Dissociative Disorders

Overview

Phase-based treatment (ISSTD guidelines): safety/stabilization → trauma processing → integration. Standard trauma protocols without preparation typically destabilize dissociative clients. Specialist supervision is essential.

First-line treatments

• IFS — Internal Family Systems

  Natural fit — parts language matches the client's internal experience without pathologizing it.

• SE — Somatic Experiencing

  Restores window of tolerance before any reprocessing.

Also consider

• EMDR

  Adapted with substantial preparation phase and conservative titration.

• Schema

  Mode work maps onto parts work for many dissociative presentations.

• DBT

  Stabilization skills when self-harm and crisis behaviors are prominent.

Cautions

• Do not pursue trauma processing until stabilization is solid — destabilization can be severe.
• Seek consultation/supervision from a dissociation-trained clinician; ISSTD certification track exists.

Related tools

• Parts Mapper

Related worksheets

• Dissociation-Specific Grounding
• Window of Tolerance
• Safe Place Visualization
• Container Exercise
• Parts Map
• Flashback Halting Protocol