Signs of a Dissociative Disorder

This list is not for diagnosis, but combines wisdom from multiple sources to help trauma therapists more quickly identify someone who may have a dissociative disorder. Click here to download a PDF of this handout.

  • Three or more prior diagnoses (esp. BPD, Bipolar, mood disorders)

  • Prior treatment failure

  • Concurrent psychiatric and somatic symptoms

  • A history of abuse as a child (esp. twisted, complex)

  • An inability to recall childhood events from the years 6 to 11

  • Severe headaches and other pain syndromes

  • Impaired affect regulation

  • Chronic destructive behavior

  • Easily learning coping skills in session, inability to use them outside

  • Distorted relationships with others

  • Loss of one's system of meaning.(i.e. losing one's core beliefs, values, religious faith, or hope in the world and other people - https://www.verywellmind.com)

  • Neglect in infancy

  • Physical unavailability of primary caregiver in the first 2 years of life

  • Childhood caregivers who were frightened or frightening

  • Fluctuating symptoms and levels of function

  • Time distortion, time lapses, or frank amnesia

  • Being told of disremembered behaviors

  • Others noting observable changes

  • The discovery of objects, productions, or handwriting in one’s possession that one cannot account for or recognize

  • Hearing voices (80% or more experienced as within the head) that are experienced as separate, often urging the patient toward some activity

  • The patient’s use of “we” in a collective sense and/or making self-referential statements in the third person

  • The eliciting of other entities through hypnosis or a drug-facilitated interview

  • Traumatic medical history or childhood hospitalizations/procedures

  • Refugee population

  • Ability to block out pain, high pain tolerance Indications of disorganized attachment

  • Client with lots of symptoms and report a history of a great childhood

  • Therapist feels “floaty”, inexplicably tired or confused when the client is present .

Items in bold are ones we can usually learn very early in treatment or during intake questions

Compiled from Van der Kolk, 2001, Kluft, 1999, Twombly, 2013

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