Internal vs external reality

One of the ways I like to think about my dissociative experiences is through the concepts of internal reality and external reality. I think of external reality as being the objective aspects of one’s external environment, including physical surroundings, social interactions, and events. On the other hand, I think of internal reality as being one’s subjective internal experience, which includes one’s thoughts, memories, and emotions. One’s center of focus is usually balanced between their internal and external realities—they are aware of and are able to interact with their external reality while simultaneously being able to perceive and connect with their internal reality.

Through synthesizing my experiences with dissociation, I believe that someone who has a more dissociative brain may have difficulty with both differentiating between and simultaneously experiencing their internal and external realities. That is, for more dissociative individuals, there are times where they may

1. misattribute experiences occurring internally as occurring externally, and vice versa¹; and
2. be entirely detached from either their internal or external reality, only being able to perceive one or the other at any given time².

I will demonstrate this with a few personal examples.

There are times where I may believe I am interacting with the external world, but in reality I am only engaging internally. This often happens in therapy when I’m having a dissociative response. When I become triggered, I may turn my body away from my therapist, close my eyes, curl up, and stop responding to or engaging with her. My therapist may talk to me, asking me questions to help me “come back” to reality. Although I often hear her and believe that I am actively responding to her, I actually am not. This leads me to be confused by why she isn’t engaging with my responses and is instead continuing to ask me questions. It takes me a while to realize that my reality is off and that I am actually not interacting with the external world—I merely think that I am. Oftentimes, this state feels dreamlike, slow, and slightly off.

As another example, I quite frequency experience what could be considered to be audible hallucinations related to my trauma. For instance, while working at my desk, I may hear people having an argument in the distance, perhaps in a neighboring apartment unit, but I initially don’t pay much attention to it. As time goes on, I become more curious about it, and stop what I’m doing to try and figure out what is happening. All of a sudden, I become terrified and believe that this argument is actually happening right next to me—my heart races and I begin to shake in fear. A few seconds later, I realize that this “argument” is not actually real; I’ve been imagining it the entire time. This could be considered a flashback in PTSD terminology—I believe it is a memory, but I genuinely, if only for a brief period, believe that it is actually happening in my external environment.

As a final example, happenings in my internal reality may bleed out externally. I often have mini dissociative intrusions, where a memory or emotion may pop up internally, and I’m so focused on my internal world that I start to act it out externally—I may utter something, or make a jerky body movement, in response to my internal experience, but I’m unaware that I’m acting anything out. I’m so absorbed in my internal reality that I lose awareness of my external surroundings, leading to unintentional external expressions of what I am experiencing internally. This can be very embarrassing at times, as I may inadvertently make odd and inappropriate noises in a quiet environment where others may hear me.

Many of my dissociative experiences involve a lack of connection between my internal and external realities. I have countless examples of this, but I provided three in this post.