The shame of dissociation

by | 7 March 2019 | 33 comments

She enters the therapist’s room and there is nothing but terror. Something has happened – she doesn’t know what; the therapist doesn’t know what – but here she is now: here and not here. In a 30-something body, she looks child-like, fragile, vulnerable. The therapist feels the familiar thud of compassion on the inside of her, the almost-overwhelming need to protect and care and repair. Does she move towards her, take her hand, guide her to her chair? Or does she wait, encourage autonomy, let this scene play out? It’s never an easy choice, nor an obvious one. She waits.

The woman’s eyes flick around the floor. Her breath is caught up in her ribs, hardly exhaling. Her fists are clenched. Her shoulders shrug upwards around her neck, protectively. The agony of being is raw on her face. Terror and dread and shame and confusion. She shuffles slightly forwards. Everything seems strange. She’s not sure where she is, what she is doing here. She knows this place, but only as if in a dream. She doesn’t know it now. The ache of dissociation sits heavily in her.

‘Come on in,’ says the therapist softly, not daring to break the tension with too much volume. ‘You look very scared.’


Find the complete article in Carolyn's new book, 'Unshame: healing trauma-based shame through psychotherapy', available now!

A word of explanation

I had therapy mainly between 2006 and 2015. These blog posts are not verbatim accounts of sessions, but rather the client equivalent of ‘case studies’ - amalgamations of various sessions, ‘narratively true’ rather than ‘historically true’. Although often written for stylistic purposes in the present tense, they are very much from a past period of my life. Ideally they should be read within the wider context of other blog posts, articles and my book, to give a more integrated and rounded sense of where I was at, where I’m at now, and the process that took place between those two points. I have been on a journey of recovery, and the difference in me from when I was in therapy (especially at the beginning) to now is testament to the brain’s ability to recover from even the most appalling suffering.

My primary work now is writing, followed closely by training therapists, counsellors and other professionals to support survivors of trauma. Regrettably I cannot provide one-to-one support but our charity framework PODS (Positive Outcomes for Dissociative Survivors) provides a helpline and a range of other services: please go to for more information, and if you are looking for support.

For training, please see our range of live courses at, and our online courses at We also publish a range of resources to support recovery from trauma, which you can see at My first book, Recovery is my best revenge, is available to buy at




  1. I think it must put the therapist on the back foot when you come into the room already dissociated in a part. It must strike a lot of fear into them, dreading what kind of a therapy session it’s going to be. I wouldn’t want to be a therapist! But the more visibly freaked out the therapist is, the more the dissociation and mis attunement is worsened and intensified. What I learned from your fab Dissociation and DID online course, is how the dissociation of the client can so easily trigger the therapist to leave their own window of tolerance, and once the therapist is triggered themselves, the hypervigilant client picks up on this in a empathic sensing way and before you know it there is conflict and attack because the therapist doesn’t understand they are (unintentionally) worsening your dissociative capacity. I previously worked with someone who was shaming of my parts, which only intensified my own shame surrounding them. the crisis team are also TERRIBLE at reacting to dissociative parts when they front. Now I work with someone who is non shaming about the parts, I’m building a relationship where I am able to welcome my parts with less shame, and with less shame, comes more progress and better integration and teamwork between the parts. Love this blog Carolyn. You highlight issues that are so fundamentally important, and I only wish that more NHS clinicians would step off their arrogant self-important pedestals and actually listen to what you have to say. You speak for all of us Carolyn, and survivors NEED someone with confidence who is prepared to add their own public voice and speak with conviction. Therapists don’t always get it right. I’m glad yours did, and that I now have found one who works in a better and more therapeutic way. The evidence that the right approach is vital lies in my very noticeable improvement. Sorry for the rant. I feel passionate about this!

  2. That could easily have described one of my own therapy sessions….. the shame, the denial, the fear, the confusion….. I have wondered how my therapist copes with everything that comes out in our sessions. I have seen and felt his compassion but still struggle with accepting myself.

    Thank you for sharing this, Carolyn.

