Dissociative Disorders
Dissociative Disorders (DSM-5-TR)
Disruptions in consciousness, memory, identity, or perception. Includes DID, depersonalization/derealization, and dissociative amnesia. Often co-occurs with complex trauma histories. Phase-oriented treatment is standard.
Prevalence: ~2-6% lifetime for pathological dissociation in community samples; ~1-1.5% for dissociative identity disorder; substantially higher in trauma-exposed and clinical populations
Clinical Picture
Dissociative disorders sit at the intersection of trauma, identity, and consciousness. They range from depersonalization/derealization (feeling detached from oneself or one's surroundings) to dissociative identity disorder (the presence of distinct identity states). Treatment requires specialized knowledge: general trauma approaches applied without understanding dissociative processes can inadvertently destabilize clients by accessing traumatic material faster than the system can integrate it. The structural dissociation model (van der Hart, Nijenhuis, Steele) provides a framework for understanding how the personality becomes divided in response to overwhelming experience.
Treatment Considerations
Phase-based treatment is standard: first establish safety and stabilization, develop internal communication and co-consciousness (in DID), then carefully approach trauma processing, and finally integrate and rehabilitate. Therapists working with dissociation need training beyond general trauma work. The practical safeguard is screening for dissociation before beginning any trauma-processing protocol, because standard EMDR and other exposure-based procedures can destabilize a dissociative client whose dissociation went undetected. Adapted EMDR and IFS are both used with dissociative presentations, though the published evidence is largely case series rather than controlled trials. Hypnosis is used by some specialists to facilitate communication between parts, but it raises suggestibility and can distort memory, and hypnotically influenced recall carries consequences that reach outside the therapy room into any later legal proceeding. Treatment is typically long-term.
Approaches and Evidence
Of 10 associated approaches, 3 have completed assessments for this topic, 1 have source checks awaiting assessment, and 6 have neither recorded yet. Each completed assessment states its population and rationale; source checks alone do not establish effectiveness. These categories describe different findings and review stages; they are not a ranking of treatments. 1 framework is shown separately.
Limited evidence (3)
These assessments describe a reviewed, limited evidence base. The rationale explains the available evidence and its limitations.
Art Therapy
Naumburg / Kramer · 1940
Reviewed population: One middle-aged woman with SCID-D-diagnosed dissociative identity disorder; relational art therapy combined with DBR during ongoing multimodal psychotherapy.
Gerge and colleagues (2025) describe reduced depersonalization and greater bodily connection in a single case. This uncontrolled, combined-treatment report cannot establish either component’s independent effect, comparative efficacy, remission, or generalization to other dissociative disorders.
Reviewed
Deep Brain Reorienting
Frank Corrigan · 2020
Reviewed population: One middle-aged woman with SCID-D-diagnosed dissociative identity disorder; relational art therapy combined with DBR during ongoing multimodal psychotherapy.
Gerge and colleagues (2025) describe reduced depersonalization and greater bodily connection in a single case. This uncontrolled, combined-treatment report cannot establish either component’s independent effect, comparative efficacy, remission, or generalization to other dissociative disorders.
Reviewed
Ego State Therapy
John & Helen Watkins · 1997
Reviewed population: One 16-year-old male inpatient diagnosed with dissociative identity disorder, receiving ego-state therapy within multimodal care.
Lee, Kang and Moon (2022) report improved recognition of identity states, family conflict and school refusal during treatment including medication, stabilization, psychoeducation and family therapy. A single uncontrolled case does not isolate ego-state therapy or establish efficacy for adults or other dissociative disorders.
Reviewed
Source checks available — assessment pending (1)
Sources have been checked for this topic, but a condition-specific assessment has not been completed. Open the source notes to read each document’s population, recommendation and limitations.
Sensorimotor Psychotherapy
Pat Ogden · 1981
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
Discussed in the source
The guideline includes a named discussion of sensorimotor psychotherapy. It offers expert practice guidance without a separate evidence grade or a general recommendation for PTSD.
Scope: Sensorimotor work within phase-oriented treatment for adults with dissociative identity disorder.
Assessment not yet completed (6)
No completed assessment or source check for this topic is recorded yet.
Advanced Integrative Therapy
Asha Clinton · 2002
Attachment-Focused Eye Movement Desensitization and Reprocessing
Laurel Parnell · 2013
Internal Family Systems
Richard Schwartz · 1995
Lifespan Integration
Peggy Pace · 2003
Psychedelic Somatic Interactional Psychotherapy
Saj Razvi · 2016
Trauma-Sensitive Yoga
David Emerson / van der Kolk · 2005
Associated Frameworks (1)
These are conceptual or research frameworks. They are not ranked as treatment evidence.
Structural Dissociation
Onno van der Hart, Ellert Nijenhuis, Kathy Steele · 2006
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
Discussed in the source
Structural dissociation is discussed as one etiological model. This does not make it a separately recommended treatment or the sole basis of the guideline.
Scope: Conceptual models of adult dissociative identity disorder.
Additional Source References (1)
These source checks also address this topic. They are listed separately from the catalogue associations above. Read each source’s scope and direction; a mention may concern a related intervention or a neutral recommendation.
Psychodrama
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
Discussed in the source
The guideline discusses psychodrama among expressive adjuncts within structured treatment. This is expert practice guidance, not a separately graded recommendation for other conditions.
Scope: Adults with dissociative identity disorder or closely related dissociative presentations.
Cases Featuring Associated Approaches
These teaching cases share approach links with this topic. They may illustrate a different presenting concern.
Reading This Page
Why are these approaches listed with Dissociative Disorders?
The catalogue associates 10 approaches and 1 frameworks with this topic. These links support learning and comparison; association alone is not a treatment recommendation or evidence of effectiveness.
How should I read the evidence assessments?
Assessments are specific to the population and scope stated on each card. They include a rationale, source links, and a review date. An overall review of an approach does not automatically apply to this condition, and a randomized-study label does not by itself mean that a study found benefit.
What does "Assessment not yet completed" mean?
A condition-specific assessment has not been recorded. Approaches with checked sources appear in a separate assessment-pending group; a checked source can support, oppose, or discuss an intervention without recommending it. Neither pending group means that no research exists or that the approach is ineffective. Frameworks are shown separately.
Sources and Review Scope
Source links and dates on assessment cards apply to the stated population and rationale. The clinical overview and prevalence text above are separate authored content; an approach's evidence label does not verify those statements. Recorded narrative notes and citations remain available on individual modality pages, with their review status identified. The bibliography provides further reading.