Dissociation: Three Ways to Get Help

by | 19 October 2018 | 23 comments

Treatment on the NHS for dissociation and dissociative disorders isn’t always forthcoming. In this video Carolyn talks about three ways of getting help in these circumstances.


  1. The Listening Place (TLP) is a suicide prevention charity. The NHS plus many other organisations refer suicidal people to them plus they take self referrals. Essentially they listen and people see the same volunteer on a regular basis. And they’re excellent plus, importantly, accessible . Alas there’s only one branch – its in Pimlico in Lomdon.

  2. Excellent video Carolyn. Honest, informative and inspiring.

  3. Great video and sounds reassuring for sufferers.

  4. Thankyou
    A really honest look at what suppirt really does look like
    As a counsellor I am faced with this often
    And I’m thrilled to hear you talk about therapy in such a posative light
    And yes when asked we DO offer low cost as i hear individuals stories I see the need increasing.
    My own way to navigate this….was to cut off the back half of my home turn it into 2 more therapy rooms…. (I have high street premises) and take on student counsellors in their final years as well as qualufied counsellors preoared to offer low cost.
    No rental meant low cost
    So counsellors can also think outside the box in how to offer help.
    I’ve just negotiated the use of a barn locally once a week for suppirt groups. And the owners have offered low cost rent which in turn offers low cost support
    If we ALL pull together support CAN look promising and be robust to carry clients.
    Thankyou again
    I’ve attended your training and am always left empowered to cintinue my work and humbled by your story.

    • Becky, what you’re doing is marvellous, wishing you success in all your ventures!

  5. Thank you Carolyn. Your comments are so helpful for survivors. I am a therapist battling the NHS with my client to get to the London Clinic for Dissociative Studies for an official assessment as this would help her claim for financial support. I have accompanied my client to two local psychiatrists as they have refused to refer her. I don’t think they have a clue about dissociation or even recognizing it. Many psychiatrist do not go the psychological route but the drugs route and look for symptoms to treat with drugs and therefore do not understand the psychology of dissociation. Carry on the good work you are doing -it is much appreciated.

  6. As a therapist this is so so true Love your ideas for making a few quid.🌸

  7. As always, so accurate and am sure helpful. And as you suggested am sure there are many counsellors and psychotherapists who offer concessional fees to those facing financial constraints.

  8. Thank you Carolyn, I think your video is brilliant. I will certainly be recommending it to others. Well Done!!! Jan Egan

  9. Good video.
    Just a personal experience of the NHS….. – had *excellent* therapy on NHS, until 2011 when they essentially dismantled the local psychotherapy service to make way for cookie cutter IAPT/CBT. It was catastrophic to my mental health as for the first time in my life i had found someone i felt safe with, a safe place to remember etc, & just at the point where i felt secure in the relationship & Parts were starting to emerge, they ripped her away with very little notice, & are no longer offering any long term therapy. This bereavement – which is what it was in effect, at the hands of ignorant CCG bosses, was actively harmful to me & started the suicidal ideation not experienced before – the lid had been taken off the ‘can of worms’ & i was left to deal with the consequences alone.

    If they offered me NHS therapy again i wouldnt take it. -They are CONTINUALLY changing things, they have no concept of how taking away someone’s therapist can affect traumatised people. They think it’s like changing an asthma nurse or a hairdresser. If i were physically well i may have made an official complaint about it, but it seemed pointless anyway, in the main they seem to be interested in what looks good on paper – numbers of people through the service, waiting lists etc, regardless of whether people are actually recovering in the long term.

    Sadly I am very ill physically – mostly housebound, & even though i managed over the last 7 yrs, to scrape together some money to pay for private T, (- honestly therapy is worth more than food to me because i know it’s the way out of this living nightmare). But despite an exhaustive search, there is no one local enough to me (i am too ill to travel outside of my small town) who has experience of working with dissociative disorders (- there is one but he & i didnt gel at all!) – so I’m left praying for a therapist from somewhere else to move here.
    I dont respond well to non face2face approaches so am just in limbo, it’s awful. But i figure if i survived my childhood i can survive the wait.

