Dissociative Disorders

Eating DisordersEveryone has periods when disconnections occur naturally and usually unconsciously. However, a person who has a dissociative disorder has persistent and repeated episodes of dissociation. These usually cause distressing internal chaos and may interfere with work, school, social, and/or home life. However, some people apparently function well which hides their distress. Dissociative disorders can be caused by many things. For example, dissociation is a defence mechanism helping people to survive traumatic experiences. Studies show that a history of trauma, usually abuse in childhood, is almost universal for people who have moderate to severe dissociative symptoms. This is how people survive the trauma at the time be that sexual, physical or emotional abuse or torture. The person being abused leaves their body (depersonalisation) and may explain it like they were not present but standing looking on or may have experiences where they cannot connect with the person who was abused as themselves. This is a very common experience for most people who have experienced severe trauma in their life.

There are five types of dissociation. These include:

  • Amnesia

    where a person cannot remember incidents or experiences that happened at a particular time, or when they cannot remember important personal information.

  • Depersonalisation

    which is a feeling that your body is unreal, changing or dissolving. It also includes out-of-body experiences, such as seeing yourself as if watching a movie.

  • Derealisation

    where the world around you seems unreal. You may see objects changing in shape, size or colour, or you may feel that other people are robots.

  • Identity Confusion

    where you feel uncertain about who you are.

  • Identity Alteration

    where there is a shift in your role or identity that changes your behaviour in ways that others could notice. For instance, you may be very different at school from when you are at home. This would need to be much more extreme than the normal variation of behaviour that you would expect to see across different settings.

No matter how many times I had gone to talk therapy, I couldn’t find a way to connect with the night child. I had abandoned, I just hated her. I had n compassion for her at all. I was finally understanding that I would be stuck in the muck of dysfunction until I could find a way to stop judging her so unmercifully

Marilyn Van Derbur (A survivor of childhood sexual abuse spanning 13 yrs by her father)


A person with dissociative disorder may have an altered sense of reality, identity and continuity.

They may have other problems too which can include:

  • PTSD

  • Depression

  • Mood Swings

  • Anxiety And Panic Attacks

  • suicidal tendencies and/or self-harm

  • headaches

  • hearing voices

  • sleep disorders

  • phobias

  • alcohol and drug abuse

  • eating disorders

  • OCD

A person with a dissociative disorder may also experience:

  • gaps in memory

  • finding themselves in a strange place without knowing how they got there

  • out-of-body experiences

  • loss of feeling in parts of their body

  • distorted views of their body

  • forgetting important personal information

  • an inability to recognise their image in a mirror

  • a sense of detachment from their emotions

  • the impression of watching a movie of themselves

  • feelings of being unreal

  • hearing internal voices and dialogue

  • feeling detached from the world

  • forgetting appointments

  • a feeling that a normal environment is unfamiliar

  • a sense that what is happening is unreal

  • forgetting a learned talent or skill

  • a sense that people they know are strangers

  • a perception of objects changing shape, colour or size

  • child-like behaviour

  • being unsure of the boundaries between themselves and others

  • feeling like a stranger to themselves

  • being confused about sexuality or gender

  • feeling like there are different people inside them

  • referring to themselves as ‘we’

  • behaving out of character

  • writing in different handwriting


AbuseThe aim of treatment for a dissociative disorder is to bring about increased connection and integration between feelings, thoughts, perceptions and memories, and to foster a sense of confidence and empowerment. One effective treatment for dissociative disorders involves extensive psychotherapy or counselling, usually over several years. This approach targets underlying causes as well as the effects of the dissociative problems.

Eye Movement Desensitization and Reprocessing (EMDR) is a specific type of therapeutic technique often used in the treatment of trauma related symptoms that can contribute to the treatment of dissociative disorder. There is no medication to treat dissociation however, medication may be helpful in treating co-existing symptoms of depression, anxiety, or insomnia.

Trauma related conditions can be so difficult for people to understand and talk about. We at the Goldsmith Clinic fully appreciate the difficulties that a person who has been hurt so severely will have with trust. We understand that progress is always slow and we are patient and compassionate in our approach to treatment. We believe that people can and do get better and that they can lead a healthy and normal life in time with the correct professional help.

Without realising it, I fought to keep my two worlds separated. Without ever knowing why, I made sure, whenever possible, that nothing passed between the compartmentalization I had created between the day child and the night child

Marilyn Van Derbur (Miss America by day)