Who's treatment is this anyway? Helpful and harmful aspects in the treatment of dissociative identity disorder phenomena

Document Type


Degree Name

Doctor of Psychology (PsyD)

Year of Completion


First Advisor

Danielle Knafo


There is a great deal of controversy regarding the diagnosis of dissociative identity disorder (DID) and the overlap with other disorders, particularly borderline personality disorder and schizophrenia spectrum disorders. Criticism of the definition of DID abounds, and no widely agreed upon conceptualization of DID exists. The controversy and disagreement regarding what constitutes DID is equally present with respect to the treatment of DID. The purpose of this study was to attempt a better understanding of the helpful and harmful aspects of treatment for individuals who experience severe dissociative states according to first-person accounts. Thirteen individuals were recruited from Australia and across the United States, and interviewed using online telecommunications. A mixed methodology qualitative analysis, using grounded theory and interpretative phenomenological analysis, was conducted by a team of coders on the verbatim transcripts of interviews. Analysis of interview data revealed that people prefer a client directed, collaborative, relational, trauma-informed therapeutic approach that honors the subjective experience and works within one's defensive system. Further analysis indicated that the current biomedical paradigm under which most mental health professionals operate and forced interventions are counter-therapeutic and often re traumatizing. Additionally, many participants found their greatest healing and support from resources outside of the mental health system. Overall, participants attributed their recovery process to a widely ranging variety of interventions, including psychotherapy, social and peer support, lifestyle changes and personal coping strategies. Results are consistent with other qualitative studies and first-person accounts of individuals identifying with having recovered from different diagnostic categories, such as schizophrenia and bipolar disorder. Clinical implications, hypotheses and suggestions for future research are discussed.