What are the main signs of dissociation?

Researchers who built the Clinician-Administered Dissociative States Scale grouped the experience into three areas. There is derealization, when the world seems unreal or dreamlike. There is depersonalization, when you feel detached from your own body or self. And there is amnesia, meaning gaps in memory. A distorted sense of time is also a common part.

Is dissociation during a session normal?

Dissociation is a recognized, well-documented experience, not a sign that something has gone wrong with you. It ranges from mild spacing out to stronger states, and it varies from person to person. A strong or distressing episode is worth raising with your care team, who can help you make sense of it.

How is dissociation measured?

The most widely used tool is the Clinician-Administered Dissociative States Scale, built by Bremner and colleagues in 1998. It uses 27 items, some answered by the person and some rated by an observer, each scored from 0 to 4, to capture changes in how the body, the surroundings, time, and memory feel in the moment.

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What does it feel like to dissociate during a session?

Short answer

Dissociation during a session often feels like detachment. You may feel disconnected from your body, as if you are watching yourself from a distance. The room can look unreal or dreamlike. Time may speed up or stall. Researchers built a validated scale that captures these exact sensations, so the experience is known and measurable.

The research

Bremner, J. D., Krystal, J. H., Putnam, F. W., Southwick, S. M., Marmar, C., Charney, D. S., & Mazure, C. M. (1998). Measurement of dissociative states with the Clinician-Administered Dissociative States Scale (CADSS). Journal of Traumatic Stress, volume 11, issue 1, pages 125 to 136.

Sample a clinically diverse group of more than 100 people, including trauma survivors, people with other psychiatric conditions, and healthy volunteers

Published 1998

Journal Journal of Traumatic Stress

In 1998, J. Douglas Bremner, John Krystal, Frank Putnam, and their colleagues set out to measure something that had long been hard to pin down: what a person actually feels during active dissociation. They built the Clinician-Administered Dissociative States Scale, or CADSS. It uses 27 items, 19 answered by the person and 8 rated by a trained observer, each scored from 0, meaning not at all, to 4, meaning extremely. The questions ask about the felt experience directly. They cover whether your body or the world around you seems unreal, whether time feels sped up or slowed down, whether you feel detached from yourself, and whether there are gaps in what you can recall. The team grouped these into three areas: derealization, when the world seems unreal; depersonalization, when you feel detached from your own body or self; and amnesia, gaps in memory. They developed and tested the scale with a clinically diverse group of more than 100 people, including trauma survivors, people with other psychiatric conditions, and healthy volunteers, and reported good agreement between raters and good internal consistency. The scores reliably told apart people who were actively dissociating from those who were not.

Read the paper

What does this mean for you?

Dissociation can be unsettling precisely because it is hard to put into words. This research matters because it shows the experience is not random and not imaginary. It has a shape. Feeling far from your body, seeing the room as flat or dreamlike, losing your grip on time, these are recognized features that clinicians can name and measure. If it has happened to you in a session, you are describing something real and well documented.

It helps to be clear about what this scale can and cannot tell you. The CADSS measures the experience of dissociation. It does not explain why it happens for any one person, and it does not say how common it is in any single kind of therapy. It was built and tested mostly with people in clinical settings, so your own experience may look different. Dissociation also sits on a spectrum, from mild spacing out to stronger states, and no two people describe it in quite the same way.

For a person in the gap between sessions, the useful part is the language. When you can name what happened, feeling detached, unreal, or outside of time, you can bring it back to your care team in words they will recognize. That turns a strange, lonely moment into something you can talk through. Dissociation is a described feature of some sessions, not a personal failing, and simple grounding steps can help you feel present again.

The takeaway

Name it plainly. A detached body, an unreal-feeling world, or distorted time are known signs of dissociation, not signs that something is wrong with you.
Come back gently. Grounding steps, like slow breathing or feeling your feet on the floor, can help you return to the present.
Bring it to your team. If a session brought on a strong or distressing dissociative experience, tell your care team so they can support you.

Terms in this page

Dissociation Grounding

This is the work Asendar™ was built for: helping you find words for what happened in a session and carry them safely into the days that follow, so a strange or detached feeling is less frightening and easier to share. If you want a simple read on where your head is starting from today, take your Mental Readiness Score.

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