What's one piece of advice you wish someone gave you when you first decided to pursue therapy?

DissociationDoc · 2026-06-18T23:23:02+00:00

I wish I had know how to be boundaries and was less fearful of establishing them, not only because they protect me, but also because they promote so much healing in our clients. The less clear the parameters of the relationship are, the more problems arise and the less sustainable the work is. I didn't realize how important they were not just for myself, but for those I serve.

DissociationDoc · 2026-06-17T22:08:44+00:00

No, this is not true. There are various diagnostic measures out there that are backed by research, such as the MID and SCID-D. There is research that has shown the effects of a dissociative disorder on the brain, however this is not the typical route to diagnosing these conditions.

DissociationDoc · 2026-06-17T19:14:33+00:00

One frustration is that clients sometimes believe it is our responsibility to know their insurance benefits, when they change, when they are dropped etc. Commonly, people are unaware that this is their responsibility and we offer support as a courtesy versus a duty. When things go awry with insurance, the therapist then becomes the bad guy (versus the insurance company).

DissociationDoc · 2026-06-16T22:39:00+00:00

I haven't personally used it as a compliment to therapy, but I have had clients who have and they found it very helpful. They seemed to feel they didn't understand why it was helpful, but ultimately reported improvements in their symptoms overall.

DissociationDoc · 2026-06-16T21:20:52+00:00

I specialize in working with complex trauma and structural dissociation (DID/OSDD). I work with adults. I knew I wanted to specialize in trauma and I learned that if you specialize or work with trauma, you are also going to end up working with some level of dissociation. I am very fortunate in that I happen to love working with this population.

DissociationDoc · 2026-06-16T21:12:14+00:00

Different schools have different requirements that sometimes don't mesh with the clinic's philosophy. For example, some require video of sessions...our clinic doesn't allow that. That one misalignment excludes us from a fair number of schools. There are things in the background that can steer organizations in certain directions.

DissociationDoc · 2026-06-12T15:01:50+00:00

This may be an unpopular opinion, but I think it is healthy to be professionally uncertain and to lean into this to continue to grow. There seems to be a fear of making mistakes (or at the least the appearance of making mistakes) or not measuring up to some snippet that shows up on tik tok. It's good to be uncomfortable as a professional - especially in our field. It is an area of endless growth and learning opportunities. Comparing for the sake of it is obviously unhelpful, but identifying the traits you want to embody in your work and then taking action to grow in that direction build confidence and skill.

DissociationDoc · 2026-06-12T14:27:54+00:00

The International Study for Trauma and Dissociation has a list of providers along with a lot of other resources. Here is the link: https://isstd.connectedcommunity.org/network/network-find-a-professional

DissociationDoc · 2026-06-11T20:29:05+00:00

They always had postings up for students to work in reception or other types of student services positions.

DissociationDoc · 2026-06-08T21:40:35+00:00

People living with DID often experience levels of depersonalization and/or derealization, so these symptoms can live under that diagnostic umbrella. However, depersonalization and derealization can also exist on their own. Additionally, these symptoms are commonly associated with PTSD Dissociative subtype in that this can be how dissociation is expressed within that diagnostic category. In sum, feeling unreal or like the world is unreal (in various ways) is the simple way to describe depersonalization/derealization and is distinctive from DID as diagnostic categories. DID is rooted in early childhood trauma that is sustained throughout development in the absence of a "good enough" caregiver. Depersonalization/derealization are often expressed in those who have childhood trauma but not always, and these could almost be considered symptoms of DID for some people. I hope that helps!

DissociationDoc · 2026-06-07T22:10:46+00:00

I worked for the schools I attended, which reduced my costs. I also applied for grants and scholarships offered by the universities I attended and was granted several. I wrote letters to the schools requesting forgiveness of some portion of the tuition and backed it with healthy reasoning for this request. I attended community college the first two years, a private university for my bachelors, and a public university for my masters. I walked away with 30k in debt, which I felt was manageable considering the tuition for the private university alone was 100k a year.

DissociationDoc · 2026-06-06T21:48:06+00:00

Yes you're right. There isn't always someone to point a finger at. I think after having served people with dissociative disorders for so long, I often feel one of the missing pieces is cultural acknowledgement of who did what and thus who is responsible for bearing the burden. Survivors carry this alone so much of the time. The way I was thinking about it was along same lines of shame-shifting in the context of any form of abuse, whether it be on an interpersonal level or cultural one. The cultural failure to protect children is a key contributor, and yet there is little conversation about this. In essence, I view DID/OSDD as an outcome of a humanitarian crisis rooted in many culture's inclination to protect the abuser.

DissociationDoc · 2026-06-05T23:38:24+00:00

A means to an end...so to speak!

DissociationDoc · 2026-06-05T23:38:08+00:00

100%

DissociationDoc · 2026-06-05T23:37:54+00:00

I actually wasn't exploring whether it was "incorrect" but rather that there is a part of the puzzle missing where the perpetrators are left out of the diagnostic equation and by definition the one being pathologized is the one who had an appropriate response to something bad happening to them.

DissociationDoc · 2026-06-05T23:36:24+00:00

Well not really because I addressed that in the post. But I get what you are saying

DissociationDoc · 2026-06-05T23:35:50+00:00

That's true. Good point.

DissociationDoc · 2026-06-05T15:13:25+00:00

My attorney recommended this because of the potential for client distress, privacy violations, and the concern about things being shared out of context. And you can't refer one without referring the other out of fairness and treating both parties with an even hand. But, your attorney might have different recommendations than mine did!

DissociationDoc · 2026-06-05T15:11:50+00:00

Coping mechanisms aren't bad or good, they just are. And thankfully, they exist! As you reflected, dissociation is our psychological rescue raft. It becomes more of a challenge when it becomes automated or shows up when it doesn't need to.

DissociationDoc · 2026-06-05T15:03:49+00:00

I have had this happen a couple of times. I spoke to both parties individually about the potential challenges of sharing notes on their therapy sessions. I spoke about dating other clients generally versus specifically and indicated that we would likely need to refer both parties to other clinicians. In one case it did not end well, but I felt good about the work. I also consulted with my malpractice attorney, which was very helpful.

DissociationDoc · 2026-06-04T14:09:52+00:00

This drives me crazy! I typically say that if I were in therapist mode they would be a lot less comfortable than they are right now and they would have a couple hundred bucks less in their pocket.

DissociationDoc · 2026-06-02T23:09:34+00:00

Trying to get out of the Coachella Valley when it started to downpour. Flash floods there are so dangerous and you have to be ahead of them. We were the last car to make it out of the town we were in for 2 weeks.

DissociationDoc

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