Visual representation of dissociative disorders

If you experience moments of feeling unreal, disconnected from your body, or uncertain whether your memories and experiences belong to you, you’re not losing your mind. Dissociation is the mind’s way of surviving what would otherwise be unbearable. It’s a creative adaptation to overwhelming circumstances—one that may have saved your life but now creates its own suffering.

Dissociative disorders are among the most misunderstood conditions in mental health. Many clinicians lack training in recognizing and treating them. Many people with dissociative symptoms have been misdiagnosed for years—told they have bipolar disorder, schizophrenia, or simply anxiety—without ever having their dissociation properly identified or addressed.

Understanding Dissociation

Dissociation exists on a spectrum. At one end are everyday experiences most people know: losing yourself in a book, driving on autopilot, or daydreaming. At the other end are severe disruptions in identity, memory, and consciousness that significantly impair functioning.

What distinguishes pathological dissociation from everyday experiences is the involuntary nature, the distress it causes, and its roots in overwhelming experience—usually early, repeated trauma. When a child faces terror from which there is no escape, the mind learns to escape internally. Consciousness fragments. Experience becomes compartmentalized. The unbearable is kept at bay.

These strategies work remarkably well in the short term. But they create profound problems over time: gaps in memory, a fractured sense of self, difficulty staying present, and relationships disrupted by sudden shifts or absences that others don’t understand.

Dissociation is not a choice or a weakness. It’s an automatic protective response that developed for good reason. Treatment doesn’t aim to eliminate this capacity but to help you develop more flexible, conscious control over it—to no longer need the protection against threats that have passed.

Forms of Dissociation

Depersonalization: Feeling detached from yourself, your body, or your thoughts
Derealization: The world feels unreal, dreamlike, or distant
Amnesia: Gaps in memory for significant events or periods
Identity confusion: Uncertainty about who you are
Identity alteration: Shifts in sense of self, sometimes experienced as different “parts”

Dissociative Disorders I Treat

I provide specialized treatment for the full spectrum of dissociative conditions.

Dissociative Identity Disorder (DID)

Formerly called Multiple Personality Disorder, DID involves the presence of two or more distinct identity states or personality states, along with gaps in memory for everyday events, important personal information, or traumatic events. Contrary to media portrayals, DID is not dramatic or obvious—most people with DID have learned to hide their symptoms and function in the world. It develops as a response to severe, early childhood trauma.

Other Specified Dissociative Disorder (OSDD)

This diagnosis applies when dissociative symptoms cause significant distress but don’t meet full criteria for DID. This includes presentations where identity states are present but don’t take full control, or where amnesia between states is not present. OSDD is at least as common as DID and requires the same specialized treatment approach.

Depersonalization & Derealization

Characterized by persistent or recurrent experiences of feeling detached from yourself (depersonalization) or your surroundings (derealization). You might describe feeling like a robot, watching yourself from outside your body, or experiencing the world through a fog or glass wall. These experiences can be terrifying, especially when you don’t understand what’s happening.

Dissociative Amnesia

Involves inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. This may involve specific events, periods of time, or, in rare cases, one’s entire identity and history. The memories are not lost—they’re compartmentalized and inaccessible to conscious recall.

What Living with Dissociation Is Like

If you struggle with dissociation, you may recognize some of these experiences:

In Your Inner World

Feeling like you’re watching your life from outside your body
Looking in the mirror and not recognizing yourself
Hearing voices inside your head (not from outside)
Finding evidence of actions you don’t remember taking
Feeling like different people at different times
Losing time—hours or days you can’t account for
Memories that feel like they happened to someone else

In Daily Life

Others telling you about things you said or did that you don’t remember
Finding objects among your possessions you don’t recognize
Having very different handwriting at different times
Knowing how to do things you don’t remember learning
People you don’t recognize treating you like they know you
“Coming to” in unfamiliar places without knowing how you got there
Relationships that confuse you because you can’t remember interactions

“For many people with dissociative disorders, the hardest part isn’t the symptoms themselves—it’s the isolation of having an internal experience that others can’t see and often don’t believe.”

Treatment Approach

Effective treatment for dissociative disorders follows a phase-oriented approach that prioritizes safety, stabilization, and integration.

Safety and Stabilization

Before any trauma processing can occur, you need a foundation of safety—both external (in your environment and relationships) and internal (the ability to manage distressing emotions and dissociative episodes). This phase focuses on building coping skills, establishing communication between parts of self, reducing crisis behavior, and creating enough stability to do deeper work.

Processing Traumatic Memories

When stability is established, we carefully begin to process the traumatic experiences that necessitated dissociation. This is paced work—not flooding or rapid exposure, but gradual, titrated processing that respects the mind’s protective mechanisms while allowing integration. The goal is for memories to become part of your narrative rather than intrusive fragments.

Integration and Reconnection

Integration doesn’t mean eliminating parts of yourself. It means breaking down the amnesic barriers that keep aspects of self separate, allowing for communication, cooperation, and eventually a more unified sense of identity. For some, this leads to fusion of distinct parts; for others, it means harmonious co-existence. The goal is flexible functioning, not a specific endpoint.

Living in the Present

The final phase focuses on building a life that’s no longer organized around trauma and survival. This includes developing healthy relationships, establishing meaningful activities and goals, and learning to live fully in the present rather than being pulled into the past.

My Approach to Dissociation

I work from a psychodynamic, relational framework informed by the latest understanding of trauma and dissociation. Key elements include:

Respecting defenses: Dissociation developed for survival. I don’t try to strip away defenses but help you develop alternatives and choices.
Working with all parts: Every aspect of self has value and function. Treatment involves understanding and working with—not against—all parts of the system.
Pacing carefully: Going too fast can destabilize and retraumatize. I prioritize stability and follow your system’s readiness.
Building internal communication: Much early work focuses on helping parts of self communicate, reducing internal conflict and improving cooperation.
Relational healing: Trauma happened in relationship; healing also happens in relationship. The therapeutic connection is central to the work.

Important to Know

You are not “crazy” or making this up
Dissociation is a real, recognized condition
Treatment is effective when properly specialized
Recovery does not mean forgetting what happened
Integration does not mean losing parts of yourself
You can learn to live a present, connected life

Common Concerns

What if I don’t have clear “alters” or “parts”?

Dissociation exists on a spectrum. You may experience significant dissociative symptoms without having clearly distinct identity states. Depersonalization, derealization, amnesia, and identity confusion all exist along this spectrum and all respond to treatment. A formal diagnosis of DID is not required to benefit from dissociation-informed therapy.

Will I have to remember everything that happened?

No. Healing does not require recovering detailed memories of every traumatic event. In fact, the pressure to “remember” can be counterproductive and retraumatizing. What matters is processing enough to reduce symptoms and allow for integration—not achieving a complete historical record.

How long does treatment take?

Treatment for complex dissociative disorders is typically long-term, often several years. This isn’t because it doesn’t work—it’s because the mind developed these patterns over many years and genuine change takes time. That said, symptom relief and improved functioning often begin well before treatment ends.

Will I need to be hospitalized?

Most people with dissociative disorders can be treated on an outpatient basis, especially with appropriate pacing and stabilization work. Hospitalization is sometimes needed for safety during periods of crisis, but it’s not a routine part of treatment.

Is DID real? I’ve heard it’s controversial.

DID is a recognized diagnosis in the DSM-5 with substantial research support. The “controversy” largely stems from sensationalized media portrayals and outdated debates. Clinicians who specialize in trauma and dissociation consistently encounter and successfully treat these conditions. The question isn’t whether DID is real—it’s whether clinicians are trained to recognize it.

Dissociative Disorders