  3. Carolyn, thank you for your honesty and bravery and allowing yourself to be ‘seen’ in this way. I cried so much reading this blog, it helped me understand certain people in my life more completely and gave me yet another well of compassion for them when my own had run dry. As a counsellor I am so grateful to read this helpful account from the therapist’s point of view, it’s yet again given me the courage to keep on perservering with some of my very damaged clients, and to not worry that I so often feel so inadequate! Thank you for sharing.

  4. I’ve been in therapy on and off for the past 30 years. I’ve recently started working with a clinical psychologist, who introduced and drew out the concept of the “window of tolerance”. I found it very helpful, and was interested to see that you had attached colours. Mine would be different – red for the top over-loaded space; green/blue for the middle, coping and accessible to therapy window and dark grey/black for the bottom, soup-like fog of dissociation.
    Maybe it’s helpful for therapists to introduce the concept and encourage the client to use their own colours/patterns/shapes which fit for them.
    I’m new to your blog and. although it’s painful to know that others share some of my sort of story, it is helpful to know that I’m not alone.
    Thank you Carolyn.

  5. Such a wonderful insight into what is going on. I often feel inadequate when working with dissociation but hearing you describe the balance between attending to you own feelings whilst being there with the client are so reassuring. I found this incredibly powerful. Thank you

  6. This was a beautiful, painful, account of both sides of the session. As a therapist, only starting out on the journey of helping clients to heal, this gives me strength and hope that I too will be able to make a difference one day with a client.

  7. Oh my good gracious this rings too true. Thank you for being here, the validation given and the meaning given – that I may actually “be” … be all my selves. Thank you for helping me to grow very slowly towards recognising and in time accepting all of them. If I survive Anorexia which as an adult I am unable to secure any help with, poses huge risk to life, you have inspired me in trying to do whatever I can to enable change/instigate understanding where is is desperately needed e.g. within our mental health system. Bless your heart x and all those who “suffer”

  8. Wow! I just forwarded my therapist this blog with a huge “Thank You!” I never realized the magnitude of turmoil that she must go through to be there for all of us. I didn’t have a choice about going through this trauma, but she does and she continues to fight the good fight with me, even so. 💜

  9. Thank you Carolyn

  10. I know just how debilitating it is when i go of on one of my jollies as I call them. Not jollies at all. Some times a child or an adult amongst familier faces or are they! Whoever comes and goes it’s so different each time, but always ends with me losing my life. Usually horrifically. Not only me at times either my children to. It’s so restricting can’t shop,walk in town. Carry be left with my grandson been known to throw things thinking they are a ball. Life is so hard. Thank you for writing this artical so good for me to hear I’m not on my own.

  11. Awful and brilliant; brilliantly awful. Vivid, painful truth. ‘Shame is a two person emotion’ and hence the ‘Catch 22’. Why the instinct to isolate is so strong…..even and especially from my husband and children. That shame monster needs slaying and you are showing the way…….

  12. Wow
    Finally someone who can articulate the wrestling match that goes on inside
    Yes I want to run and hide but also I want someone to stay with me and stop the panic spreading, someone to reassure me that I’m not mad! My brain becomes so scrambled that I too struggle to form a sentence or to articulate the pain. However some part is always on watch and somehow has a birds eye view!
    Thank you for sharing I feel less mad each time I read one

  13. Please know that your writing has touched levels of unchartered thoughts and realizations.
    Thank you for the opportunity and perspective.
    And also sharing of yourself, it is immensely tender and terrifyingly accurate.

  14. Thank you Carolyn.

  15. Thank you Carolyn, I too was this therapist. I struggled to breathe when reading this. It was like you were in the room observing sessions over the past 4.5 years! I am now able to be that bridge. The Woman now accepting and open towards all parts bar the youngest, (we’re almost there though).
    The other parts now trusting the adult woman to look after them as she reassures them that they are now safe. That is old stuff and also giving them permission that it’s ok not to be ok.
    Self harming has ceased and shame is giving way to rage against others, perpetrators who stole her childhood, stole her personality, stole her innocence but can no longer steal her future.
    We are getting there, one session at time for as long as it takes. Thank you for giving me the courage to keep going. The privilege of joining my client on her journey and for my own healing along the way.

