Dissociation and EFT: How to Work Safely With Dissociation

Dissociation can sometimes be confusing when working therapeutically because, from the outside, it may look remarkably like an improvement.

A person who was highly emotional may suddenly become calm. They may report that they cannot feel anything. When asked how intense the problem is now, they may say:

“Zero.”

But zero does not always mean the problem has been resolved.

Sometimes it means the person is no longer fully connected to the emotional experience.

Understanding this distinction is particularly important when using EFT with people who have experienced trauma.

What Is Dissociation?

Dissociation refers to a disruption in the normal integration of awareness, memory, emotion, perception, identity or bodily experience.

It exists on a spectrum.

At the milder end, many people have experiences that could be described as dissociative. You might drive somewhere familiar and realise that you remember very little of the journey. You may become so absorbed in a book or film that you temporarily lose awareness of what is happening around you.

Trauma-related dissociation can be considerably more significant.

A person might describe:

• feeling numb;
• feeling detached from their body;
• feeling as though they are watching themselves from outside;
• experiencing the world as unreal or distant;
• becoming foggy or blank;
• losing access to emotion;
• suddenly becoming extremely tired;
• being unable to think clearly;
• having difficulty remembering parts of an experience;
• feeling as though they have “gone somewhere else.”

Rather than immediately viewing these responses as dysfunctional, it can be useful to ask:

What is the dissociation doing for the person?

Dissociation Can Be Protective

When something is overwhelming and a person cannot fight or escape, the nervous system has other ways of responding.

For some people, psychological disconnection becomes part of surviving the experience.

If being fully present means experiencing unbearable fear, pain, helplessness, shame or other overwhelming sensations, distancing from the experience may provide a form of protection.

This is particularly relevant in childhood trauma.

A child may have very limited ability to physically escape a threatening environment. They may depend upon the very people or environment associated with the threat.

Psychologically “going away” can therefore become an extraordinarily intelligent survival response.

The problem is that a response developed in one environment can continue operating long after that environment has changed.

Years later, something relatively small may activate the same protective pattern.

The person may consciously know:

“I am safe now.”

But their nervous system may still respond:

“This feels like something I need to escape from.”

Dissociation can become that escape.

Don’t Start by Trying to Remove the Dissociation

This has important implications for therapeutic work.

If dissociation has functioned as protection, immediately trying to eliminate it may not feel safe to the person’s system.

The therapeutic question therefore changes.

Instead of asking:

“How do we stop this person dissociating?”

we can become curious about:

“Why does this person’s system need dissociation?”

That is a very different starting point.

It allows us to respect the response rather than fighting it.

Start With What Is Happening Now

When someone has a history of significant trauma, there can be a temptation to search immediately for the traumatic event believed to be causing their current difficulties.

That isn’t always necessary or advisable.

With EFT, we can begin with what is happening in the present.

For example:

“When I think about talking about this, I notice myself becoming foggy.”

“I can feel myself starting to disappear.”

“I can’t really feel my body.”

“Everything suddenly feels very far away.”

“I know something is there, but I can’t connect with it.”

These are all experiences that can be noticed without requiring the person to enter deeply into a traumatic memory.

The aim initially isn’t necessarily to make the dissociation disappear.

It is to become curious about the process.

What Happens Just Before the Person Dissociates?

One of the most useful questions can be:

What happens immediately before the dissociation?

There may be a sequence.

For example:

Trigger → body sensation → fear → dissociation

Or:

Memory → shame → overwhelm → dissociation

Or:

Feeling trapped → physiological activation → dissociation

The dissociation may therefore be the final stage of a process rather than the beginning of it.

If we can identify what happens immediately beforehand, we may have a much more manageable target for EFT.

Perhaps the client notices:

“My chest tightens.”

“My stomach drops.”

“I suddenly feel trapped.”

“I get a feeling that something bad is going to happen.”

“I want to get away.”

These experiences may provide a therapeutic doorway without deliberately taking the client into the traumatic event.

The Fear of Remaining Present

Another important area to explore is:

What would happen if you didn’t dissociate?

This should be approached gently and without pressure.

For some people, the answer may reveal the protective logic behind the response.

They might implicitly experience:

If I stay present, I will feel everything.

If I stay in my body, I am vulnerable.

If I feel this, I will lose control.

If I remember, I won’t be able to cope.

If I remain here, I am trapped.

The therapeutic target may therefore not actually be dissociation.

It may be the perceived danger associated with remaining present.

EFT and the “Dissociative Zero”

This is particularly important for EFT practitioners.

In EFT we frequently ask clients to evaluate the intensity of an emotional problem.

Imagine a client begins with an intensity of eight out of ten.

After tapping, you ask:

“How intense is it now?”

They answer:

“Zero.”

It would be tempting to conclude that the problem has been resolved.

But we need more information.

