Acera Health

Dissociation and Borderline Personality Disorder

Reviewed by: Melody Stone
Rear view of specialist sitting on chair and talking to young people during psychotherapy in office

Dissociation is a psychological phenomenon that many individuals with Borderline Personality Disorder (BPD) experience. This can range from mild detachment from immediate surroundings to more severe forms, such as feeling disconnected from one’s own body or experiencing amnesia. Approximately 75% of individuals with BPD experience dissociative symptoms. Understanding the connection between dissociation and BPD is crucial for those affected, their loved ones, and mental health professionals. Dissociation often occurs as a coping mechanism in response to intense emotional pain or stress, allowing individuals to escape from distressing situations mentally.

At Acera Health, we provide comprehensive information and treatment options to help manage these challenging symptoms effectively. Our approach includes evidence-based therapies such as Dialectical Behavior Therapy (DBT), which has been shown to be particularly effective in reducing dissociative symptoms in individuals with BPD. By addressing both the dissociative symptoms and the underlying emotional dysregulation, we aim to help individuals achieve greater stability and improve their overall quality of life. For those seeking to understand their symptoms better, taking a BPD Test can be an essential first step towards obtaining a proper diagnosis and appropriate treatment.

What is Dissociation?

Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories, or sense of identity. This can be a coping mechanism to handle trauma or stress. Approximately 2% of the general population experiences dissociative disorders, highlighting the prevalence of this condition. Dissociation can manifest in various forms, ranging from mild detachment from immediate surroundings to more severe forms, such as feeling disconnected from one’s own body (depersonalization) or experiencing memory gaps and amnesia.

Mild dissociation can include daydreaming or zoning out, which many people experience occasionally. However, more severe forms, often seen in those with trauma-related conditions like Borderline Personality Disorder (BPD) or Post-Traumatic Stress Disorder (PTSD), can significantly impair daily functioning. These severe forms can involve dissociative amnesia, where a person is unable to recall important personal information, or dissociative identity disorder, where two or more distinct identities or personality states are present. Understanding dissociation and its impact is crucial for providing appropriate care and support for those affected.

Borderline Personality Disorder (BPD)

Borderline Personality Disorder is a mental health condition characterized by intense emotions, unstable relationships, and a distorted self-image. According to the National Institute of Mental Health, BPD affects about 1.4% of the adult U.S. population. Individuals with BPD often struggle with impulsivity, fear of abandonment, and difficulty maintaining relationships.

Symptoms of BPD

  • Emotional Instability: Rapid mood swings, intense episodes of anger, depression, and anxiety.
  • Impulsive Behaviors: Risky behaviors such as spending sprees, substance abuse, reckless driving, or self-harm.
  • Unstable Relationships: Intense and unstable relationships with friends, family, and loved ones, often swinging between idealization and devaluation.
  • Distorted Self-Image: An unstable sense of self, leading to sudden changes in goals, values, and vocational aspirations.

The Link Between Dissociation and BPD

Dissociation is a common symptom among individuals with Borderline Personality Disorder (BPD), often triggered during periods of intense stress or emotional turmoil. This psychological response serves as a coping mechanism to manage overwhelming emotions, helping individuals to temporarily escape distressing experiences.

Dissociation in BPD can manifest in various ways, each affecting an individual’s perception of reality and self:

  • Depersonalization: Feeling detached from oneself, as if observing oneself from outside the body. Individuals may describe this sensation as feeling like they are watching themselves in a movie or feeling unreal.
  • Derealization: Experiencing the world around them as unreal or dreamlike. People with derealization may feel as though their surroundings are distorted, foggy, or artificial, making it difficult to engage with reality.
  • Amnesia: Inability to recall important personal information, often related to traumatic or stressful events. This memory loss can be localized (specific to a certain event) or generalized (covering broader aspects of one’s life), significantly impairing daily functioning and relationships.


Understanding these manifestations of dissociation is crucial for effective diagnosis and treatment of BPD. At Acera Health, we incorporate specialized therapeutic approaches to help individuals manage dissociation and its underlying causes, promoting better mental health and well-being.

Causes of Dissociation in BPD

Several factors contribute to the development of dissociation in individuals with BPD:

  • Childhood Trauma: Many individuals with BPD have a history of childhood trauma, including physical, emotional, or sexual abuse. Dissociation can develop as a coping mechanism to protect against the pain of these experiences.
  • Emotional Dysregulation: The intense emotional experiences common in BPD can lead to dissociation as a way to manage feelings of overwhelm and distress.
  • Stress: High levels of stress, whether from interpersonal conflicts, life changes, or internal emotional turmoil, can trigger dissociative episodes in people with BPD.

