Introduction
Have you ever found yourself driving home from work, only to realize you can't remember most of the journey? Or perhaps you've been so engrossed in a movie that you felt like you were right there with the characters, forgetting you were sitting on your couch? These experiences are common examples of a psychological phenomenon called dissociation.
In her book "The Myth of Sanity," Martha Stout delves deep into the world of dissociation, exploring its various forms, causes, and impacts on our lives. Stout, a clinical psychologist with extensive experience treating trauma survivors, presents a compelling and accessible look at this complex topic.
Dissociation is a coping mechanism our brains use to help us deal with emotionally overwhelming situations and traumas. While it can be a useful survival tool, it also comes with potential drawbacks. Our brains can become accustomed to "checking out" and avoiding emotionally challenging situations, which can prevent us from fully engaging with life and processing our experiences.
This book summary will take you on a journey through the key ideas presented in "The Myth of Sanity," helping you understand the nature of dissociation, its effects on memory and identity, and how it relates to trauma, particularly in childhood. We'll also explore some of the more extreme forms of dissociation, such as dissociative identity disorder, and discuss ways to overcome dissociative tendencies.
The Nature of Dissociation
Dissociation as a Survival Mechanism
Imagine you're driving through an intersection when you suddenly realize another car is about to crash into you. In that split second before impact, you might feel as if you're no longer in your own body, watching the accident unfold from outside yourself. This is dissociation in action.
Dissociation is a normal and common reaction to highly stressful or traumatic situations. It allows our brains to "disconnect" emotionally from what's happening, enabling us to act calmly and rationally rather than panic. In life-threatening situations, this can be crucial for survival.
However, dissociation is a double-edged sword. While it can be helpful in the moment, it can have lasting impacts that are far from useful after the traumatic event is over. Our brains might form connections between the traumatic event and seemingly unrelated stimuli, causing us to dissociate at unexpected moments.
For example, consider a woman named Beverly who jumps at the sound of a train whistle while reading a newspaper. Suddenly, her heart is pounding, she feels the urge to run, and she smells chlorine. Unknown to her, her brain has emotionally transported her back to a childhood moment when she witnessed her younger sister being hit by a car after leaving the town swimming pool.
As a result of this dissociative reaction, Beverly might feel inexplicably tired, paranoid, or afraid for the rest of the day. This example illustrates how dissociation, while initially protective, can disrupt our daily lives long after the traumatic event has passed.
The Impact of Trauma on Memory
To understand dissociation better, we need to look at how trauma affects the brain, particularly in relation to memory formation and storage.
Under normal circumstances, our five senses send information to the amygdala, the emotional processing center of our brain. The amygdala assesses the emotional significance of this information and passes it on to the hippocampus. The hippocampus then sorts the information based on its emotional importance and integrates it with other memories.
However, in overwhelming emotional or traumatic situations, this process breaks down. When the amygdala registers an event as having extreme emotional significance, the hippocampus struggles to organize the information or integrate it with existing memories. As a result, traumatic memories often exist as isolated sensory images or bodily sensations, disconnected from the brain's language-processing areas.
This disruption in memory processing can lead to significant gaps in a person's recollection of their past. Take the case of Julia, a highly intelligent Stanford graduate and award-winning documentary filmmaker. Despite her success, Julia couldn't remember most of her childhood. She had no recollection of her teachers' names, her graduation, or even learning to drive. The only vivid memory she had from childhood was of her mother putting down her pet dog when Julia was 12.
Julia's memory gaps were a result of severe childhood trauma, including physical and sexual abuse by both parents. As a child, Julia learned to "go somewhere else" mentally during the abuse – in other words, she dissociated. When in this dissociated state, her memories weren't recorded and sorted properly by her brain. Effectively, she had been psychologically absent for much of her childhood.
This example illustrates how dissociation, while protecting us from immediate emotional pain, can have long-lasting effects on our ability to form and recall memories.
Manifestations of Dissociation
Losing Time and Out-of-Body Experiences
Dissociation can manifest in various ways, from minor experiences of "zoning out" to more severe symptoms like losing time or having out-of-body experiences.
One manifestation is a state called fugue, or "flight." In fugue, a person's mind can carry out intellectually-driven functions like waking up, going to work, and even having conversations, but the part of the brain that experiences emotions and remembers events isn't functioning properly.
Julia, the patient mentioned earlier, experienced frequent periods of fugue. On one occasion, she woke up thinking it was Tuesday, only to be informed by a coworker that it was actually Friday. Strangely, no one had noticed her acting differently during the days she couldn't remember.
More common than full fugue states is demifugue, which involves a temporary feeling of separation from reality rather than a complete disconnect. For instance, another of Stout's patients, Lila, described her state of demifugue as her "flyaway self." During these episodes, the world seemed to shrink and become very small, as if she were looking at things through the wrong end of a telescope.
