Navigating the Path to Healing: Finding the Right Therapist for Dissociative Identity Disorder

Are you or a loved one living with Dissociative Identity Disorder (DID)? Finding the right therapist who specializes in treating this condition can be a crucial step on your healing journey. Let's face it, it can also be daunting, exhausting, and incredibly vulnerable. In this article, we will explore the challenges of navigating the path to healing and provide insights into finding the right therapist when working with DID.

Finding a therapist who understands the unique challenges faced by individuals with DID is paramount. Their expertise can make a significant difference in your healing process. From establishing trust and safety to implementing effective therapeutic techniques, the right therapist can help you navigate the challenges and complexities of living with DID. In this article, we will discuss the essential qualities to look for in a DID therapist and provide practical tips on finding the right professional to guide you on your path to healing. Let's embark on this journey together and empower ourselves with the knowledge needed to find the right therapist for managing dissociative identity disorder.

Understanding Dissociative Identity Disorder (DID)

Dissociative Identity Disorder, formerly known as Multiple Personality Disorder, is a mental health condition that affects an individual's sense of self, memory, and identity. It can be a result of trauma or abuse experienced during childhood. Understanding how to manage this condition requires the expertise of a qualified therapist who has experience in working with DID clientele.

Individuals with DID often experience distinct personality states, known as alters, that may have their own memories, behaviors, and identities (age, culture, religion, sexual orientation, gender/gender expression, etc.). Two key features of DID are that the client is experiencing distress as result of the condition and that the condition is causing an impact in the client's ability to function in different aspects of their life (with friends, with family, at work or school, etc.). Living with DID can be overwhelming. However, with the right support and treatment, individuals with DID can learn to manage their symptoms and lead fulfilling lives.

The importance of finding the right therapist

Therapy for DID is not a one-size-fits-all approach. It requires a therapist who is knowledgeable about the condition and is skilled in providing specialized treatment. The right therapist will create a safe and supportive environment, where you can openly explore your experiences, process trauma, and work towards your goals. It is also important to note that many people expect integration of "alters" or the distinct personality states experienced with DID to be the primary goal. For some clients, integration is a goal, while others focus on increasing function internally within the DID system or externally within the world.

Qualities to look for in a dissociative identity disorder therapist

When searching for a therapist to help you manage dissociative identity disorder, there are several important qualities to consider:

1. Experience and Expertise: Look for a therapist who has specific experience in treating DID. They should have a deep understanding of trauma-informed care, the disorder, its symptoms, and effective treatment approaches. Ask potential therapists about their experience working with individuals who have DID. 2. Empathy and Compassion: Living with DID can be challenging, and it is essential to find a therapist who is empathetic and compassionate. They should create a safe and non-judgmental space for you to share your experiences and emotions. A therapist who genuinely cares about your well-being will be more effective in helping you heal. 3. Collaborative Approach: The therapist you choose should be willing to work collaboratively with you. They should involve you in the treatment planning process, respect your goals and preferences, and adapt therapy techniques to suit your needs. The therapist should never push you to discuss sensitive topics or push you into goals that are not your own. Your therapist should be open to feedback about how you feel your work is going. Collaboration fosters a sense of ownership and empowerment in your healing journey. 4. Cultural Competence: Consider the therapist's cultural competence and sensitivity. Dissociative Identity Disorder can affect individuals from diverse backgrounds, and it is essential to find a therapist who understands and respects your cultural values and experiences. A therapist who is sensitive to your unique needs can create a more inclusive and supportive therapeutic environment.

5. Continuing Education: Look for a therapist who stays updated on the latest research and treatment approaches for dissociative identity disorder. They should actively seek opportunities for professional development and engage in ongoing education to ensure they provide the most effective care.

Tips for finding a therapist experienced in treating DID

Finding the right therapist for managing dissociative identity disorder can feel overwhelming, but with these practical tips, you can streamline the process and increase your chances of finding the right professional to guide you on your path to healing.

• Researching Potential Therapists Start your search by researching therapists who specialize in trauma and dissociative disorders. Look for professionals who specifically mention experience in working with individuals with dissociative identity disorder. Online directories, professional organizations, and referrals from trusted sources can be valuable resources for finding potential therapists. Therapy plays a vital role in the healing journey for individuals with dissociative identity disorder. It provides a safe space to explore and process traumatic experiences, develop coping strategies, and work towards integration and healing. A skilled therapist will use a combination of therapeutic techniques tailored to your specific needs. These may include therapies such as Brainspotting, Eye Movement Desensitization and Reprocessing (EMDR), ego state therapies (Developmental Needs Meeting Strategy (DNMS), Internal Family Systems (IFS), inner child work, etc.), Dialectical Behavior Therapy (DBT), etc. The therapist will also focus on building resilience, fostering self-compassion, and developing healthy coping skills. Remember, healing from DID is a gradual and complex process. It requires commitment, patience, self-discovery, and a quality relationship with your therapist. The right therapist will be there to support you every step of the way.

