Dissociative Disorder Therapy

Dissociative Disorders are a common defense/reaction to stressful or traumatic situations. Severe isolated traumas or repeated traumas may result in a person developing a dissociative disorder. A dissociative disorder impairs the normal state of awareness and limits or alters one’s sense of identity, memory or consciousness. Once considered rare, recent research indicates that dissociative symptoms are as common as anxiety and depression, and that individuals with dissociative disorders are frequently misdiagnosed for many years, delaying effective treatment. In fact, persons suffering from Dissociative Identity Disorder often seek treatment for a variety of other problems including depression, mood swings, difficulty concentrating, memory lapses, alcohol or drug abuse, temper outbursts, and even hearing voices, or psychotic symptoms. Many people have symptoms that have gone undetected or untreated simply because they were unable to identify their problem, or were not asked the right questions about their symptoms.

Some people with undetected dissociative symptoms can function well at work or school. Only close friends or family are aware of the person’s inner struggles or suffering.

What kind of events or experiences are likely to cause symptoms of dissociation?  There are traumas within one’s home, either emotional, physical or sexual abuse. Other types of traumas include natural disasters, such as earthquakes, political traumas such as holocausts, hostage situations, wars, random acts of violence, or the grief we feel after the death of a family member or loved one. Dissociation is a universal reaction to overwhelming trauma. Recent research indicates that the manifestations of dissociation are very similar worldwide.

Misdiagnosis of People with Dissociative Identity Disorder

Most people with undetected Dissociative Identity Disorder experience depression and often are treated with antidepressant medications. While antidepressant medications may help some of the feelings of depression, it does not alleviate symptoms of dissociation. Some people suffering from undetected dissociative symptoms are misdiagnosed as having psychotic disorders including schizophrenia and are treated with antipsychotic medication resulting in long term side effects.

Five Specific Symptoms of Dissociation

The five symptoms of dissociation include:

  • Amnesia or memory problems involving difficulty recalling personal information
  • Depersonalization or a sense of detachment of disconnection from one’s self. A common feeling associated with depersonalization is feeling like a stranger to one’s self.
  • Derealization or a sense of disconnection from familiar people or one’s surroundings
  • Identity confusion or inner struggle about one’s sense of self/identity
  • Identity alteration or a sense of acting like a different person

These five symptoms of dissociation are often hidden and cause much inner turmoil and suffering. Often the person experiences a lot of other symptoms such as anxiety, depression and mood swings. For a more detailed description of these five symptoms, see Steinberg M, Schnal  M: The Stranger in the Mirror: Dissociation-The Hidden Epidemic, HarperCollins, 2001

How I Can Help

Because dissociative symptoms are typically hidden, it is important to see someone who is familiar with dissociative symptoms and who has the ability to diagnose these disorders. I am familiar with recent advances in the ability to diagnose dissociative disorders and use the Dissociative Evaluation Scale (Putnum and Carlson) for screening. People with dissociative disorders often respond well to specialized psychotherapy. In addition to focusing on understanding the dissociative symptoms, the primary focus is on self awareness, self acceptance and understanding ways of coping with stress. This can lead to feeling more in control and  being better able to lead a healthy, productive life. Medication can be used as an adjunct to psychotherapy for others symptoms, but is not the primary form of treatment for dissociative disorders.


Steinberg M, Schnall M: The Stranger in the Mirror: Dissociation-The Hidden Epidemic, HarperCollins, 2001, 2000. Translations: Spanish, Italian, Chinese

Steinberg M: Handbook for the Assessment of Dissociation: A Clinical Guide. Washington, D.C., American Psychiatric Press, 1995


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