Healing Trauma from Within

Therapy for Dissociation

Phase 1

DID work tends to be more long-term and adjustments will be made to the phases of phase 1 trauma therapy. Additional areas of focus might be allowing parts to have a voice with the aim of coconsciousness, co-acceptance and increased integrated functioning. This goal is facilitated by a consistent approach of helping those with DID to respect the adaptive role, importance and validity of all parts, to find ways to consider the wishes and needs of all in making decisions and pursuing life activities (through negotiation) and to enhance internal support, accountability and safety between parts (ISSTD, 2011).

Integration is a process referring to all work on dissociated aspects of a person’s experience and involves an ongoing process of working towards less dissociative dividedness. Fusion refers to a point in time when two or more parts/alters experience themselves as joining together with a complete loss of subjective separateness. Final fusion refers to the point in time when the persons sense of self shifts from that of experiencing parts to that of being a unified self. For some people a more realistic long-term outcome may be “functional multiplicity” which is sufficiently integrated and coordinated functioning among parts/alters to promote optimal functioning

Phase 2 

In addition to the Phase 2 strategies involved in standard trauma work (see trauma therapy page) we will discuss and reach agreement upon which memories will be the focus, at what level of intensity they will be processed, which types of interventions may be used, which parts will participate, what steps will be taken to maintain safety during the work, and which procedures will be used to contain traumatic memories if the work becomes too intense (ISSTD, 2011). The process of Phase 2 work allows the individual to realize that the traumatic experiences belong to the past, to understand their impact in his or her life, and to develop a more complete and coherent personal history and sense of self. In addition, those with DID become able to recall the traumatic experiences across parts, especially those who were previously amnestic or without emotional response to them.

Phase 3

Involves additional gains in internal cooperation. This may include a more solid and stable sense of self and sense of how a person relates to others and to the outside world. As people begin to feel less fragmented, they usually develop a greater sense of calm, resilience, and internal peace (ISSTD, 2011). They may acquire a more coherent sense of their past and deal more effectively with current problems. The person may begin to focus less on past traumas, directing energy to living better in the present and to developing a new future perspective. Those with DID may need help to deal everyday life problems in a nondissociative manner, tolerating everyday stresses, emotions, and disappointments as a routine part of human existence. Eventually, many clients experience this phase as one in which they become increasingly able to realize their full potential in terms of personal and interpersonal functioning (ISSTD, 2011).

Dissociation occurs on a spectrum, from “spacing out” to experiences of fragmentation as experienced by those with Dissociative Identity Disorder. I have experienced the full spectrum of dissociative challenges in both my own lived experience and my trauma work with clients. My focus on work with DID is a recent addition to my clinical work which I am able to fulfil with support from a specialist DID consultant. I am currently undergoing the ISSTD training to specialise in the treatment of dissociative disorders and can offer assessment through the SCID-D clinical interview.

Dissociation Articles & Resources