Recommended source: Find A Therapist - International Society for the Study of Trauma and Dissociation (connectedcommunity.org)

• Initial Consultation with a Therapist Once you have a list of potential therapists, schedule an initial consultation with each one. This meeting will give you an opportunity to gauge their expertise, ask questions, and assess whether you feel comfortable and supported by them. Remember, therapy is a collaborative process, and establishing a good fit with your therapist is crucial. If you meet with a therapist and feel like it isn't a good fit, that's ok! You can let your therapist know that the fit does not feel right and ask for a referral.
  

• Questions to Ask a Potential Therapist Prepare a list of questions to ask during the initial consultation. Here are some suggestions:

- How many clients with dissociative identity disorder have you treated? - What treatment approaches do you use when working with a client experiencing DID? - How do you create a safe and supportive therapeutic environment for individuals with DID?

-How do you involve and incorporate alters into therapy?

-How do you approach trauma-informed care? - Can you provide references from past colleagues? - Are you willing to collaborate with other healthcare professionals involved in my care?

-Are you open to hearing feedback?

-What are ways you know when a client is improving?

• Evaluating the Therapist-Client Fit During the initial consultation and subsequent sessions, pay attention to how you feel when interacting with the therapist. Trust your intuition and consider whether you feel heard, understood, and supported. You deserve a good fit with your therapist. It may take time for you to feel really connected with them and that's pretty normal, but if something feels off or not right, trust your instinct.

Conclusion: Finding hope and support in the journey

Therapy plays a crucial role in the healing journey of individuals with dissociative identity disorder. It provides a safe space to explore and process traumatic experiences, explore and possibly integrate different identities, and develop coping skills and techniques for managing symptoms.

A few of the primary goals of therapy for dissociative identity disorder is to establish trust, safety, and regulation. Working to build these 3 things within the therapy space, within the client, within the internal system are all aspects of the work.

The right therapist can guide you through this process, offering expert guidance and support. Additionally, therapy can help individuals develop healthy communication and cooperation among different identities, leading to greater functionality.

The Pine Center offers compassionate care and treatment for those experiencing dissociative identity disorder. If you have questions or concerns, please reach out.

Dissociative Disorders: How the Mind Protects Itself

In a world where our minds constantly process and store information, there are times when it becomes overwhelmed. For some individuals, this overload can lead to what is known as a dissociative disorder; an instinctive defense mechanism that allows the mind to protect itself. But what is the science behind this phenomenon?

Dissociative disorders are characterized by a dissociation, or detachment, from reality. This can manifest as a disruption in a person's memory, identity, or perception of the environment. Although the exact cause of dissociative disorders is still being studied, experts believe it is often triggered by traumatic experiences or severe stress.

The mind's ability to dissociate acts as a safeguard, allowing individuals to compartmentalize distressing or overwhelming memories. It's a survival instinct that protects the individual from emotional turmoil that they may not be ready to confront. However, while dissociation can be helpful in the short term, it can also lead to significant challenges in daily life.

Understanding dissociative disorders

Like most things, dissociation occurs on a spectrum. The way I consider dissociation is on a spectrum from adaptive (helpful) to seemingly maladaptive (unhelpful or sometimes even harmful). Everyone experiences dissociation to some extent. Most folks have had the experience of "highway hypnosis" where miles and minutes have passed without awareness to what has taken place. Other times, we've driven our entire route home from work only to think "Whoa, I was zoned out that entire time!" That is dissociation, albeit, in a mild form. Dissociative disorders are mental health conditions that are characterized by a disconnection or detachment from reality. This can manifest as a disruption in a person's feelings, memory, behavior, identity, or perception of the environment. There are several types of dissociative disorders, including dissociative amnesia, depersonalization/derealization disorder, and dissociative identity disorder (DID).

I want to take a moment to express that folks who experience dissociative disorders are very much folks with the same basic wants and needs as everyone else. While the symptoms of dissociative disorders and DID can be distressing for those experiencing them or for folks close to them, the people who experience these symptoms are very much human. My guess is that you likely already know someone in your life who knows (or doesn't) that they experience a version of a dissociative disorder or DID and simply don't know.

