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If no physical illness is found, the person may be referred to a psychiatrist, psychologist or licensed, independent social worker—mental health professionals who are specially trained to diagnose and treat mental illnesses. These professionals use specially designed interview and assessment tools to evaluate a person for a dissociative disorder. The therapist bases his or her diagnosis on the patient’s report of the intensity and duration of symptoms—including any problems with daily functioning caused by the symptoms—and the therapist’s observation of the patient’s attitude and behavior. The therapist then determines if the patient’s symptoms and degree of dysfunction indicate a specific disorder, based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), which is the standard guidebook for the diagnosis of recognized mental illnesses in the United States.

How are dissociative disorders treated?

The first goal of treatment is to relieve symptoms and control the disturbing behavior. Treatment then aims to help the person safely express and process painful memories, develop new coping and life skills, restore functioning, and improve relationships. The best treatment approach depends on the type and severity of the dissociative disorder, but most likely will include a combination of treatment methods including the following:

• Psychotherapy — Psychotherapy (a type of counseling) is the main treatment for dissociative disorders.
• Cognitive therapy — This type of therapy focuses on changing dysfunctional thinking patterns.
• Medication — There is no medication to treat the dissociative disorders themselves. However, a person with a dissociative disorder who also suffers from depression or anxiety may benefit from treatment with a medication such as an antidepressant or tranquilizer.
• Family therapy — This helps to educate the family about the disorder and its causes, as well as to help family members recognize symptoms of a recurrence.
• Creative therapies (art therapy, music therapy) — These therapies allow the patient to explore and express his or her thoughts and feelings in a safe and creative way.

Is hypnosis a recognized treatment for dissociative disorders?

Clinical hypnosis is a treatment method that uses intense relaxation, concentration and focused attention to achieve an altered state of consciousness (awareness), allowing people to explore thoughts, feelings and memories they may have hidden from their conscious minds. Hypnosis may be used to help people better understand any underlying reasons for their thinking patterns and/or behavior—in order to change them—or to find out if past events are linked to current problems or disorders.

The very relaxed state achieved during hypnosis makes the person better able to respond to suggestion and imagery. In this way, hypnosis can help some people change certain behaviors, such as stopping smoking.

Some therapists recommend hypnosis as a treatment for dissociative disorders because it can help recover any repressed memories linked to the disorder. It also may be helpful for people whose symptoms are severe or who need crisis management. However, hypnosis also poses a risk of creating false memories—usually as a result of unintended suggestions by the therapist. For this reason, the use of hypnosis for dissociative disorders remains controversial.

What is the prognosis (outlook) for people with dissociative disorders?

The outlook for people with dissociative disorders varies. Dissociative amnesia and dissociative fugue often respond quickly to treatment. Depersonalization disorder and dissociative identity disorder tend to be chronic (ongoing) conditions that require many years of treatment. In most cases, however, treatment for dissociative disorders is generally effective.

Can dissociative disorders be prevented?

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Reviewed: 06/2007