What do you need to know if your partner or loved one has a dissociative disorder?
Dissociation and dissociative disorders are often mentioned with complex post traumatic stress disorder (CPTSD). As many of you know, the language and the literature – much of which is aimed at clinicians – can be overwhelming. For those outside of the clinical field, it’s a challenge to break it down and understand.
To complicate matters, you or your loved might not even know if you have a dissociative disorder. You might suspect it but it might be hard to access care and clinicians. Maybe you are seeking information to help you understand something that may or may not be diagnosed.
My partner and I have experienced all of this. He spent the majority of his adult life knowing something was ‘off’ but not having language or recognition of dissociation. It wasn’t until the last few years after seeing many, many mental health clinicians that we now know dissociation is a primary issue.
As a result of our personal journey in seeking understanding and care, I spent a lot of time educating myself on dissociation. While there is not a single source of information I exclusively recommend, there are several articles on different websites that have been helpful to me. This post lists ten of them.
*I also include a brief synopsis and a quote. The posts are not in a recommended order.
When your partner has a dissociative disorder: ten posts to help you understand
Links Between Trauma, PTSD, and Dissociative Disorders by Matthew Tull, PhD
This article on Verywellmind.org provides a digestible overview of the causes and definitions of the types of dissociative disorders
It’s thought that long-term trauma is a root cause of dissociative disorders, with dissociation occurring as a coping strategy that allows people to distance themselves from a trauma that may otherwise be unbearable.
Matthew Tull, PhD
Complex PTSD and Dissociative Symptoms by Dr Arielle Schwartz
Dr Schwartz’s post outlines the multi-faceted issues that lead to symptoms of CPTSD and what causes dissociative symptoms in the past and present. Dr Schwartz writes:
Often, dissociative symptoms are triggered by recent events involving relational losses or perceived threats that are reminiscent of historical traumatic wounds.
Dr Arielle Schwartz
Dissociation: How People Cope with Trauma They Want to Forget by Robyn Brickel, MA, LMFT
Robyn Brickel, MA, LMFT has so many wonderful and readable posts on complex trauma (click here to see my interview with her). This post provides a compassionate and trauma-informed lens to dissociation as a normal reaction to abnormal circumstances. I like the resource list at the end.
As a protective strategy for coping with trauma, dissociation can be one the most creative coping skills a trauma survivor perfects.
Robyn Brickel, MA, LMFT
What to Do About Suicidal Thoughts in a Pandemic by Robyn Brickel, MA, LMFT
With trauma, dissociation may lead to fragmentation or a separation of a part(s) of the person that contains the emotions, sensations, and thoughts of the trauma. Robyn Brickel’s post on suicidal thoughts is a relevant example of how this happens and what it can look like.
A survivor of trauma, especially one of complex trauma, may use hyperarousal or hypo-arousal to protect themselves. A part may learn to dissociate as a means of survival and protection. Sometimes people may consider suicide as another way to protect themselves—another way out of the trauma and away from the pain.
Robyn Brickel, MA, LMFT
DID or DDNOS: does it matter? PODS/Carolyn Spring
Another post with clear definitions and insight on dissociative disorders, including a description of the structural dissociation treatment model. The author articulates the challenges of differentiating dissociative disorders not otherwise specified (DDNOS) and dissociative identity disorder (DID) and whether this is necessary.
People with DDNOS need to understand that their experiences are valid and real and not inferior in any way to people with dissociative identity disorder.
Explaining Dissociation and DID. PODS website.
EMDR in the treatment of dissociative disorders PODS/Carolyn Spring
As a trauma treatment modality, EMDR is often discussed. However, in the case of complex trauma and dissociation, additional cautions are warranted. This article discusses its usage and provides links to research on the topic.
The ISSTD (International Society for the Study of Trauma and Dissociation) endorses EMDR as an adjunctive treatment in their Guidelines for Treating Dissociative Identity Disorder in Adults (2011). They recommend that EMDR is not used as a standalone treatment but as part of an overall treatment plan.
Treating Dissociation. PODS website.
Documentary about Trauma and Dissociation by Peaceful Impact Publisher (free on Youtube)
This short seven part series by Peaceful Impact Publishers provides a brief overview of trauma and dissociation with an explanation of the structural dissociation model. Each video is approximately three minutes.
From the summary on the documentary:
We have produced a short documentary that explains clearly and comprehensively what emotional trauma, structural dissociation and polyvagal theories are and how they effect human life.
Anssi Leikola, Psychiatrist, Therapist, Author and Trauma Survivor
Helping a Loved One with Dissociation by Dr Catharine Hynes
This brief post is a good starting point for the conversation about how to support a loved one with dissociation. Dr Hynes writes:
Patience, kindness, care and concern are the things that will most help them to establish safety in the present, which will help them to re-integrate their emotions and their personalities and become more emotionally stable.
Dr Catharines Hynes
I include this interview with Janina Fisher as she is one of the leaders in the treatment of dissociative disorders and complex trauma. While written for clinicians, the post provides a window into her work, which is expanded upon in her book Healing the Fragmented Selves of Trauma Survivors.
I wrote this post two years ago as my partner and I were beginning to understand dissociative disorders and what kind of treatment to look for. I write:
Reactions to triggers can happen in a milli-second. Some partners including me notice the dissociation before their partner does. Many of us experience shock when a loved one reacts out-of-context to what appears to be a neutral situation.
Finally, I know it is challenging to find a practitioner who treats CPTSD and dissociation. A few suggestions of resources to help you:
|International Society for the Study of Trauma and Dissociation|
|Blue Knot Foundation (Australia)|
|Questions To Ask A Potential Therapist About Complex Trauma by Lilly Hope Lucario. (Not a list of practitioners but questions to consider asking.)|
|Trauma Aware Care does not offer individual support but has excellent courses on complex PTSD.|