There is an important difference between:

“It’s zero because I can think about it and it genuinely doesn’t bother me anymore.”

and:

“It’s zero because I can’t feel anything.”

The second response may indicate dissociation rather than therapeutic resolution.

This is why feedback in EFT needs to involve more than simply obtaining a number.

We are interested in the person’s entire response.

Can they remain present?

Can they think about the issue?

What happens in their body?

Has their perception of the event changed?

Can they access the memory without becoming overwhelmed or disappearing from it?

Does the change remain when the issue is revisited later?

A zero is useful information.

But we need to understand what that zero means.

Give the Client Control

Control is particularly important when working with trauma.

Many traumatic experiences involve helplessness, inability to escape or violation of personal boundaries.

Therapy should not inadvertently reproduce those dynamics.

The client needs to know that they can:

• stop;
• slow down;
• decline to answer;
• keep details private;
• open their eyes;
• move their body;
• stand up;
• orient themselves to the room;
• change the subject;
• decide how closely they want to approach a memory.

This isn’t simply about making someone comfortable.

The experience of having genuine choice can itself be therapeutically important.

You Don’t Need the Whole Story

EFT practitioners sometimes believe they need detailed information about what happened in order to work effectively.

Often they don’t.

A client may be able to say:

“Something happened when I was seven.”

And that may be enough.

Or:

“There’s a particular moment I don’t want to describe.”

We can respect that boundary.

The client can work with:

“This thing that happened.”

“This feeling in my stomach.”

“That moment.”

“The part I don’t want to talk about.”

The therapist does not necessarily need the details in order to facilitate the process.

Working With Small Aspects

When the client has sufficient capacity to remain present, more specific traumatic material may eventually emerge.

Even then, there is rarely a need to tackle an entire traumatic experience at once.

EFT lends itself particularly well to working with aspects.

Instead of:

“The abuse.”

we might eventually work with something much smaller:

“The moment I realised something was wrong.”

“The expression on their face.”

“The sound of the door.”

“The feeling of being unable to move.”

“What happened immediately afterwards.”

Each is a much smaller piece of information for the nervous system to process.

The principle is:

Work with what the person can remain sufficiently present with.

If they begin disappearing, becoming increasingly foggy, losing orientation or becoming significantly overwhelmed, that is important feedback.

It may mean we have gone too far, too quickly.

Coming Back to the Present

When dissociation begins occurring during a session, the priority may no longer be processing the traumatic material.

It may be helping the person reconnect with the present environment.

That could involve stopping the trauma-focused conversation and encouraging awareness of what is happening here and now.

For example:

“What can you see in this room?”

“Can you feel the chair underneath you?”

“Can you feel your feet?”

“Look around and notice where you are.”

“What do you notice about the room?”

Movement may also be helpful for some people.

The intention is not to force the person out of dissociation.

It is to provide information that supports orientation to:

Here. Now. This environment.

Don’t Chase Catharsis

Powerful emotional release isn’t necessarily evidence of effective trauma therapy.

Neither is the absence of emotion.

The aim isn’t to make someone experience the maximum amount of emotion they can tolerate.

Nor is it to get them through a traumatic memory as quickly as possible.

Effective work can be remarkably quiet.

Sometimes a profound therapeutic shift is simply:

“I can think about that now and remain here.”

That can represent an enormous change.

Safety Before Depth

When working with dissociation, deeper is not automatically better.

A useful therapeutic sequence can be:

The purpose isn’t to force open traumatic memories.

It is to create conditions in which the nervous system no longer needs to protect the person in quite the same way.

When Specialist Support May Be Needed

Dissociation ranges considerably in severity.

Occasional feelings of disconnection are very different from significant dissociative symptoms involving substantial memory gaps, lost periods of time, severe depersonalisation or derealisation, major identity disturbance or rapid destabilisation.

Practitioners need to work within their training and professional scope.

Where dissociation is significant or complex, appropriate assessment and support from a clinician with specialist trauma and dissociation expertise may be necessary.

Risk issues such as self-harm or suicidal thoughts also require appropriate assessment and safeguarding rather than being treated simply as another EFT target.

EFT can be incorporated into trauma-informed work, but tapping should never replace appropriate clinical assessment or specialist care where this is required.

A Different Way of Thinking About Dissociation

Perhaps one of the most important shifts is to stop seeing dissociation simply as something that has gone wrong.

At some point, the person’s nervous system may have discovered:

“When I cannot escape physically, I can escape psychologically.”

That response may once have helped them survive something they could not otherwise control.

Our job isn’t necessarily to take that protection away.

Instead, we can work respectfully with the system that created it.

We can become curious about what triggers it.

We can work with what happens immediately before it.

We can help the person develop greater capacity to remain present without becoming overwhelmed.

And gradually, the nervous system may discover something new:

I can be here without having to disappear.

That is a very different therapeutic goal from simply trying to stop someone dissociating.