Generation Dissociation

By Madison Margolin

In today's world, dissociation seems like an obvious response to our turbulent zeitgeist: war, plague, political strife, inflation, just to name a few. For some, dissociative tendencies are a common symptom of trauma.That feeling of being checked out from yourself, vacating the body, the fear of unsafety so big that no one's home to experience it. The inability to feel your feelings. In other ways, dissociation manifests in our actions: doom scrolling, binge watching, and yes, taking drugs, including ketamine. 

Understanding Dissociative States

But, what if dissociation—rather than being only a symptom of trauma—were also part of the cure? There's a Talmudic adage that goes something like, "the handle of the axe comes from the forest that fells it," meaning to say that the point of our injury is also the point of our healing. Then it's no wonder that for 'generation dissociation,' ketamine—a dissociative anesthetic used legally off-label as a mental health treatment, and underground all over the world in the party scene—is one of today's most popular, if not the most popular, drug on the legal and black markets. And the benefits of its use are, well, questionable. 

In some cases, dissociation is just that: an escape, a reprieve, a fix. But in other cases, it might be just what we need: a contained, dissociative experience to take us out of our pain, out of the depths, allowing us not quite to feel, but to float above it all, to experience a transcendence that can't even be touched by that which ails us. And if used responsibly, so much promise is there—or rather, in the not there—of dissociation's therapeutic flair.

A ketamine trip can feel something like this: vivid flashes, a scattering of images, and a stubborn absence where a continuous self should be. For some, that absence reads like relief; for others, it reads like an alarm. In clinics and after-parties alike, people report the same bewildering mismatch between memory and meaning: powerful emotions with no tether, a sense of insight that feels borrowed, or the uncanny sensation of watching one’s life from just out of frame.

The subjective state called dissociation is defined by the splitting off of perception, memory, and identity. It argues that these experiences can yield both rapid relief and real harm, and that they demand a distinct set of harm-reduction and integration tools precisely because the “you” who lived through them is often not the “you” who must make sense of them afterwards. 

Clinicians may recognize dissociation as a spectrum from everyday spacing out to clinical depersonalization and derealization. At one end sits transient experiential dissociation—the kind people report after a night of too much stress, grief, or a heavy dissociative trip, a temporary slipping of anchor. At the other is persistent dissociative disorder, a chronic splitting of experience that shapes identity and function. The difference matters because one is often reversible with care and containment; the other typically needs long-term, trauma-informed treatment.

A Look at Dissociative Psychedelics & Experiences

Dissociative psychedelics are the pharmacological cousins that tend to pry that anchor loose. Ketamine, DXM, nitrous oxide, and, in some intense ibogaine sessions, elements of the PCP family, all act on NMDA receptors. It short-circuits the brain’s self-modeling—the neural framework that creates your stable sense of “I.” For users, the result can feel like a dissolved boundary: time unmoored, body maps rearranged, memory arriving in shards. It’s not the same texture as serotonergic ego-dissolution—where the mind feels vast and boundless—but a different kind of unravelling, one that often leaves a person stranded outside the narrative of their own life.

“When you weren’t there” names that dislocation: gaps in recall, the sense that important moments happened to a version of you you can’t access. Sometimes the missing pieces are implicit—somatic residues, a mood that won’t name itself—rather than explicit memories you can report. That’s where the overlap with trauma becomes fraught: if a journey reactivates adaptive dissociation born of past harm, what looks like insight can re-open wounds. Distinguishing ephemeral dissociative states from trauma-linked dissociation is essential to keep people safe and to know whether integration is a short conversation, or the start of real clinical care.

People describe dissociative experiences in language that makes sense of something slippery. Perceptual changes often include a sense of floating, leaving the body, a stretching or collapsing of time, and odd shifts in how the body feels mapped in space. Sounds may seem distant or amplified. Lights and textures can become unreal. These are not small distortions. They can feel like being in a dream where the rules keep changing.

On the level of self, the change is sharper. Many report fragmented memory, as if portions of the session happened to someone else. A common report is feeling like an observer rather than a participant, watching one’s life from the periphery. Temporary amnesia for parts of the session is frequent. When people try to tell the story later they find gaps, mismatched fragments, or only somatic impressions, such as tightness in the chest, or hollow in the gut, that refuse tidy language.

