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Dissociative Identity Disorder Treatment: Experience Matters

October 18, 2010 Holly Gray

Finding an experienced therapist for DID treatment isn't always possible. Read about things to look for in an inexperienced clinician. Dissociative Living blog.

My friend Dana recently moved to a new city and has searched fruitlessly for a therapist for months. Finding quality treatment for dissociative identity disorder (DID) is often one of the most frustrating challenges of living with DID. Despite the fascination it holds for many people, DID isn't widely understood, even among mental health professionals. Like so many others, Dana is in a position where she may have to choose between an inexperienced therapist and no therapist at all.

Does Experience Really Matter In DID Treatment?

Yes, absolutely. But lack of experience doesn't have to rule a therapist out altogether. With proper supervision, a willingness to set aside preconceived notions of dissociative identity disorder, and a dedication to education, I believe many therapists can provide effective treatment for DID. If I were considering hiring an inexperienced clinician, I'd ask these preliminary questions:

  • Do you have supervision from someone who has treated dissociative identity disorder? If so, how extensive is their experience?
  • What interests you about treating someone with DID?
  • How would you describe DID to someone with no knowledge of the disorder?
  • Do you have expectations about what treating DID might be like? If so, what are they?

DID Treatment Requires Specialized Skill and Education

The first two questions are deal-breakers for me. If you have no experience treating DID and you're unsupervised or your supervision is as inexperienced with it as you are, we aren't going to work together. Though I want more therapists to learn about DID and gain experience treating it, if I'm going to be a guinea pig I'm going to be a well-looked-after one. Someone has to know what they're doing.

DID Treatment Requires Genuine Professional Interest

The answers to the remaining questions help inform my intuition about a therapist's readiness to take on a DID client. For example, if you tell me you want to treat DID because you're fascinated by it, I'll likely thank you for your time and be on my way. Intrigued by DID? Read a book. As for me, I'm there for help, not to indulge your curiosity.

For some of these therapists, there is an excitement about treating a DID patient that appears to have more to do with experiencing the disorder than with treating the patient. - The Dissociative Identity Disorder Sourcebook, Deborah Haddock

Treatment for Dissociative Identity Disorder Is An Investment

Choosing a therapist is a hiring decision. My insurance company and I pay my psychologist a fee in exchange for services rendered. Beyond monetary investment, the stakes are even higher. People with Dissociative Identity Disorder are easily re-traumatized and the wrong clinician can do more harm than good. I'm not going to spend years of my life and thousands of dollars on therapy that's ineffectual at best. My DID treatment is, first and foremost, mine. And like my friend Dana, I won't trust it to just anyone.

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APA Reference
Gray, H. (2010, October 18). Dissociative Identity Disorder Treatment: Experience Matters, HealthyPlace. Retrieved on 2019, July 20 from https://www.healthyplace.com/blogs/dissociativeliving/2010/10/dissociative-identity-disorder-treatment-experience-matters



Author: Holly Gray

edward
says:
June, 15 2019 at 12:09 pm
I was diagnosed with did in 2014 by a va psycaiatrist the problem is the va has no qualified therapist in the va mental health system.nor do they have any interest in finding qualified care for did .searching online for a therapist in my city there were numerous therapist online that say they treat did .I googled what qualifications are required for a therapist in nv to treat did there were no results .
3B's
says:
April, 12 2013 at 8:03 am
Would you be more specific? What is the good news that a helpful that a good therapist doesn't have a private practice? If she doesn't have a practice, how is that you can access her again to see her in counseling? And do you mean by"switch" that some part other than you comes to the forefront, and then your clinic assigns you to a different therapist? If you want a certain therapist but that therapist is not available, there in nothing you can do but accept a different therapist.
tina c.
says:
February, 7 2013 at 6:01 pm
Dear Holly,
I was "diagnosed" with DID a few years ago by a woman who had experience with this. The great news is that she invested so much of herself into her former DID clients that she no longer had a private practice. She was awesome. The only way to see her again is to allow Vanessa to try to kill us and I don't want that. My point, I have bounced around for three years trying to find help or balance. Once someone experiences a "switch" they SWITCH me to someone else in the office very much less qualified than the first. I have no idea what to do I just found this blog and thought maybe you or someone knew what i should do.
castorgirl
says:
October, 22 2010 at 11:07 pm
This is a tough one... I live in a small country where there are no therapists registered with the ISST-D. That's also an indication of how well the diagnosis is accepted here. So given that, how am I expected to find a DID specialist, let alone one which uses the subsidised scheme that I am entitled to - and is the only way I can afford therapy? This would possibly be the same situation if you were living in some of the smaller towns in America. So, while I understand what you are saying, it also adds to a sense of defeat when you can't find anyone experienced.

I've seen a therapist new to DID and was fascinated by it. I've seen a clinical psychologist who was a highly recommended trauma specialist. I've seen a therapist who was treating other DID clients, had over 20 years experience and was highly recommended. Each of these people, with the best of intentions, were unable to help me, and often did incredible damage to my system.

