woking, guildford and online

Therapy for dissociation and dissociative disorders, in person and online

Working with dissociation entails an integration of trauma therapy and what is often referred to as “parts work”.

When there are overwhelming experiences that cannot be integrated at the time, a person’s personality structure divides varying degrees to manage the experiences. These parts of self have different degrees of feeling “me and not me”, varying degrees of autonomy, individuality and contact or knowledge of other parts of self. These parts of self are usually stuck “in trauma time” and find themselves reliving the traumatic experiences over and over without awareness that time has moved on and life is (hopefully) different today.

Dissociation and Extreme Trauma

With extreme trauma there may be multiple parts of self, multiple groups of parts of self, and will usually have high degrees of “me and not me”, individualisation and elaboration, and autonomy. Some may be aware that they are one personality, others will find it hard to fathom. It is important to know that this is a normal response to severe trauma and is highly adaptive for a traumatic world- the mind done the best thing at the time and each person’s self system has a very logical way of managing. However, the issues that come with it, especially when/if the trauma is over, adapting to “normal life” can be hugely difficult and terrifying.

Healing Through Internal Cooperation

Every part of a system if there for a reason, no part is more or less important and no part is more or less of a person; they are all you. Every aspect of self has a purpose, some parts of self may hold a trauma so that a part of self that functions externally can “depersonalise” or make the experience seem “unreal” to reduce overwhelm. Some parts of self hold emotions that were too intense to handle for the self structure as a whole. Some parts of self may hold different aspects of the same situation: in a sequential manner or simultaneous manner of conflicted aspects. Some parts of self manage the external world, while others manage the internal world. Different parts of self will often have conflicting relationships with other parts: shame, guilt, blame whilst others will have nurturing or closer relationships internally. Some may be unaware of each other at all.

Using a personalised approach of working on the relationship between parts of self, and working through a trauma and attachment based framework I believe is necessary. This can be highly scary process to start, especially when a core dilemma is the need to connect along with a fear of people getting close, so it is important not to rush. It is also important not to slow down too much either. My job will be both to speed up and slow down the process depending on what we are doing and your ability to regulate or co-regulate with me at the time. With dissociation, I aim to work with you to improve cooperation internally, to work through traumas gradually, whilst helping parts of self understand the parts they and others play in keeping you alive and work on adjusting things slowly to adapt to how life is today. It is fully cooperative and done with communication and permission. You are in charge here and I work with parts of self for them to make decisions.

Frequently asked questions

What does dissociation actually feel like?

It varies. Some people describe feeling foggy, far away, or like they are watching themselves from outside. Others lose time, or notice they respond completely differently in different situations. Some feel numb rather than absent. All of it is the mind doing something protective, even when it is inconvenient.

Is dissociation the same as DID?

No. Dissociation sits on a spectrum. Almost everyone dissociates mildly, such as driving somewhere and not remembering the journey. Dissociative Identity Disorder is at the far end of that spectrum and is comparatively rare. Most of the people I work with sit somewhere in between.

What is parts work?

Parts work treats the mind as having different aspects that developed to handle different things, rather than one single voice. When trauma has been ongoing, those parts can end up separated from each other. The work is about building cooperation between them rather than getting rid of any of them.

Is it safe to work with dissociation online?

It can be, with care. Grounding matters more online because I cannot read the room in the same way, so we agree signals and stabilisation strategies early. For some people the room is better, at least to begin with. We would talk this through before starting.

Do I need a diagnosis to work with you?

No. Many people I see have never had their dissociation named by anyone, and only recognise it when they read about it. A diagnosis is not needed to start, and I am not a diagnosing clinician. If you are looking for something to use between sessions, grounding using your senses is a reasonable place to start. Where dissociation sits alongside ongoing trauma, it usually belongs with therapy for complex PTSD.

How long does this work take?

Longer than most other work, and I would rather be honest about that. Building stability comes before anything else, and that phase alone can take months. This is open-ended work, and it moves at the pace your system allows rather than a timetable.