’t notice. If they get a hint, they might be able to help themselves.
Change the topic, what they were doing or focusing on and distract them by engaging them in conversation, asking them questions or showing them something.
Keep them moving. Don’t let them sit down to wait until they feel better. Immobility breeds dissociation. Even if you just walk up and down a hallway together, that is helping.
Involve them in play. It is best to choose a game that needs coordination of both hands and feet. It can be as easy as throwing an item back and forth. It helps if the item has a surface that stimulates their sense of touch and doesn’t fly straight lines. Actually, throw badly on purpose to make it harder for them to catch. Engage them in conversation while you are playing.
A minute of unskilled dancing can have the same effect.
Crack a joke to get them to laugh. Laughter is a natural anti-dissociatiant. They cannot laugh and dissociate at the same time. The brain won’t have it.
If you can’t make them laugh, maybe you can annoy them. A little anger works wonders in the face of helplessness. You could also make small mistakes on purpose, like calling their hamster the wrong name or getting their age wrong. People feel a deep need to correct others. Sometimes that is how you get them back to engage with you.
Encourage them to sing a song with you. That will have them focus on rhythm, words, timing etc and activate relational regulation as well as regulate their breath.
Play “mirror”. Make funny faces and ask them to imitate them with their own face. That’s not just funny (see laughter), using their facial muscles also engages their brain differently and helps to ground them.
Sometimes making a loud noise like clapping your hands right next to their head can startle someone out of light dissociation.
There are a lot of games you can play that involve thinking and mindfulness over here.
Insist that they use words and speak. This will activate the part of the brain that usually shuts down during dissociation. They might struggle to find words and names. Just encourage them not to give up.
Sometimes people dissociate into traumatic memories. They get stuck in an endless flashback. That is not the time to ask them about their experience or let them share what they are re-experiencing (real trauma work does not happen dissociated! There is no healing in staying in this condition). This is the time to stubbornly refuse to understand what they are talking about. They need to get oriented in time and space.
Play the 54321 game. There are different versions of it, but usually it is something like this: name 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and one thing you can taste. Again, it might be difficult to find words, but that makes it even more important.
Ask questions that will help them to get oriented. Ask them about
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their full name,
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current address
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workplace or profession
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current age
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the date and day of the week
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the name of the building you are in
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what they had for lunch
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names of their children or spouse
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….
Whatever it needs to help them remember that they are grown up and have a life today.
Walk them through the 5 steps to stopp a flashback. Encourage them to use the discrimination exercise thoroughly. Help them to separate what is happening now from what they re-experience. We like to add a little math here and calculate how many years have passed since the bad things happened.
Ask your friend to make the situation different from when they started to have a flashback/dissociate. Change three things:
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Posture and position: Ask them to move out of the posture they took when they dissociated.
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Place and location: Ask them to change the room or at least move to a different part of the room
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topic and thought: The one they had been pondering got them into this situation. They need to think about something else.
To prepare for a possible intervention, ask your friend about the DBT Skills they use and how their Skill-Chain starts. Let them show you where they store their SkillKit. You can then provide the first item from the skill chain when they need it.
Talk about the option of touch. Would it be ok if you touched them when they dissociate? And where? Touch can sometimes get mixed with the flashback experience, that is why you have to be careful. Don’t hold them by their wrists!
It might help if you take their hand and squeeze it lightly while asking them to squeeze back. This might create an anchor for them to pull themselves out of the dissociation.
You could also pull their hand lightly away from them, while you steady them with your other hand on their shoulder. Ask them to imagine that you are pulling them out of the fog of dissociation into reality (this can also support a switch).
Ask them to make eye contact and keep eye contact. People tend to look down when they dissociate. There is something about eyes that holds our attention. With some practice your gaze can be an anchor that helps them to activate relational regulation and ground them in the present. Support this by talking softly, explaining what is going on and expressing safety in your tone of voice, body language and words. Be calm. That is contagious.
If your friend shuts down completely, you have to change tactics. Their senses are mostly switched off. They might not be able to see or hear you or sense touch. They are not able to respond to any of the tools I have shared so far. You will need ammonia inhalants. They smell terrible, but even if your friend isn’t able to smell anymore, they send a sharp pain through the brain that basically wakes the dead. If the dissociation is deep, it might take some time and more than one inhalant, but they will come around eventually. Hold the smelling salts in a way that they have to breathe it in. Ask your friend where they store their ammonia inhalants. They need to carry them like someone with diabetes carries glucose. Be ready to start the orientation/grounding exercises above as soon as your friend comes to. Make sure your friend is ok with this! You will be causing them some pain and that can have a negative effect on your relationship. Most dissociation of this kind lifts after about 30 minutes and it might be best to just wait.
What kind of intervention you should choose depends on the severity of the dissociation and the things you have at hand. You would usually combine several of them. No matter what you do, it is key to communicate safety.
If you are insecure, you can practice with your friend while they are grounded and just playing dissociation. That might give you greater confidence in your ability to help them and your friend will know that you are a safe helper too.
Sometimes you will fail. Sometimes your friend wants to stay dissociated. It might be easier for them, than feeling their feelings at that moment. If this happens you have to let go and let them dissociate. They can’t cope any other way. You can’t ground anyone against their will.
Sometimes dissociation is difficult to stop because there is more than one part of the person dissociating or the part who is struggling is not the one who is fronting. Someone who dissociates because of their inner experience will spin back into dissociation the moment they don’t get distracted anymore. It is necessary to change the inner experience.
Find out more about helping a DID system with grounding.
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