I've found that experience counted for little. What did count was the therapists willingness to learn and have an open mind. Yes, they had to be skilled, have good boundaries and be willing to hear all sorts of painful things, but the main thing I found was what they call here, the therapeutic fit. That is, we could talk to each other, and there was some level of trust. My current therapist isn't perfect, but she's willing to listen and challenge me appropriately. She has other DID clients and has over 20 years experience, but that was only part of the picture - my previous therapist had similar credentials. What makes her different, is the way we interact. Some of the system hate her, but they are still listening to her... they didn't listen to the previous therapist, except for finding ways to undermine her - oh yeah, I'm a doll of a client :)

Yes experience counts, but it's not the whole picture.

In reply to by Anonymous (not verified)

Holly Gray
says:
October, 23 2010 at 9:01 pm
Hi castorgirl,

"Yes experience counts, but it’s not the whole picture."

Exactly - it simply cannot be the whole picture for many people; people like my friend Dana who have to choose between an inexperienced therapist and none at all. And like you point out, other things - like boundaries - are important too.

" ... it also adds to a sense of defeat when you can’t find anyone experienced."

I know that feeling well. It took years for me to find regular, ongoing treatment from a clinician with experience diagnosing and treating DID. The search added to my feelings of isolation and powerlessness. I'm very fortunate to have found my current psychologist.
An Infinite Mind
says:
October, 21 2010 at 4:05 pm
I agree 100%! An unskilled therapist can make DID symptoms far worse. I always recommend asking, "How many DID clients have you completed treatment with. You will be surprised how many therapists will say they had a DID client but when you ask if they treated them, the answer is usually no.
Our site has great links to help you find a therapist in your area plus our private data base lists many others.

In reply to by Anonymous (not verified)

Holly Gray
says:
October, 21 2010 at 5:03 pm
"You will be surprised how many therapists will say they had a DID client but when you ask if they treated them, the answer is usually no."

It really is surprising to me, though I shouldn't be surprised by now. I've heard so many painful stories from people who are desperate for help and end up in therapy with clinicians who have no business treating DID. And yet, I'm astonished every time I hear another one.

Your site made an impression on me the first time I came across it. I wasn't publicly writing about Dissociative Identity Disorder at the time and I was struck by your willingness to share your diagnosis. People like you, who are not ashamed of DID and are passionate about increasing awareness and understanding of it, helped me find the courage to do the same. I have deep respect for the work you do at An Infinite Mind. Thank you.
Renee
says:
October, 20 2010 at 6:26 pm
Great post! I hope it saves some people the heartache and financial hardship of choosing an inexperienced therapist. Having done that myself, I can say that getting yourself invested in a theraputic relationship with a counselor who doesn't have training in this area is like the blind leading the blind. I invested my trust, which doesn't happen easily, and am now dealing with the consequences.

If you struggle with DID, read and re-read this before choosing a therapist!

Thanks again.

In reply to by Anonymous (not verified)

Holly Gray
says:
October, 21 2010 at 4:45 pm
Hi Renee,

'The blind leading the blind' is an apt phrase! I spent a few years in therapy with a therapist who'd never treated DID before. I was very fortunate in that she was a skilled counselor and was a huge help in many areas. Still, I made virtually no progress with DID while seeing her. I'm one of the lucky ones in that regard. Others, like you, suffer real consequences from inexperienced therapy.

Thanks for reading and taking the time to comment, Renee.
Paul
says:
October, 19 2010 at 4:51 am
Great post. I think it's important to have good experience. I will say, though, that I think it's equally important to be careful when therapists with experience think they know all the answers. Dissociative disorders manifest differently in each of us. So, we are our own expert on our own experience. Sometimes "experts" forget that. And that's often not helpful. I agree it is an investment on behalf of the therapist. I would say that it's on par with the investment that a therapist must make with a severely suicidal patient. Both are really hard. And both require a really steady hand.

In reply to by Anonymous (not verified)

Holly Gray
says:
October, 19 2010 at 6:27 am
Hi Paul,

"I will say, though, that I think it’s equally important to be careful when therapists with experience think they know all the answers."

Good point, thanks for bringing that up. I have no doubt that you're right. But surprisingly, I've not had this experience. In fact, what I've seen is that the more experience a clinician has with Dissociative Identity Disorder, the more respect and awareness they tend to have for the complexity of DID and their own limitations in understanding it. Conversely, those therapists with very little to no experience with it tend to have pretty set-in-stone ideas about what DID is and how to treat it. Still, I know you're right - a clinician who thinks they have nothing more to learn isn't likely to be all that more effective than one who has everything to learn.

Even so, I think the greater risk comes from inexperience, not extensive experience. The last 6 years has taught me that clinicians without experience treating DID can be dangerous. I realize that's an intense word and I use it purposefully. I'm astonished at the choices many inexperienced therapists are making in treating DID. It's alarming to me that so many therapists are treating DID without supervision or education.

"I agree it is an investment on behalf of the therapist."

You're probably right but what I meant was that it's an investment that I'm making, not an investment my psychologist is making. Because I consider it an investment, I expect high returns.

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