    All that not to be negative, just to warn people that pinning your hopes on the NHS can do more damage than help. – prior to therapy i was coping much better, but during therapy we necessarily took down some defensive barriers & in that safe place i began to naturally remember. But then they stopped half way through the process.
    I wouldnt give back my awareness, but in many ways i am worse off having started a process that was supposed to be long term/open ended, than i was prior. In the same way that someone whose 12hr long heart surgery was stopped after 90 mins & surgeon pulled out leaving the patient abandoned open on the table!

    Just a cautionary tale about trusting the NHS in this regard.

    • Lavender,

      I am so sorry to hear about your experience with NHS and agree about NHS’s lack of therapeutic thinking and the effect of it on a person. There are some therapists who travel to their clients rather than the other way round. Good luck with all.

      • Hi Silvia thank you for your kindness. Unfortunately i have looked into this & discussed it with a therapist but we agreed that sadly this wouldn’t be appropriate for me for several reasons, not least that i don’t feel wholly safe at home (due to nightmare neighbours) & am too ill to move.

    • Can I provide a glimpse from the other side of the discussion?

      I am an integrative humanist counsellor working in the NHS in an IAPT-based service. I am very experienced in working with survivors and DID, but am rarely able to see people with those issues because of the insistence that CBT is the only worthwhile therapy – whether it works for survivors or not.

      Those who have accessed the NHS IAPT services will know that they rely heavily on the Minimum Data Sets (MDS) – those forms they get you to fill out every session. The anonymised data is analysed and used to define what treatment will be offered to future clients. If someone manages to recover in a shorter number of sessions, that is evidence that clients in general need less input and therefore future clients will be offered fewer sessions than before – we used to offer 20 sessions of therapy, but that has now reduced to 8. We are pushed to complete the work and get people into ‘recovery’ quicker and quicker, contradicting their own IAPT protocols and training. If the person does not ‘recover’ in the targeted number of sessions we get fined or don’t get paid at all. Hence, those providing therapy from within an IAPT service (and most are not NHS staff) may be tempted to cherry-pick clients to ensure they will reach targets and be paid. The rest of us who are trying to work ethically and with client’s needs in mind, pick up those marginalised clients and frequently miss out financially.

      Counsellors know there is a huge need, but while the CCG remains convinced that CBT is the only reputable treatment out there, I am struggling to keep my job and fight against constant criticism that because I don’t have an IAPT qualification (ie. a 5 day CBT certificate course compared to my post graduate diploma, 15+ years of experience, registration and accreditation with BACP), I am not deemed competent or qualified to work with clients.

      I don’t want to have to work privately, because I don’t want to charge people for what I do and don’t think survivors should carry the burden of what their abusers did to them. If it is a health issue, then it should be free on the NHS.

      NHS counsellor’s do care and the BACP is fighting for better representation within IAPT and for more choice for people. Let’s hope appropriate change comes very soon.

      • Woo

        I am not at all surprised to hear that, but it sounds incredibly hard. The kind of ‘kentucky fried’/’Mc’ counselling that experienced therapists such as yourself are forced to offer must be appalling to have to try & deliver while also caring deeply about the client. It’s disgusting that you are financially penalised. And of course one of the problems is that grossly under educated CBT ‘therapists’, have no idea of the harm they may be causing.

        The whole system in my opinion just shows the contempt with which mental health is actually viewed, despite the soundbites. And the cult of positive thinking and CBT will I’m afraid prevail, since the powers that be are only interested in what looks good on paper, not what actually changes lives.

  10. Thank you for this Carolyn, I’m endeavouring to become more of an expert on this issue of dissociation and trauma, I seem to be getting more and more clients with trauma as a backdrop to their lives, so between yourself and Bessel van der Kolk, I’m on my way to providing much better support for them.

