Opposite sides of the same coin – Dissociation and Empathetic Detachment – negative and positive poles

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When a doctor is working in an emergency care unit, he/she is expected to keep his/her personal feelings contained. This is called Empathetic Detachment. Empathetic Detachment resembles Dissociation in some ways. For example, when a victim enters the emergency room and a doctor needs to operate, the doctor is expected to act professionally; contain personal feelings and thoughts; and hold ones own personal opinion to him/herself. Empathetic Detachment is a state of mind which seems to contain the personal judgement of a medical situation – by professionally focusing on the medical procedures at hand.

Dissociation is a state of mind where when one is faced with either real or perceived terror, one freezes into an alternative state of mind in order to [1] cope better with the situation and also [2] in order to protect oneself from real or perceived danger.

There is a fine line between empathetic detachment and dissociation. The one main difference between the two terms is the context, for example when one is an expert in the field of medicine, psychopathology, mental health and addictions, and one is performing a professional operation, often one uses empathetic detachment to perform a complex incision; whereas if one is experiencing a personal real or perceived threat in society one could apply the dissociation.

A similarity between empathetic detachment and dissociation is the feeling it has on the psyche.

Another difference between empathetic detachment and dissociation is that empathetic detachment is intended to purposefully do good consciously  i.e. perform surgery, analyze a complex human situation or comprehend human ambivalence versus dissociation which occurs as a conscious or unconscious personal state of mind based on a identified or non-identified personal trigger.

The notion of empathetic detachment does not seem to cause long-term harm to an individual, if one applies self-care. However with dissociating that is not always the case. Dissociating could originally have been a beneficial coping mechanism at the moment, when the choices where either fight, flight or freeze, however in the long-term, if dissociating is not acknowledged and explored, it could become a chronic component with a serious mental illness symptomology.

The Communication Model Approach is both a professional and a peer model approach with compounds of each. This means that the practitioner juggles between the two-states as a matter of navigating between symbiosis and strong emotions of serious mental illness. Self-awareness and the ability to self-identify feelings of empathetic detachment and dissociation are key to applying the Communication Model effectively.



Hart, Bernard (1958) The Psychology of Insanity. Cambridge University Press p. 41-50.



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