What Is Cognitive Dissociation?

Cognitive dissociation, frequently referred to as dissociation, refers to a disconnection between thoughts, memories, surroundings, actions, and identity. Cognitive dissociation can be normal and healthy but also pathological. This article discusses what cognitive dissociation is, what mental health conditions it can impact and the potential causes of cognitive dissociation.
Klara Hatinova

Klara Hatinova

Klara is postgraduate researcher in experimental psychology at the
University of Oxford.

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What Is Cognitive Dissociation?

Cognitive dissociation is a psychological phenomenon that disrupts the integrated functions of consciousness, memory, self-identity, and perception. The DSM-V defines dissociation as “disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behaviour” [1].

The Dissociative Experiences Scale (DES), proposed in 1986 by Prof Bernstein and Prof Putnam [2], can measure the psychological construct of cognitive dissociation. This questionnaire, composed of 28 questions, gives individuals a score between 0 and 100.

Cognition is the collective term for the processes in the brain, such as memory, attention, thinking, decision making and perception. It is one of the core principles of Cognitive Behavioural Therap

Normal Cognitive Dissociation

Everyday experiences can also be characterised as cognitive dissociation. For example, when driving for long periods of time, being absorbed in something, forgetting the passage of time, such as a movie, project or musical performance [3]. Daily cognitive dissociation can also be maladaptive, such as ‘zoning out’ or feelings of fogginess in the mind [4]. Cognitive dissociation experiences can be triggered by acute stress or substances like caffeine, phentermine or Adderall. Critically, normal cognitive dissociations are brief in duration.

Cognitive Dissociation In Mental Health

Cognitive dissociation is a primary characteristic of a group of mental health conditions called dissociation disorders, as defined in the DSM-V. These include [1, 2]:

  • dissociative amnesia: inability to recall autobiographical information
  • depersonalization/derealization disorders: feeling disconnected or estranged from one’s body, thoughts, or emotions, perceiving one’s surroundings as foggy, surreal, or visually distorted
  • borderline personality disorder: although not strictly a dissociative disorder, borderline personality disorder can be characterised by severe stress-related dissociative symptoms
  • dissociative subtype of PTSD: in contrast to most patients with PTSD, patients with cognitive dissociations show different neurobiological responses to triggers and memories [5]

Many other mental health conditions are characterised by higher rates of cognitive dissociation compared to the general population, as can be measured by DES. These include schizophrenia, eating disorders, anxiety disorders, affective disorders and OCD or ADHD [6, 7].

Critically, experiencing dissociative symptoms can reduce the efficacy of treatment, for example, using the , Lexapro or amytriptyline, and make it risky to prescribe other neuroactive drugs including klonopin, which is used to manage anxiety disorders. One study found that the success of CBT in OCD was also predicted by cognitive dissociation scores [8].

Causes Of Cognitive Dissociation

Absorption in an activity, similar to a state of ‘flow’ as discussed by Charkraverty, is among the most common causes of cognitive dissociation in the general population. Sleep deprivation can also increase the chances of experiencing cognitive dissociation, particularly symptoms of fogginess or mind-wandering [9].

Pathological cognitive dissociation is most commonly caused by stress and/or trauma, although there are reports of cognitive dissociation without stress or trauma [10].

Summary: What Is Cognitive Dissociation

To summarise, cognitive dissociation is a complex phenomenon when two domains of cognition, such as time perception and vision, or perception of self and attention, are disrupted. Cognitive dissociation occurs in the general population but is more frequent in mental health patients. Understanding cognitive dissociation is critical for accurately managing these conditions, as it can influence their symptom severity and response to treatment. If you notice symptoms of cognitive dissociation that disrupt your daily activities, seek in-person professional help.

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Klara Hatinova

Klara Hatinova

Klara is a postgraduate researcher in experimental psychology at the University of Oxford. She has worked across a spectrum of hot topics in neuroscience, including her current project measuring reinforcement learning strategies in Parkinson’s disease. Previously, she studied the efficacy of psilocybin as a therapy for critical mental health conditions and examined molecular circadian rhythms of migraine disorders. She completed her undergraduate degree in Neuroscience at the University of Glasgow and participated in a year abroad at the University of California, where she worked on a clinical trial for spinal cord injury.