Demifugue can also manifest as out-of-body experiences. Imagine a college student returning home for Thanksgiving. As soon as her plane lands, she begins to feel extremely tired and heavy, as if her body suddenly weighs a ton. Throughout the weekend, she feels almost as if she isn't really there at all. This is dissociation, likely triggered by some childhood trauma associated with her home.
These examples show how dissociation can range from brief moments of feeling disconnected to longer periods of lost time or altered perception of reality.
Childhood Trauma and Dissociation
The Vulnerability of Children to Trauma
Children are particularly susceptible to trauma and its lasting effects. In the United States alone, nearly 5 percent of all children are reported as victims of abuse. Conservative estimates suggest that 38 percent of American girls and 16 percent of American boys experience sexual abuse before the age of 18. Beyond direct abuse, many children witness violence or are affected by disasters and other traumatic events.
Children are more vulnerable to frightening situations and therefore more likely to be traumatized than adults. This is because traumatic situations disrupt or violate our existing worldview, making us feel helpless and overwhelmed. Since children have less life experience, their sense of meaning is more easily influenced by emotionally overwhelming situations.
Consider the case of Matthew, a nine-year-old boy whose parents frequently had verbal arguments. One day, Matthew found his mother in the kitchen after his father had stormed out. His mother, muttering profanities, began smashing plates against the wall, yelling "That maggot!" with each plate broken. During this incident, Matthew felt hollow and numb, and the next day, he barely remembered it.
As an adult, Matthew would dissociate whenever a conversation reminded him of his parents' arguments, even if the connection wasn't obvious. He would space out, getting a faraway, glazed look in his eyes. This illustrates how childhood trauma, even if not directly abusive, can lead to dissociative tendencies in adulthood.
Dissociative Identity Disorder: An Extreme Coping Mechanism
In its most extreme cases, childhood trauma can result in dissociative identity disorder (DID), formerly known as multiple personality disorder. While much about DID remains unknown, psychologists understand that it almost invariably occurs in chronically abused children as a survival mechanism.
In situations of extreme, prolonged stress, the body often "gives up" and dies. However, humans have psychological mechanisms that allow us to cope with extreme stress. In the most drastic cases, this can result in DID – a condition where a person's mind is "split" between different identities, or "alters," each with separate memories and character traits.
For a chronically abused child, dissociating into different alters can provide a mental escape. Each alter can cope individually with the abuse, compartmentalizing it and allowing the child to survive. However, when the child grows into an adult and escapes the abusive circumstances, the condition can become problematic. A person with DID may lapse into one of their alters at any moment, leading to strange or inappropriate behavior.
One extreme case Stout encountered was a patient named Garrett. As a child, Garrett endured severe abuse from his uncle, who also abused Garrett's younger brother, Lef. Tragically, Garrett's uncle beat Lef to death when Lef was just six years old, with Garrett forced to watch.
This repeated trauma led Garrett to develop several different identities to compartmentalize the abuse. One identity was James, a young boy who appeared almost exclusively when Garrett was alone. Another was Gordon, a tough, foul-mouthed protector. The darkest alter was Abe, who was convinced that Garrett had killed Lef and deserved to die by suicide as punishment.
Garrett's case illustrates how DID can develop as an extreme coping mechanism in response to severe, chronic childhood trauma. By creating multiple identities, Garrett's mind found a way to survive the unbearable.
The Subtleties of Dissociative Identity Disorder
Recognizing Subtle Switches in Behavior
While cases like Garrett's involve dramatic switches between distinct personalities, most cases of dissociative identity disorder (DID) are more subtle. These cases often involve what appears to be the same person acting in unrecognizable ways.
Most people aren't objective observers of others' behavior. We tend to mentally distort facts or events to maintain a consistent image of the people we know. For instance, if your partner appears sullen and irritable one evening, you're more likely to attribute this to an external event than to integrate the trait of sullenness into your mental profile of them. If this behavior surfaces regularly, you might reclassify them as moody, but you're unlikely to consider that they might be showing signs of DID – even though that might be the case.
Less than one percent of the American population is likely to have the form of DID characterized by different named personalities. Far more common are cases that involve a kind of "switch" to a person that appears to be the one we know but who acts in unrecognizable ways.
Take the case of Nathan, a colleague of Stout's. Most of the time, Nathan was extraordinarily jovial, sociable, and warm. He had been married for 15 years and was considered a wonderful father by his wife. However, Nathan occasionally exhibited strange behavior. He would sometimes disappear for long periods without warning or explanation, regardless of prior commitments. He also had a tendency to fly into fits of jealous rage around his wife. One moment, he'd be acting like his usual self – but then, suddenly, he'd become inconsolable, incessantly questioning his wife about her past relationships.
As a result of Nathan's unpredictable behavior, his wife often felt like she didn't really know her own husband, and worse, that she didn't matter to him at all. This is a common problem for people dealing with such "switches" – they often feel like they're walking on eggshells, afraid of triggering that person's most frightening and alienating behavior.
