I recently had a dental procedure that involved local anesthesia. I watched the dentist do her work through the reflection on the examination light. Though I didn’t see the drill, my entire head vibrated from my mouth. The gel she swabbed on my teeth was dark purple; for a few moments, it looked like she had removed them. The tip of the light that bonded the composite material first glowed a neon yellow, then flashed into nightlight blue. I left the office with a facial deformity and a speech impediment, though, thankfully, both disappeared as the anesthetic wore off.
(Science, technology, engineering, and mathematics are amazing.)
Dissociation is a useful coping skill at the dentist’s office. Though I was watching her work on the teeth in my mouth, the anesthetic left me feeling disjointed sensations: pressure and vibration, but no pain. Was this actually happening? My throat reflexively swallowed when the saliva began to pool; sometimes I tasted the metallic salinity of blood—my blood. But was this actually happening to me? My hands rested on my belly, like small boats of muscle, flesh, and bone floating on slow waves of abdominal breathing. A woman whose face I could not see was sanding down teeth. Were those actually my teeth?
When the dentist announced that she was done, I rejoined my body in space and time within one or two eyeblinks. Everything—except for the small, numb portion of my mouth—had reintegrated.
Problems arise when we only have one coping skill to deal with life’s myriad stressors. Imagine disconnecting from time during a job interview or separating from reality when a friend is in distress and needs your help. The interviewer may assume that you are inattentive or intoxicated. Your friend may come to believe that you are unreliable and unresponsive. Doors you wanted to walk through close.
Imagine that any time a challenge appears, the only way you can deal with it is by disconnecting in space, time, and identity. Gone are the abilities to ask for help, defend yourself, or protect people you care about. You just disappear.
Sometimes people end up relying on only one coping skill because it was the only skill that was useful—and lifesaving—in the past. Consider the child who grows up with a father who drinks large volumes of alcohol. When he starts roaring and the dishes shatter against walls near and far, hiding and dissociating are protective. And what if he drinks to this point of loathing and destruction most nights of the week? It seems safer to feel nothing at all rather than terror and tense muscles all the time.
The skills we use frequently—intentionally or not—are the skills we come to rely on.
Maria Yang, MD 