Dissociative Disorder Treatment That Helps You Feel Whole Again

The DSM-5 recognizes three primary dissociative disorder diagnoses:

Dissociative Identity Disorder (DID): Previously referred to as Multiple Personality Disorder (MPD), DID is characterized by the existence of two or more distinct states of identity or personality that recurrently assume control over the individual’s behavior. Each state of identity or personality can potentially possess a unique name, history, mannerisms, voice, and characteristics. DID is nearly always developed in response to extreme levels of prolonged childhood trauma and is typically associated with dissociative amnesia, which are gaps in memory related to daily events, personal history, or traumatic experiences.

Dissociative Amnesia: This diagnosis is based on an inability to remember important autobiographical information typically related to traumatic or stressful events that is too extensive to be explained by ordinary forgetfulness. Someone with dissociative amnesia may experience gaps in memory related to specific events, particular aspects of experiences, or in some instances, broad swaths of their entire life history. One form of dissociative amnesia, dissociative fugue, involves confused travel or wandering along with confusion regarding the individual’s identity and personal history.

Depersonalization/Derealization Disorder: This disorder is characterized by a persistent or repeated sensation of depersonalization, which is feeling disconnected from one’s own thoughts, feelings, sensations, or body, or viewing oneself from an outside perspective, or derealization, perceiving the external world as unreal, remote, dreamlike, or distorted. Individuals with this disorder typically maintain reality testing (they know the experiences are not literally true) but find the experiences profoundly distressing. Symptoms can persist for hours, days, weeks, or months and may wax and wane over years.

Other Specified Dissociative Disorder (OSDD): Diagnoses under the category of OSDD involve dissociative symptoms resulting in substantial distress; however, not enough to warrant a diagnosis of one of the above three main categories. While OSDD is a critical category that acknowledges many possible expressions of dissociative experiences, including sub-threshold DID and culturally specific dissociative experiences, it is not a specific diagnostic entity within the DSM-5.

While all the dissociative disorders have unique characteristics, there are some similarities among them, including:

• A feeling of being detached from your body, mind, or emotions
• Feeling that the world, people, or surroundings are unreal or distorted
• Memory lapses about certain time frames, specific events, or details about yourself or others
• Uncertainty about who you are, your past, or if your sense of identity is changing
• Flashback episodes concerning past traumatic incidents with possible amnesia before or after the episode
• Confusion about your life history or memories of specific events
• Alternate identity states or “alters” in addition to the original identity state, characterized by differences in speech patterns, posture, gait, and perspective on reality
• Low stress tolerance and inability to cope with typical forms of stress
• Difficulty forming and keeping stable interpersonal relationships
• Self-harming behaviors (more frequently seen in patients diagnosed with DID and OSDD)

Dissociative disorders significantly impact a person’s ability to function socially, at work, and in daily life, and both increase the likelihood of co-existing mental illnesses such as depression and suicidal ideation.[6] Early intervention by trained professionals will improve long-term outcomes.

The development of dissociative disorders can usually be traced back to trauma, particularly when experienced during childhood when the brain and sense of self are especially susceptible to damage caused by overwhelming traumatic experiences.

Below are some factors that increase the risk of someone developing dissociative disorder:

• Childhood trauma — Prolonged physical, emotional, or sexual child abuse is considered to be the largest and most reliable risk factor for dissociative disorders, specifically DID and OSDD.[7] The more severe, longer, and earlier in a person’s life the abuse happened, the higher the likelihood of a dissociative disorder
• Traumatic experiences — Any type of traumatic experience, such as earthquakes, assaults, wars, or extended invasive medical treatment, may cause individuals who are predisposed to develop dissociative symptoms.[8]
• Neurobiological factors — Dissociation involves measurable changes in brain areas involved in the regulation of memory, awareness of self, and emotional regulation; research provides evidence supporting the existence of a neurological basis for dissociative phenomena.[9]
• Developmental vulnerability — Younger children are at a higher risk for using dissociation as a method of regulating their environment as they lack sufficient ability to use other methods; early dissociation can become a habitual response pattern that persists into adulthood.[10]

You should seek professional clinical support for dissociation when:

• Dissociative experiences are recurring, persistent, or causing significant distress
• Memory gaps or identity confusion are affecting daily functioning, relationships, or safety
• Flashbacks, self-harming behavior, or suicidal ideation are present along with dissociative states
• There is co-occurring post-traumatic stress disorder (PTSD), major depressive illness, or another mental health condition
• You have been identified as needing evaluation for a dissociative disorder by a mental health professional or psychiatrist

Dissociative disorders are commonly undiagnosed, either due to people with these disorders not recognizing their symptoms as indicative of an actual psychological disorder, or due to clinicians lacking adequate education and training in identifying dissociative disorders. Seeking evaluation from a professional with experience in trauma and dissociation is an important first step.

At Agape, treatment for dissociative disorders starts with a thorough clinical assessment that evaluates a client’s dissociative symptom type and severity, their trauma history, whether there are any co-occurring conditions, and safety needs. Treatment is highly individualized. Dissociative disorders exist on a spectrum, and effective treatment requires careful, paced clinical work that prioritizes safety and stabilization before trauma processing begins. 

Key components include:

• Cognitive Behavioral Therapy (CBT) helps patients develop new cognitive patterns and behaviors that reduce the frequency and intensity of dissociation and associated distress.
• Dialectical Behavior Therapy (DBT) teaches clients the necessary skills to deal with their emotions, tolerate distress, avoid self-destructive behaviors, and improve interpersonal relationships. These skills are especially important for those patients diagnosed with dissociative disorders who have self-harming tendencies or are emotionally unstable.
• Eye Movement Desensitization and Reprocessing (EMDR) is especially helpful to clients who have developed post-traumatic stress disorder (PTSD) as a result of their trauma.