  16. Thank you so much Carolyn. To read the comments, thoughts and fears of failure of the therapist has been so encouraging and enlightening. To know that therapists don’t have all the answers, don’t always know what to do and sometimes are grossly aware of their limitations and inadequacies has given me the strength and courage to continue to work with DID clients. I so often have these feelings too and somehow always assumed I just don’t have the skill and knowledge of other therapists. What a relief to know I’m not alone! I so appreciate the honesty of your writing.

  17. Thank you Carolyn for sharing such insightful, helpful work in this area of trauma and shame. Working with such brokenness and consequent dissociation is extremely challenging for therapists and does cause us to question ourselves at a deep level. I’m so thankful that I have the privilege of reading your blogs.

  18. My granddaughter lives with me, she has a range of parts. I am worn out with them, she is worn out with them.
    We just keep on keeping on, talking through whenever she is up to it.
    I find your posts really helpful. Thank you.

  19. Thank you Carolyn. I was able to feel the shame and distress. Thank you for finding the words, so often they evade us. Thank you for helping me to understand what my clients may not be able to vocalise. Most of all thank you for sharing with us all

  20. Thank you for this Carolyn. Despite being a sad piece of writing to read, I also took comfort from it as a therapist in reminding myself that in those moments, it is connection as a human being that really matters, and to feel inadequate and panicking that I am not enough for that client is a normal reaction to something you witness where you constantly question how can you be good enough for your client.

  21. This piece evokes a myriad of feelings and thoughts to be processed. Most importantly it as if it’s the voice I find so very difficult to find when in my therapy sessions. The rawness of this piece totally explains what I can’t. Thank you.

  22. As always, so encouraging and supportive. To hear the inner thoughts of the therapist to be so close to my own is such helpful feedback…and increases my confidence to stay, to hold, and to go with. Thanks.

  23. I don’t remember much about my first therapy session to my healing journey. I do remember the terror and carefully avoiding Paula’s hand when she reached out to shake mine. I remember drifting in and out of the room and feeling confused and not daring to hope she might be able to help me stop the chaos.

    It was almost six months before I remembered Paula’s name or even where her office was in the clinic where she worked. I relied on the little appointment cards and alters to get me there. I could see the concern and confusion in Paula’s eyes when I first began seeing her. She told me later she wasn’t sure what was happening, but she had a major theory.

    Six months after I began to see Paula, in February 1990, she gave me the diagnosis of what was then called multiple personality disorder. I had seen the movie Sybil, and I was afraid and yes, I was ashamed.

    My shame centered around my small knowledge about how Sybil supposedly formed DID. I knew my grandfather had been sexually inappropriate, but I didn’t think it was “that bad”. However, I had been having horrific flashbacks long before I approached Paula for therapy and realized that he must have done much more than I knew at first.

    The shame, blame, and denial kicked in and it hurt.

    I was ashamed of what had happened to me. I was ashamed of my memories and how I was telling Paula about them. I was a liar, I just knew it, and I was telling those stories to get attention. I was weak. I was stupid. I was crazy. I didn’t belong in this world at all and never did.

    Thank you for this article. It helped me to look back to the beginning and realize just how far I have come.

  24. Respect and admiration to you Carolyn,

    Thank you,


  25. This is so moving and feels so so true. Thankyou for putting this out there Carolyn. It’s everything all together, raw, vulnerable, moving and full of hope. As a survivor and therapist this is so helpful. It captures something so essential and needed. I do relate to the acute vulnerability and the need for therapists to be real – both really there and really human x

  26. Thank you Carolyn. A tender, truthful post from both sides of the therapy room.

  27. Thank you.

  28. I cried buckets reading this. Thank you.

  29. “It’s like a membrane surrounding the being. It doesn’t seem as if life is possible without it. It is a protein structure around the soul: without it, we fear annihilation.”

    Yes – that!

    Thankyou Carolyn,

    • I agree. For me that membrane is semi-permeable, where ‘stuff’ leaks through at times of vulnerability.

  30. I can’t say how moved I was to read this thank you for sharing

  31. Thank you deeply, Carolyn ………..

  32. Thank you for sharing. I am a psychotherapist working with a client with DID.
    So helpful.


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