  11. As a survivor of DID firstly thank you for the videos..but knowing there is little to none help out there via the NHS is both deeply depressing and a dreadful indictment of our failed mental health system.
    As someone who was referred from my local IAPT to a psychiatrist because of “complex needs” only to be discharged with no help,no recommendations and no interest, this video reinforces the hopelessness of the current situation.
    I live in a small town with few ,if any,therapists and so would have immense trouble locating one even if I could afford to do so.I am currently on ESA and believe it would be taken away should I earn any extra money in order to self finance therapy..a catch 22 situation I think many will have.
    There seems so few places we can turn to. The mental health budget has been slashed almost beyond repair and frankly I can’t see it ever getting back to normal. I wonder if there is a pressure group we could be pointed towards that will at least try and make our voice heard ?

    • The rules on ESA allow an amount to be earned by an individual as long as this amount does not exceed what DWP allows. The person who assists people with disabilities at local Jobcenters or Citizens Advice can give current work allowances while claiming ESA. I know because I have done this to help me fund my education.

  12. Thank you Carolyn, I am going to send your video to my GP in the hope that it will refresh some fight in her to do what she can to influence change.

  13. Ive come up against MAJOR issues having ANY help from the NHS. Ive paid privately for over 4yrs putting me in debt. The community mental health team didnt even know more other than the name and refused to help, and the community psych nurse literally said to me “i didn’t learn about DID at uni so why should i need to now”. There are added complications in my case as have severe anorexia also and my alters have been disganosed with eating disorders too. So the eating disorder team won’t touch me because of the DID and the Complex Needs team said i was “too complex”. We’ve done 3 complaints going as far as MP level but its been awful and its been so awful. The last meeting they literally said the help in my area was nothing as they have no funding. I was told by the MP’s that the NHS won’t acknowledge any evidence based research thats not uk based, so all the studies done in the USA and OZ etc etc, they won’t acknowledge or use and they said they have no plans to perform any research or studies into DID in the near future. The diagnosis has screwed me over in regards to getting any help so been putting myself in debt now for 4yrs to just keep myself alive.

  14. that just makes me even more angry, not with Carolyn, but with the medical service. I’ve lived with a wrong diagnosis of uncontrolled epilepsy for 40 yrs, only by my anger and frustration I found first in 2013 that I’ve got CPTSD, I live in Belfast and have had at times daily life threatening events in our terrorism, then had to fight to get to the Eng epilepsy centre for a review as we don’t have good neuro dept here, 2016 was diagnosed with NEAD, Dissociation, and some epilepsy but they can’t tell the difference. The only neuropsychiatrist works in the hospital slap in the middle of my childhood home where I had terrible experiences, I hate going there, and, after waiting 2 yrs, till June this year and mentioning some of my incidents I nearly died, I can’t go back there, so there’s no treatment for mr. I did go to one of the charities working with victims of the the Troubles but my counsellor just made me talk it over, it was before the full diagnosis and he never spotted any of my other conditions, I’m in a worse condition thanks to that

  15. From one that has been though the system to get funding to go to The Clinic in London yes it takes time and help. You do not need your Psychiatrist for the referral that has to come from your GP. Your GP does the referral and you go from there it does help if you have letters from Therapists, Counsellor or any qualified person to back your referral. We had contacted the Pottergate clinic in Norwich and done the two assessment papers they will send you and mark and send you a report afterwards which was included in the referral.
    It took two years to get funding for the assessment and then about a year to then get funding for Therapy at the Clinic but to us it has been worth the time and owe GP practice did all the work chasing up the CCG. Then after the assessment the Clinic help chasing and worked out a way that they did the Therapy and local mental health team give us a care cordinater to help us with everything else.

    So must important is a good GP

  16. There’s evidence on my medical notes to suggest I had DID at 5yrs from what I’m reading I’m probably likely to be told by the NHS I have grown out of it?!? This is really interesting thanks for sharing it’s really helpful.

  17. I’ve learned so much, more so that I knew I had DID but disassociated from the knowing when I realised no one cared. Well not no one cared when the professional help was never going to happen.


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