Practice Guidelines for Identifying and Treating Complex Trauma-Related Dissociation

(Blue Knot Foundation, 2020) *Additional to the updated (2019) Practice Guidelines above

 Dissociation – in simple terms psychological absence from the present moment – is problematic if it is trauma-related. Mindful noticing and awareness are important to healthy functioning and dissociation cuts across this capacity; they are different and incompatible processes. As mindfulness-based approaches are now prominent in diverse varieties of psychotherapy, and dissociation impedes mindful noticing, therapists might be expected to know about dissociation and the challenges it poses to client engagement in the ‘here and now’ of therapy.

In fact, the opposite is the case (‘One characteristic of dissociative phenomena is how frequently they are misdiagnosed or not accounted for at all. Many people in the mental health profession do not know what dissociation looks like or how to assess for it’ (Danychuk & Connors, 2017: 39). These guidelines which address dissociation – and which are additional to the updated guidelines for treatment of complex trauma per se – aim to fill this clinical gap.

They also present the corresponding research base in the form of three chapters:
(1) ‘What is Dissociation and Why Do We Need to Know about It?’ (segue and repeat of ch 2 of the updated complex trauma guidelines;
(2) ‘Dissociation as Default: Structural Dissociation, Childhood Legacies, and Unintegrated Parts’, and
(3) ‘A Healthy Defence Gone Wrong’: Unintegrated self-states (‘parts’) and DID’.