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Sex - Overview | July 6, 2021, 11:48 CDT

Dissociation During Sex Is Not Uncommon
More than 'zoning out,' dissociative episodes can prevent intimacy and pleasure.

Written by

Fjolla Arifi
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Photography by David Heisler

All of your senses are stimulated in the bedroom, but sometimes you may notice feelings of pleasure are suddenly replaced by out-of-body experiences, sensations of unfamiliarity and general withdrawal, especially as the intimacy ramps up. If this sounds familiar, taking steps to identify the causes of disconnection could be beneficial to you, your partner and the relationship.

Dissociation comes in many forms, affecting up to 75 percent of individuals at least once in their lifetime. Whether a result of anxiety, dissociative disorders or trauma, dissociation can affect your sex life and sexual functioning.

What is dissociation?

Dissociation is a disruption in consciousness, memory, identity and perception. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are three types of dissociative disorders: depersonalization/derealization, dissociative amnesia and dissociative identity disorder. When we dissociate during sex, it's most likely a case of depersonalization or derealization.

The two are similar but distinct, said psychologist and sex therapist Alexa Andre.

"Derealization involves the disconnect between a person and reality," Andre said. "Derealization experiences feel as if the external world is strange or unreal, or time is moving unexpectedly fast or slow."

"Depersonalization experiences, on the other hand, are a sense of feeling disconnected from the body. Some find they're watching themselves as an observer, or feel like their body is unusually large or small," Andre explained.

Despite different levels of severity, depersonalization episodes are relatively common.

"Dissociative symptoms occur after upsetting memories in 45 percent of cases, during states of anxiety or depression in 66 percent of cases or for no specific reason in 35 percent of cases," said Andre.

How common is dissociation during sex?

According to one study, women with a history of childhood sexual abuse experience more dissociative symptoms and sexual difficulties than women without a history of abuse. However, dissociation can occur during any setting in which individuals experience stress or anxiety, regardless of past trauma.

"There's a variety of reasons why someone can experience dissociation during sex," sex therapist Jo Robertson said. "[This includes] trauma history, negative body image, a lack of sexual arousal, stress, discomfort with your body or not feeling connected to sexual partners."

Clinical sexologist Melinda DeSeta emphasized that although trauma or fear is often the root cause of dissociation, the exact cause is unclear.

"Dissociating during sex is more common than you may think," DeSeta said. "If someone becomes emotionally or physically triggered during intimacy, the mind unconsciously detaches itself from the experience to avoid painful feelings."

Despite limited research on sex and dissociation, Andre points to the connection between dissociative episodes and lack of mindfulness during intimacy.

"Judging your sexual performance from a third person's perspective is a key factor in sexual arousal problems," Andre explained. "This detachment is problematic because it prevents the individual from fully experiencing and enjoying the sexual activity. The literature on sexuality has not directly addressed dissociation during sexual activity. However, awareness of the present moment and a connection with one's body are the focus of theoretical and empirical studies that link distraction with low sexual arousal."

How to cope with dissociative episodes during intimacy

Bat Sheva Marcus, psychologist and sex expert, shared how individuals can use techniques and coping skills to reconnect.

"In almost every situation, deep breathing or grounding exercises can help," Marcus said. "Grounding exercises might include counting backward from 100, naming five things you see or things you see in a particular color.

"For some, slowing down or stopping is the most beneficial. For others, talking to recapture their attention at the moment is helpful. It may mean raising the intensity of stimulation levels," Marcus continued. "Like all other areas of sex, there is no one-size-fits-all model, and you need to speak to your partner to understand what is most helpful for them."

Robertson emphasized the importance of communication during intimacy to ensure consent and comfort at all times, not just because of dissociation: "Asking your partner, 'Are you into this?' 'Are you okay?' or 'You feel distant' are helpful prompts to understand what they're going through."

"Sex is about being present and feeling pleasure," DeSeta said. "Communicate with your partner. Ask them what you can do to help them feel emotionally and physically safe during intimacy."

If you or someone you know is experiencing signs or symptoms of depersonalization/derealization and needs help, the National Alliance on Mental Illness has resources and a helpline at 1-800-950-6264.

Written by

Fjolla Arifi

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