These subtle switches can be just as disruptive to relationships and daily life as more dramatic forms of DID. They can leave loved ones feeling confused, hurt, and uncertain about the true nature of the person they thought they knew.
Overcoming Dissociative States
Confronting Past Traumas
While dissociative states can be deeply ingrained and challenging to overcome, there is hope. Stout's experiences with patients like Garrett and Julia demonstrate that it's possible to heal from even severe dissociative disorders by confronting past traumas directly.
Garrett, whose alter-ego Abe was intent on convincing Garrett to take his own life, made remarkable progress through hypnosis therapy. During these sessions, Abe was allowed to take control and repeatedly replay the memory of Lef's death. After a series of such sessions, Abe finally "learned" that he was not responsible for his brother's death. Two months after this realization, Abe disappeared from Garrett's psyche.
Similarly, Julia, who had almost no memories of her childhood due to severe abuse, began to recover her memories through hypnosis. She slowly confronted her past by revisiting her old neighborhood in Los Angeles and even the beach where she had once attempted suicide. This process of facing her traumatic memories head-on allowed Julia to begin integrating her past experiences into her current life.
These success stories highlight the importance of taking responsibility and directly confronting past traumas to overcome dissociative states. While it can be a painful and challenging process, it's often necessary for true healing and integration of the self.
Practical Steps for Overcoming Dissociation
If you suspect you might be dealing with dissociative tendencies, there are several steps you can take:
Keep a dream journal: This can help you "see" your mind and memories more clearly, without trying to influence them.
Practice meditation: This can help you observe your thoughts and memories without judgment, allowing for greater self-awareness.
Visit old places associated with uncomfortable memories: While this can be challenging, it can help you confront and process past traumas.
Stop self-pity and victim identification: By doing so, you reclaim power from those who have abused or tormented you.
Seek professional help: A therapist experienced in treating dissociative disorders can provide valuable guidance and support.
If you're dealing with someone who shows signs of dissociation, it's important to approach the situation carefully. If the person is violent, the first priority is to ensure your safety by removing yourself from the situation. If you're sure they're not likely to harm you, you might try gently coaxing out their "real" self after a switch by asking something like, "May I speak to [their name] when they're ready to come back?" You could also suggest therapy, although this is unlikely to be effective if the person is unwilling to recognize their problem.
Remember, overcoming dissociative tendencies is a process that requires patience, courage, and often professional support. But with persistence and the right approach, it's possible to live a more integrated, present, and fulfilling life.
Final Thoughts
"The Myth of Sanity" by Martha Stout offers a profound exploration of dissociation, a psychological phenomenon that affects us all to varying degrees. From minor experiences of "zoning out" to severe cases of dissociative identity disorder, Stout illuminates the ways in which our minds protect us from overwhelming emotional experiences.
The book's key messages include:
Dissociation is a normal and necessary defense mechanism that helps us cope with overwhelming situations.
While protective in the short term, dissociation can have long-lasting impacts on memory formation and emotional processing.
Childhood trauma is particularly likely to lead to dissociative tendencies due to children's vulnerability and limited life experience.
Dissociative identity disorder, while rare, represents an extreme form of dissociation typically resulting from severe, chronic childhood abuse.
Most cases of dissociation are more subtle, involving behavioral "switches" that can be difficult for others to recognize or understand.
Overcoming dissociative tendencies involves confronting past traumas directly and taking responsibility for one's healing process.
Stout's work challenges us to reconsider our understanding of "sanity" and "normalcy." She argues that dissociation exists on a spectrum, with all of us experiencing it to some degree. By understanding dissociation better, we can develop greater empathy for ourselves and others, recognizing that what might appear as erratic or inexplicable behavior often has roots in past trauma or overwhelming experiences.
Moreover, "The Myth of Sanity" offers hope. Through the stories of patients like Garrett and Julia, Stout demonstrates that even severe dissociative disorders can be overcome with courage, persistence, and appropriate therapeutic support. This message is empowering for those struggling with dissociative tendencies and for the people who love and support them.
The book also raises important questions about the nature of memory, identity, and consciousness. How do our experiences shape who we are? How reliable are our memories, especially those from childhood? And how can we integrate all parts of ourselves – even those we might prefer to forget or deny – to live more fully and authentically?
In conclusion, "The Myth of Sanity" provides valuable insights into the human mind's capacity for both self-protection and self-healing. It encourages readers to approach themselves and others with greater compassion, understanding that we all carry invisible wounds and coping mechanisms. By shedding light on the often misunderstood phenomenon of dissociation, Stout invites us to embrace a more nuanced and empathetic view of mental health and human behavior.
As we navigate our own lives and relationships, the lessons from this book can help us recognize dissociative tendencies in ourselves and others, seek appropriate help when needed, and work towards living more integrated, present, and fulfilling lives. Ultimately, "The Myth of Sanity" reminds us of the resilience of the human spirit and the possibility of healing, even in the face of profound trauma and psychological distress.