Cognitive and emotional patterns also shift. Mood can swing quickly from calm to terrified to elated without obvious triggers. Some people feel emotionally blunted, removed from feeling at all. Others move through intense affective peaks that arrive out of proportion to the content. Narrative fragments appear, dreamlike scenes that make little linear sense but carry strong feeling. How these symptoms show up depends on dose, the setting, and personal history. A low, medically supervised ketamine session can feel very different from a high-dose, unsupervised encounter in a noisy place. Past trauma, attachment patterns, and baseline anxiety all shape the texture of the experience.

Outcomes, Risks & Integrating These Experiences

Dissociative experiences do not have to be destabilizing. For some people they bring rapid, tangible relief. Ketamine is the clearest example, with a growing body of clinical research showing fast-acting antidepressant effects for treatment-resistant depression. Studies suggest mood improvements can appear within hours or days, offering a window of relief when other treatments fall short.

Beyond symptom relief, dissociatives can access embodied or implicit material that verbal therapies sometimes cannot reach. When cognitive defenses are bypassed, non-verbal memories and sensations can surface and be processed in ways that feel freeing. That can be particularly useful when trauma or tightly held defenses block conventional talk therapy.

People also report creative benefits: new metaphors, novel problem-framing, and relational perspective shifts. A sudden reframing of a stuck relationship or a new approach to a life problem can emerge in the wake of an experience.

Outcomes vary by context. Clinical, controlled settings with medical oversight and structured integration protocols generally produce safer, more durable results than ad hoc use among peers. Without integration, benefits may fade quickly. A mood lift can be temporary if not followed by concrete integration work, behavioral changes, or therapy that helps stabilize gains.

Dissociative experiences carry real risks. Physiologically, at higher doses or when combined with other depressants like opioids or alcohol, there is a risk of respiratory depression. Because dissociation often alters coordination and judgment, people can injure themselves during disorientation. Medical supervision matters.

Psychologically, the risks can be long lasting. Some people develop prolonged depersonalization or derealization, a persistent sense of unreality that can last weeks or months. Those with a history of psychosis or bipolar I face elevated risk of triggering mania or psychotic episodes. Nightmare-like aftereffects and heightened anxiety are reported, especially when the experience is overwhelming or poorly contained.

Memory fragmentation complicates recovery and meaning-making. Gaps in narrative make it hard to integrate the experience. Without a coherent story, fragments can become a source of anxiety rather than insight. Polydrug use and unsupervised settings amplify all of these risks. A noisy party, poor sourcing, or combining substances raises the chance of physical harm and psychological fallout.

Boundaries & Red Flags

There are also ethical boundaries for peer holders and facilitators. Peer support has value but it has limits. Holders need to know when they are in scope and when a situation requires clinical escalation. That includes recognizing signs of severe distress, emerging suicidality, or decompensation that calls for professional intervention.

Watch for warning signs that require help. Persistent derealization that does not ease across days or weeks, worsening depression or anxiety, new or worsening suicidal thoughts, or clear psychotic symptoms all warrant immediate clinical attention. If someone experiences sustained functional impairment, encourage a prompt evaluation by a mental health professional with trauma and dissociation expertise. 

Preparation begins long before a dose. Screen for red flags: a history of psychotic disorder, bipolar I, or active suicidality raises real concerns. Pregnancy and serious cardiovascular conditions are contraindications in many contexts. Check medications—some combinations increase risks or blunt therapeutic effects—so ask about SSRIs, benzodiazepines, and other prescriptions and, when possible, consult a clinician about interactions. Screening isn’t meant to gatekeep; it’s meant to protect.

Design the setting for dissociation specifically. Physical safety is primary: clear sharp objects, provide soft surfaces or padding, and make sure moving around won’t cause falls. A sober sitter is essential for newbies or for those who want to fully let go. Choose someone who knows grounding techniques and basic medical triage, who can stay calm if the person becomes disoriented. Keep lights soft, sounds predictable, and textures comforting; avoid sudden bright stimuli that can trigger panic. Have an easy-to-follow safety plan visible: contact numbers, dosage records, and a plan for escalation if needed.

In-session support should be non-intrusive and steady. A quiet presence, gentle prompts, and anchored sensory cues, such as a weighted blanket, a familiar scent, a hand to hold, help reorient someone who feels untethered. Ask simple, concrete questions instead of probing for meaning; avoid re-traumatizing interrogation or pushing for explanations the person can’t access. Know when to step back: some dissociative material needs space to unfold. Know when to intervene: prolonged unresponsiveness, breathing trouble, or signs of severe distress require action and possibly emergency care.

