In this chapter, we discuss the basic attitude for the therapists who treat patients with dissociative disorder. It has been more than 10 years since I began to present and write articles regarding dissociative disorders based on my clinical practice with these patients. This chapter is a summary of these presentations and discussions on these articles. My discussions mainly focus on the treatment on the patients with DID and DDNOS (dissociative disorder not otherwise specified) in which every aspect of dissociative disorder can emerge. Difficulties and therapeutic impasse specific to dissociative disorder can be exemplified in these disorders.
DID is still full of enigma and is misunderstood even by many mental health professionals. Among specialists, there is a wide disagreement about how to deal with patients. The number of clinicians who deny the validity of the diagnosis of DID is definitely decreasing, and people who assert that DID is mainly created iatrogenically are decreasing. However, quite often the patients are still considered to be “manipulative” and “controlling” others with their symptoms.
How to understand and treat dissociation
First thing to be discussed about is “how to understand dissociation”. As I already discussed in the chapter 9, I understand dissociation as a pathology of switching. In dissociation, mental activity occurs in fits and starts. An identity is suddenly taken over by another one, or a function is lost abruptly. Frequently patients are taken aback when the switching occurs. Instead of controlling others with their symptoms, they feel at the mercy of these symptoms.
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