Types of dissociative disorders and common symptoms

Dissociative amnesia is a type of dissociative disorder that involves significant gaps in a person's memory. These gaps can be related to a specific event or period of time, and the person may not be able to recall important personal information, such as their name or where they live. They may have an inability to recall important life events, like obtaining their driver's license, their college graduation, or wedding ceremony. This can also show up as more general "lost time", where a person has difficulty accounting for a few hours of a day or a few days of a week.

Depersonalization/Derealization Disorder is a single diagnosis within the Diagnostic and Statistical Manual 5-TR (DSM-5-TR), however, I believe it's important to outline the differences that are unique to each experience.

Derealization is a type of dissociation that involves feeling detached or disconnected from one's surroundings and environment. Individuals with this disorder may feel like they are in a dreamlike state. Other descriptions can include as feeling as if you are watching yourself but looking at another person, like living in fog, like living in a video game or simulation, or living in a dreamworld where actions do not have consequences. Derealization can also include a feeling of emotional disconnection from events and people.

Depersonalization is a type of dissociation that involves feeling disconnected from oneself, thoughts, and/or one's body. Individuals with this disorder may feel like they are watching themselves from outside their body, even floating above their own body, or feeling like they are not in control of their own body. It is not uncommon to hear that those experiencing this disorder have a sense of going through the motions or robot-like. Depersonalization can also include a feeling of numbness toward your own memories or the world around you, additionally, this may include feeling a disconnection from emotion or memory, feeling as if they are not your own. Some people experience the sensation of looking into a mirror and not recognizing themself or looking at a part of their body (an arm, a leg, a hand, etc.) and feeling as if they've never seen it before.

Dissociative identity disorder (DID), formerly known as multiple personality disorder, is a dissociative disorder characterized by the presence of two or more distinct personality states. These personality states, often called alters, may have their own unique memories, behaviors, and emotions. These personality states can vary in age, gender, gender expression, culture, religion, sexual orientation, and species.

Dissociative Disorder Not Otherwise Specified (DDNOS) is a previous name for a diagnosis that is no longer in use. Instead, Other Specified Dissociative Disorder (OSDD) or Unspecified Dissociative Disorder (UDD) are used.

OSDD is characterized by disruption to memory, identity, consciousness, or perception of your environment. This can also look like disorientation or losing awareness of one's identity or your surroundings. "Dissociative trance" is another symptom that may be experienced with OSDD. Have you ever been performing a simple task, like washing the dishes, and zoned out and become lost in your thoughts? Maybe later you found dishes in a place where they shouldn't have been? This is dissociative trance. While a very normal experience to experience it occasionally, those with OSDD can experience dissociative trance in a more intense manner. Those with OSDD may even become unresponsive to those in the external environment while in dissociative trance. Those with OSDD may experience their external world as blurry or feel frozen, paralyzed, or stuck while in dissociative trance. Those with OSDD may additionally experience times when their identity comes into question, is rejected, or when they detach from who they are.

Unspecified Dissociative Disorder (UDD) is used when folks present with symptoms of dissociation that fit many, but not all, of the criteria necessary for one of the other diagnoses mentioned in this article. This is often used as a working diagnosis, meaning that it may not be final diagnosis and other diagnoses are being considered.

Dissociative identity disorder frequently begins in childhood, but may not be recognized for years, or the person may go through a pattern of recognizing and forgetting. It is not uncommon for those who experience DID to experience frequent doubt about their experience. The experience of dissociative identity disorder can be variable depending on how much cohesion and awareness there is within the DID system. For some people who experience DID, there are high levels of system awareness with access to information about all personal states, as well as the memories and experiences they hold. For others with DID, there is low to no system awareness and every experience in between. The symptoms of dissociative disorder can vary depending on the type of dissociative disorder a person has. Common symptoms may include memory loss, feeling detached from oneself, feeling like one's surroundings are not real, and experiencing a sense of being outside of one's body. Individuals with DID may also experience gaps in their memory or have difficulty recalling important personal information.

Diagnosing dissociative disorder can be challenging because symptoms can be similar to those of other mental health conditions. A mental health professional will typically conduct a thorough evaluation to rule out other conditions and determine the most appropriate treatment.

Treatment for dissociative disorder may include therapy, medication, or a combination of both. Therapy may involve talk therapy, ego state therapy (Developmental Needs Meeting Strategy, Internal Family Systems (IFS), Inner Child, etc.), Brainspotting therapy, or eye movement desensitization and reprocessing (EMDR) therapy. Medications, such as antidepressants or anti-anxiety medications, may also be prescribed to help manage symptoms.