Document consent and expectations ahead of time. Agree explicitly about memory gaps, whether sessions may be recorded, and who will be contacted if things go sideways. Make sure emergency contacts and medical info are on hand.

Aftercare is part of the medicine. Prioritize rest, hydration, and gentle food. Advise avoiding driving or major decisions for at least 24 hours. Encourage light social contact or a check-in with the sitter the next day. Integration starts with simple containment: a quiet recovery, a warm drink, and someone present who can help stitch back the edges.

In the aftermath of a dissociative session, partial recall is common. Acceptance is the first move: missing pieces do not mean failure, and they do not erase whatever shifted value may have occurred. Normalizing gaps without minimizing the distress they cause creates a steadier ground for the work to come.

Begin where the body remembers. Immediate journaling is blunt and useful: free-write as soon as someone is able, not to force meaning but to collect impressions—the smells, the posture, single lines of dialogue, images, and sensations. Even a sentence fragment or a doodle can be a doorway. If speech feels thin, record a voice memo. The point is to externalize whatever residue exists before it softens into fog.

Pair words with somatic mapping. A slow body scan—feet, calves, hips, belly, chest, throat, jaw, face—asks what remains in muscle tone or temperature. Note any tightness, tremor, or hollow places and sit with them for a moment. Simple grounding practices—placing a hand on the belly, tasting a piece of citrus, tracing the edge of a table—help re-anchor someone whose self-model has been loosened. These are practical ways to re-establish continuity between felt sensation and narrative memory.

When memory is fragmentary, creative reconstruction becomes essential. Collage, drawing, and voice memos let non-verbal content be witnessed without forcing tidy interpretation. Ask for images rather than explanations: what color was the room, what sound kept repeating, what body part felt “different”? If a sitter was present, reconstruct a timeline together using their notes or recordings. Third-person narrative work—rebuilding the sequence from external observations—reduces pressure on the person to conjure a complete first-person account and can reveal concrete sensory anchors missed in self-report.

Integration questions may be abstract and open ended, but also could and sometimes should be concrete: “What did you learn?” vs. “When did you last feel safe as a child?” or “Where did your attention go when you felt that panic?” Concrete questions invite sensory memories and contextual clues that a fragmented mind can answer. Keep the pace slow. Iterative meaning-making—returning to the material across days or weeks—respects the way implicit memories surface over time. Resist the urge to force a single explanatory story the way a clinician might, because coercing coherence can turn helpful ambiguity into rigid, potentially harmful narratives.

Therapeutic modalities can help when fragments won’t stitch themselves back together. EMDR-informed processing, sensorimotor psychotherapy, and ketamine-assisted integration with trained clinicians are options for people whose dissociation reactivates trauma or whose symptoms persist.

Recognize the limits of peer support. A compassionate friend or sitter can help gather sensory anchors and hold presence, but persistent fragmentation or increasing distress signals the need for professional care. Timelines vary—some regain narrative coherence within hours or days; others need weeks or longer. Encourage patience and small, consistent practices: journaling, gentle movement, and brief check-ins with a trusted person.

We live in a culture that encourages checked-out living: constant crisis, endless feeds, survival strategies that teach people to thin themselves out just to keep going. For some, dissociation is a scar, a protective split born of trauma and stress. For others it has become a tool—sometimes salutary, sometimes risky—used to pry open stuck places or to find temporary refuge from an unbearable present. Ketamine and its kin sit at that uneasy intersection: medicine in clinic corridors, party staple in basements, potential doorway and potential trap.

The point isn’t to romanticize absence or to pathologize every moment of escape. It is to insist on discernment. When dissociation is offered intentionally, contained by screening, sober holding, and thoughtful integration, its not-being-there can be a space for change. When it is accidental—mixed, unsupervised, or untreated—it can deepen disorientation and harm. The work that follows a dissociative experience matters as much as the session itself: gathering fragments, tending the body, and choosing care over quick fixes. In that careful tending, a lost thread can be rewoven into something steadier—sometimes healing, sometimes partial, but always worth the deliberate attention.

Madison Margolin is a journalist and educator who cofounded the psychedelic magazine DoubleBlind. She is the author of Exile and Ecstasy: Growing up with Ram Dass and Coming of Age in the Jewish Psychedelic Underground. Her writing has been featured in outlets like Rolling Stone, VICE, and Playboy.