Dissociation and Dissociative Disorders including Dissociative Identity Disorder (DID) are the body’s response to overwhelming experiences, particularly repeated early trauma (complex trauma). Dissociation occurs along a continuum. Many people experience mild dissociation, particularly when stressed, while others experience more intense or ongoing forms related to early or repeated trauma.
Dissociation can be subtle and is often misunderstood or missed, even by health professionals. When you are dissociating you may not have the words for these experiences or recognise them as dissociation.
So, how do you get the right support?
Finding a trauma and dissociation-informed therapist can support you to heal. However, some people may find engaging with a therapist daunting and you may feel unsure or cautious, especially if trusting other people has not been safe. It’s also okay not to know where to start as your therapist will walk alongside you, moving at your pace, supporting you to feel safer and more in control.
Therapy usually happens in stages
Early therapy often focuses on:
- Supporting you to you feel safer
- Building ways for you to manage overwhelming emotions
- Helping to reduce symptoms that make everyday life harder.
This stage can take time, and often it is important to go slowly. Pacing carefully not only helps to safeguard your safety, it also reduces the risk that you will become overwhelmed or shut down.
When you first begin working with a therapist, the focus is on empowering you to feel safer, more stable and more grounded in your daily life. This phase is about building skills, strengthening support, and increasing your sense of control. You won’t be expected to go into detailed memories or process traumatic experiences until you feel and are ready. Safety and stabilisation come first
Feeling safer is the foundation of therapy. This may involve:
- Supporting you to notice when you start to become distressed or dissociated i.e. early signs
- Helping you use grounding strategies to stay more present
- Reducing your risk of self-harm or suicide
- Strengthening routines that support rest and predictability.
Making sense of your experiences
Supporting you to learn more about trauma and dissociation respectfully can be very healing. A trauma and dissociation-informed therapist can help you understand that:
- Dissociation is a common and well explained human response to trauma
- Parts of your ‘self’ developed to protect you during overwhelming experiences, often as a child
- Your symptoms make sense given what you experienced.
This understanding will often help you learn to be more self-compassionate and may help you feel less shame, if this is an issue for you.
Learning skills to manage distress
Therapy can help you develop skills such as:
- Grounding and calming techniques
- Recognising your emotions in safe ways
- Soothing your nervous system which may be on high alert (or shut down)
- Building cooperation between your parts (if you have separate parts).
As you strengthen these skills you might find that your dissociation is less intense and easier to manage.
Relationships, trust, and identity
Because complex trauma and the dissociation which often follows commonly stems from repeated harm in relationships, it is understandable that you might find it difficult to trust, grow close to others or depend on anyone.
A trauma and dissociation -informed therapist will:
- Move at your pace. “The slower you go the faster you will get there.”
- Respect your boundaries
- Work collaboratively with you
- Support you to have safer relationships over time.
Therapy may also support you to feel better, be more self-confident and self-compassionate and become less self-critical.
If you have parts it might support you to break down barriers between your parts and build understanding and cooperation. Healing does not mean getting rid of parts. For many people, it means building connection and continuity and beginning to feel safer and more in control.
Working with trauma memories when you’re ready
Trauma memories are usually explored later in therapy, once you have enough safety and skills in place.
Moving too quickly into trying to process memories can increase distress, dissociation, or self-harm urges. Trauma-informed approaches ensure that you only focus on traumatic memories when doing so is both safe and manageable. When this happens can vary a lot between people.
What to expect
Healing from dissociation and complex trauma is often slow and gradual, but little steps matter.
It’s normal to feel uncertain or frightened about therapy. A sensitive therapist will understand this and support you to work in ways that feel safe, respectful, within your limits and respond to you and your needs.
There is evidence that support can help
Research with people living with severe dissociation, including Dissociative Identity Disorder shows that trauma and dissociation-informed support which focussed on safety and stabilisation can lead to meaningful improvements in emotional regulation, self-compassion, and everyday functioning.
These improvements occurred even for people who were very distressed, had suicidal thoughts and/or long histories of trauma. With understanding, safety, and the right support, many people experience meaningful improvement in connection, wellbeing, and their quality of life.