Causes of dissociative disorder

The exact cause of dissociative disorder is still being studied, but experts believe it is often triggered by traumatic experiences or severe stress. Trauma can be any event that is shocking or distressing that causes one's nervous system to be overwhelmed. It is thought that dissociation may be a way for the mind to compartmentalize these distressing or overwhelming memories and protect the individual from emotional turmoil that they may not be ready to confront. It has been considered that the personality states present in dissociative identity disorder (DID), have encapsulated a trauma that was unable to be worked through, either on one's own or with a parent or caregiver, at the time of occurrence. This is a highly adaptive and skillful way the brain works to protect us and keep us alive during a challenging time.

The mind's ability to dissociate acts as a safeguard, allowing individuals to compartmentalize distressing or overwhelming memories. It is a survival instinct that protects the individual from emotional harm. Dissociation can occur in response to trauma or stress, but it can also be a symptom of other mental health conditions, such as post-traumatic stress disorder (PTSD) or borderline personality disorder (BPD).

Diagnosis and treatment options for dissociative disorder

Coping with dissociative disorder can be challenging, but there are strategies that can help. These may include grounding practices, mindfulness practices, such as meditation or deep breathing exercises, as well as self-care activities, such as exercise, healthy eating, and getting enough sleep. It's also important for individuals with dissociative disorder to have a strong support system, whether that be family, friends, or a mental health professional. Support systems for individuals with dissociative disorder can come in many forms. Family and friends can provide emotional support and encouragement, while support groups can offer a sense of community and understanding. Mental health professionals can provide therapy and medication management, as well as guidance on coping strategies and self-care activities.

Coping strategies for individuals with dissociative disorder

Dissociative disorders can be challenging conditions to live with, but with the right treatment and support, individuals can find hope and change. I encourage anyone experiencing a dissociative disorder to reach out and find a community of folks who understand what you're experience. There are many places this can be done; you can search in your community for support groups, you can find support groups online, through Discord, etc.

If you believe you're experiencing symptoms of dissociative identity disorder (DID), in order to better understand yourself, using an app like Simply Plural can help you to track symptoms, communicate within the system, and share information with family or friends.

It's important to remember that there are no "right" or "wrong" goals when it comes to treatment. For some folks with DID, managing symptoms of dissociative amnesia and decreasing the impact to function in daily life is the primary goal, for others a focus on blending personality states is the goal. Your path is your own and you have a right to choose regardless of your diagnosis. Through therapy, medication, and self-care, individuals with dissociative disorders can learn to manage their symptoms and lead fulfilling lives.

Conclusion: Hope for individuals with dissociative disorder

If you are someone who experiences a dissociative disorder and feel like it is impactful to your life, help is available. It's important for those struggling with dissociative disorder to seek help from a mental health professional who is comfortable and confident in working with dissociation and dissociative disorders. It is a great idea to ask a potential therapist if they have experience working with and treating those who have dissociative disorders, how they do it, and how successful they have been.

Find resources at: www.isst-d.org and please reach out if you have any questions or concerns by sending an e-mail to kaci@thepinecenter.com

The Pine Center offers treatment for dissociative disorders and therapy for dissociative identity disorder (DID) for all of North Carolina virtually and in-person in Charlotte.

Narcissistic Abuse & Narcissism 101

What is narcissism?

Narcissism is a trait, much like aggression, assertiveness, affection, charm, etc. This means that narcissism exists on a spectrum and is present at some level in everyone. Yes, we all have at least a sprinkle of narcissistic traits and it’s actually good. Healthy narcissism allows us to have a sense of self-esteem, self-worth, helps us tolerate hardship, criticism, and maintain confidence.

As you move from the healthy end of the narcissism spectrum you become less and less healthy, eventually finding narcissistic personality disorder (NPD). This is what comes to mind for most people when they hear the term “narcissism”. This is more than a trait, rather it is a diagnosable personality disorder with severe symptoms.

What is the cause of narcissistic traits or narcissistic personality disorder (NPD)?

When interacting with someone who is high in narcissistic traits, or someone diagnosed with NPD, we may see someone who appears to be self-obsessed, grandiose, superior, self-centered, and self-important. The exact cause of high narcissistic traits or NPD will vary from person to person and a definitive link to the development of NPD hasn’t yet been identified. The root of narcissism can generally be distilled down to into a few general categories:

• The parenting style they experienced during childhood – this can happen in a few ways:

  • The narcissist created from pampering:

    • Were they coddled or highly praised? Were they idolized? Could they do no wrong? Were they overindulged?

