Two Main Types of Dissociation
In this post, I'll walk you through two main types of dissociation that I see in my practice. I'll also share three gentle approaches we use together in therapy to work through these experiences.
There are two primary types of dissociation: shame-based and terror-based dissociation. Both develop as natural responses to severe trauma, and both make complete sense given what you've been through.
Here's what's important to understand: during traumatic experiences—or a series of them, like what we often see with childhood abandonment, neglect, or abuse—disconnecting was often your best and only option. As humans, we naturally move away from pain. When you had little power to physically escape from overwhelming pain, dissociation became your internal survival strategy, creating distance between you and the unbearable.
Think of it like wrapping your arms around yourself when you're freezing cold. You might not be able to change the weather (your traumatic circumstances), but you can try to keep yourself warm and buffer against the cold to survive. Your mind learned to do something similar—creating protective distance to help you endure what felt unendurable.
Dissociation can be confusing because it shows up in two ways that can feel pretty different in the body: sometimes by revving up, and sometimes by shutting down. The “revving up” version is terror dissociation.
Terror dissociation might look like:
A blank or unfocused expression, like you're looking through people
Being unresponsive, or giving answers that don't quite match the situation
Wide, startled eyes
Quick, shallow breathing
Going completely quiet or unable to speak
...and might feel like:
Your system revving up into high alert
Everything narrowing to tunnel vision
Your heart racing or pounding
Struggling to focus or understand what people are saying
Being unable to recognize when you're actually safe
Feeling trapped inside yourself, like you're behind glass
Being frozen in place by fear
While terror dissociation often involves your system going into high alert, shame dissociation tends to move in the opposite direction—toward collapse and withdrawal. You might notice your body naturally wanting to hide or make itself smaller.
Shame dissociation might look like:
Physically collapsing inward or making yourself as small as possible
Shoulders hunched protectively
Head down, avoiding eye contact
Hiding behind hair, hoods, or scarves
Covering your body with loose or shapeless clothing
Crying that feels out of control
Going silent and being unable to speak
...and might feel like:
A sensation of falling or being completely unreachable
Overwhelming self-hatred or disgust
A sense of giving up or surrender
Being pulled back into childhood moments when you felt most helpless
Unable to let anyone comfort you or believe anything positive about yourself
Losing your words or feeling disconnected from everyone around you
Feeling emotionally dead or numb inside
Like you're watching the world from underwater or from behind thick glass
It's worth noting that these two types of dissociation can sometimes overlap or shift from one to the other, and it's not always clear—even to trained observers—which type someone is experiencing in the moment. You might start with terror dissociation and then collapse into shame-based disconnection, or feel elements of both at the same time. What matters most isn't getting the "right" label, but understanding that your mind is doing what it needs to do to protect you.
Three gentle approaches to working through dissociation in therapy
1. Finding and grounding you: As your therapist, my first job is to find you—wherever your mind has taken you for safety. Maybe you're stuck in a childhood room, or floating somewhere far away, or feeling completely alone. Once I locate you, we begin gentle grounding work together. This might involve helping you notice the feeling of your feet on the floor, the temperature of the room, or the sound of my voice. We use these present-moment anchors to help you feel less alone and more connected to the here and now, even while part of you might still feel far away.
2. Understanding your escape route: There's always a good reason you needed to dissociate. Together, we'll gently explore what was happening in the moments before you escaped, so we can understand what felt dangerous and what your specific triggers might be. This helps us figure out how to move forward with more awareness and safety.
3. Gently returning to the present: Using approaches that honor both attachment and your nervous system, I'll help guide you back to this moment, back into your body, and back to feeling safe and grounded in our therapy space. We go slowly, and we go at your pace.
Remember: dissociation isn't something that's wrong with you—it's something that was right for you when you needed it most. Sometimes our brains get stuck in old ways of trying to protect us, not realizing that the trauma or danger has passed. In therapy, we honor that survival wisdom while also creating new pathways back to connection and presence.