Identifying Dissociation in BPD

Recognizing dissociation in individuals with Borderline Personality Disorder (BPD) can be challenging due to its subtle and varied presentations. However, identifying these symptoms is essential for effective diagnosis and treatment. Dissociation can significantly impact daily functioning and quality of life, making early recognition crucial.

Key Symptoms of Dissociation in BPD

  • Zoning Out: This symptom involves periods where the individual seems distant, unresponsive, or lost in thought. It may appear as if the person is daydreaming or not fully present in the moment, which can interfere with conversations, work, and other daily activities.
  • Memory Gaps: Individuals may experience an inability to recall events or actions taken during a dissociative episode. These memory lapses can range from forgetting small details to missing entire chunks of time, which can be distressing and confusing.
  • Feelings of Unreality: People may describe the world or themselves as feeling unreal or dreamlike. This can include depersonalization (feeling detached from oneself) and derealization (perceiving the external world as strange or unreal), which can disrupt their sense of reality and personal identity.


Understanding these symptoms can help in identifying dissociation in BPD and differentiating it from other mental health conditions. Early intervention can lead to better management of symptoms and improved overall well-being.

Types of Dissociative Experiences in BPD

Dissociative experiences can vary widely among individuals with BPD. Some common types include:

  • Mild Dissociation: Momentary lapses in attention or brief episodes of feeling disconnected from reality.
  • Moderate Dissociation: More pronounced detachment from emotions or surroundings, which might last for longer periods.
  • Severe Dissociation: Significant disruptions in consciousness or memory, leading to substantial impairment in daily functioning.

Treatment Approaches for Dissociation in BPD

Effective treatment for dissociation in individuals with BPD involves a comprehensive approach that addresses both the dissociative symptoms and the underlying BPD. At Acera Health, we offer a range of evidence-based treatments:

Dialectical Behavior Therapy (DBT)

DBT is a highly effective treatment for BPD that helps individuals develop skills to manage emotions, reduce self-destructive behaviors, and improve relationships. It includes components such as mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

Trauma-Focused Therapies

For those with a history of trauma, therapies such as Eye Movement Desensitization and Reprocessing (EMDR) or trauma-focused cognitive behavioral therapy (CBT) can be beneficial. These therapies aim to process and integrate traumatic memories, reducing their impact on current functioning.

Medication Management

Medications can be prescribed to manage co-occurring symptoms such as depression, anxiety, or mood instability. While there is no specific medication for BPD, treating these co-occurring symptoms can improve overall functioning.

Holistic Therapies

Incorporating holistic approaches such as yoga, meditation, and art therapy can help individuals reconnect with their bodies and emotions in a safe and therapeutic manner.

Understanding the Different Types of BPD

BPD can present in various forms, and understanding these variations can help tailor treatment approaches. The four types of BPD commonly discussed in clinical settings include:

  • Discouraged BPD: Characterized by dependency, submissiveness, and a strong fear of abandonment.
  • Impulsive BPD: Marked by impulsive behaviors, risk-taking, and difficulty controlling emotions.
  • Petulant BPD: Features irritability, defiance, and difficulty expressing anger in healthy ways.
  • Self-Destructive BPD: Involves self-harm, suicidal behaviors, and chronic feelings of emptiness.


Recognizing the specific type of BPD can aid in creating a more personalized treatment plan. Individuals with BPD often experience intense emotional episodes, commonly referred to as BPD episodes. These episodes can include rapid shifts in mood, intense anger, anxiety, or feelings of despair. During these episodes, dissociative symptoms can become more pronounced, making it challenging for the individual to remain grounded in reality. 

The causes of BPD are multifaceted, involving a combination of genetic, environmental, and neurobiological factors. Key contributors include:

  • Genetics: Family history of BPD or other mental health disorders can increase the risk.
  • Brain Structure and Function: Differences in brain regions involved in emotion regulation, impulse control, and aggression have been observed in individuals with BPD.
  • Environmental Factors: Experiences of trauma, abuse, neglect, or unstable relationships during childhood can significantly contribute to the development of BPD.


Dissociation is a significant and challenging symptom of Borderline Personality Disorder that requires a comprehensive and nuanced approach to treatment. At Acera Health, we are committed to providing individualized care that addresses dissociative symptoms and the underlying BPD, helping individuals lead healthier, more stable lives. If you or a loved one is struggling with BPD and dissociation, contact us today to learn more about our treatment programs and how we can support your journey to recovery.

Clinically Reviewed by:

borderline personality disorder | melody 1

Melody Stone, LMFT

Melody Stone is a Licensed Marriage and Family Therapist who has over 17 years of experience in the field of behavioral health. She works as the Chief Clincal Officer (CCO) to Acera Health, where she is a strong leader focused on sustainable success.

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