  • The narcissist created from highly critical, insensitive, or emotionally immature parenting:

    • Were the critical messages from parents in childhood internalized by the child, causing him/her/them to build an ideal image of worth and value (the narcissist we see externally) and be caught in a constant battle for validation, always seeking external validation for the internal doubt?

    • Was this child emotionally neglected, leaving them without a sense of self, looking to others for validation in adulthood?

• Other factors could include:

  • Genetic factors

  • Changes in brain function

  • Family history of mental health disorders

What does it feel like to experience narcissistic abuse? What’s it like to be in a family or other relationship with a narcissist? How do I know?

First, being on the receiving end of narcissistic abuse feels confusing as hell and incredibly isolating. There are likely moments where you have felt like you’re losing your grip on reality. You’ve probably even asked yourself the question, “Am I the narcissist?!?!”

Here are a few telltale signs that your family member, partner, or friend has narcissistic traits:

• They lack empathy for others

  • This one can be difficult to identify at times but keep an eye out and if you see the person experiencing emotion, ask what they’re feeling. Most often the emotion will be less about others (e.g., “I’m sad for the child without presents on their birthday.”) and more related to themselves (e.g., “Seeing the child without presents on their birthday reminded me of my childhood and I’m sad for my experience.”).

• They are highly envious

  • They can be envious of the success of their children, their partners, and their friends. This can show up in subtle and extremely destructive ways.

• They feel entitled

  • Whether it is to your time, your physical space, material possessions, or even to things like success or good luck, folks with high narcissistic traits often feel like the world and those in it owe them something.

• Narcissistic parents often parentify their children

  • A parentified child is one that takes on some or all of the responsibilities of the parent. There’s instrumental parentification, giving responsibility to a child for things, like chores, paying bills, helping siblings with homework, childcare, etc. and emotional parentification which might look like caring for a parent’s emotions (soothing a distressed parent, listening to one parent vent about the other parent’s behavior, hearing about financial stressors, providing reassurance or validation to a parent, etc.)

• They will use emotional manipulation & sometimes emotional abuse

  • This could look like using criticism, sympathy seeking, etc. to poke at the places they know will make you feel either sympathy, pity, obligation, or a sense of duty to them.

  • Emotional abuse can look many ways, here are some of the most common ways, although this isn’t an all-inclusive list:

    • Humiliation

    • Accusation, blame, denial

    • Emotional neglect and isolation, stonewalling, ignoring when someone is speaking to them, walking away, giving the silent treatment, eyerolling, etc.

    • Gaslighting, manipulating your reality and making you question your basic perception, experience, and competence.

    • Outbursts of anger & rage

• They can’t be wrong and have a need to feel superior to others

  • If you know, you know. A person with high narcissistic traits will always try to build up their own sense of self-worth and that will often come at a cost to others. This could look like criticism about strangers (e.g., “Look at how disheveled she is, I can’t believe she left the house looking like that.”), family members, or friends.

  • Additionally, it is near impossible for these folks to ever admit they were wrong, and you’ll rarely hear an apology. If you do hear an apology, it’s some iteration of the classic “I’m sorry you feel that way.” It is highly unlikely that they will take ownership for their actions or for the role they’ve played in a situation.

  • Admiration from others is vital. They can get their “narcissistic supply” of admiration and attention in many ways, this could be showing off material wealth, a successful child, etc. This could even mean taking on financial debt to obtain material possessions or overworking to achieve the thing that bring about praise and admiration.

• They’re one person in public and another person in private.

  • It is not uncommon for friends, acquaintances, or members of the community to regard those with narcissistic traits highly. Most of these folks can be very personable and can turn on their charismatic charm. Anyone who knows someone with high narcissistic traits or NPD knows that the reality of this person in private is very different. The charisma disappears in private, when insecurity starts to bubble under the surface, the mask can come off revealing something very ugly and hurtful.

• You are never enough.

  • No matter what you do, no matter how much you love them. You, your love, whatever it may be is never enough and they are never satisfied.

• They get upset when you place a boundary

  • This comes back to the entitlement and the need to access you for their “narcissistic supply” of attention and admiration. If you have a boundary in place they no longer feel safe and will likely act out or move into “love bombing” – more on that in another blog post!

I hope this post was helpful in clarifying what it's like to know someone with narcissistic traits. If this feels like your experience, you're not alone and healing is possible. Check out the resources tab on this website for more information, book recommendations, podcasts, and more. If therapy feels supportive, please reach out and schedule a session.

What topics related to narcissistic abuse and healing are you most interested in? Comment below or e-mail me at kaci@thepinecenter.com and I’ll try my best to answer your questions in my next post!