Dissociation is the process of holding two contradictory representations of the world in mind simultaneously without being forced to resolve the contradictions. When you code-switch between work and home, when you hold a loved one to different moral standards than a stranger, when you put aside a distant worry to focus on an emergency right now - all of these are equally as dissociative acts as some puppygirl getting stressed out and switching alters.
Obviously though, they are not literally 1:1 equivalent. It can be relatively easy to overlook something you would find really annoying in a stranger when your beloved friend does it, but much more difficult to maintain a cheerful customer service voice while you're struggling with pain or relationship trouble. The difference is in the degree of separation you must maintain between these contradictions, and in the intensity of the contradictory demands pulling at you. More intensely contradictory demands require more effort to maintain - more labor.
Ultimately, that's exactly what dissociation is. It is cognitive labor, performed at energetic cost in an attempt to keep you operating smoothly. It is, specifically, reproductive labor in the Marxist sense. It does not directly produce anything new, but is structurally necessary for continued function. From here it does not require a great leap of logic to realize that this dissociative labor is unevenly distributed.
More intensely contradictory demands drive more intense dissociative labor, and unresolvable contradictions are structurally concentrated in the most vulnerable populations. The privileged and wealthy are able to externalize their own dissociative loads, either onto tools or subordinates. A millionaire's friendly relationship with her live-in maid requires a great deal more work on the maid's part to maintain than on the millionaire's. Taking antidepressants can make suicide seem less necessary without actually changing any of the structural factors making you long for that way out - structural factors which may be materially much further out of reach to change than a diagnosis of depression and a prescription for SSRIs.
These conclusions taken together, it becomes clear that psychiatry - provably effective as its interventions can be in the right circumstances - misattributes the source of the strain and hardship on vulnerable populations. It isn't internal pathology, but external pressure that concentrates internal stress among the underclasses. I've been referring to this sociological approach to understanding dissociative labor as dissociology - and I intend to post more as I unpack what this framework has helped me realize and where I've been able to scale it and integrate it into broader marxist analysis.
