Tbh every time I brought it up it always baffled my therapists and we never felt we could be candid about the whole thing because of it. Thank you for posting this. It gives so many systems the help need to get the level of therapy they deserve.
I'm in that same seat now, idk how to bring up my "storyline and characters" to my therapist. Mainly because I've always pushed them off as that but I'm now starting to think I might have DID or OSDD 1-b. Especially with some of the chats we've had during and after school.
I moved on from my previous therapist which was a referral and did just get me to therapy. But she was not helpful for answers to why I was dissapearing for a couple of days at a time in reaction to dental appointments, seemingly random songs, movies at least quarterly This time I interviewed the therapists to explore to specifically getting some answers I don't care what's wrong I just want to be useful and as whole and happy as I can be now that I'm in a safe part of life, I am very happy with the new therapy person and style and am really making progress. I wish I had been ready to be vulnerable and move sooner..but it is what it is
The UK NHS are far behind of the game when it comes to recognising, or acknowledging C-PTSD, Dissociation and so-on. My experience is that despite repeated 15 one hour therapies which supposedly were to address my mental collapse, these disorders were not even entered onto my notes, or even discussed. This despite reporting a mountain of causation events and unknowingly at the time, describing the many symptoms of these disorders time and time again. I left the so-called healing talking therapies feeling un-changed, un-resolved and still fundamentally damaged and in ruin. Those experiences went on to further the sense of solitude and hopelessness.
Our closest clinic near us in the States is 4 hours away. We are a covert system, who've been in therapy off and on several years with only limited success, despite our host working very hard. Our wonderful current therapist of 3 years gave us the MID when things started happening that pointed to DID/OSDD. We also took the DES and then when results agreed with his suspicion, he began treating in consult with a couple of specialists. Too many therapists here also think DID/OSDD is bunk. Thank you for this info Dr. Mike. We wish there was more support and a greater knowledge about this where we live.
I know what I am about to type will be uncomfortable (NOT A TW) or whatever but I cannot NOt say this: Hopefully with a new President in the States we can see improved health care & more support for mental health. Please please please vote people/systems ... we need to get rid of this "person" - which I use sparingly - who would rather put his own needs over the peoples'. Ok- I'm done.
Thank you. Just remembered doing all these tests, as it was many years ago now. It does take a long time. With the tests DES and the SDQ and also the SCID-D, they all took a long time, but yes as you said it was a huge relief that it was not about my past traumas as that would have broken me as it is too much to deal with during that time. It is good that you are letting people know that as it can put people off getting diagnosed properly.
I have been having this ongoing storyline with a few characters in my head that has been going on for years. Because I know that I have extended childhood trauma, most of which I can't even remember, I'm thinking that I might have OSDD1-b, after doing a bit of research on different dissociative disorders stemming from my hearing about DID. How do I bring this up to my therapist without sounding... a bit weird. These characters and settings have been growing and evolving with me from childhood, I think about 10 - 11 is as far back as I remember but probably for longer, in fact I remember a few times that I was called by a different name than my own and I've had to correct myself when getting my name wrong. How do I bring this up to my therapist?
I was always questioning DID because I couldn't wrap my head around it when I was younger but now I maladaptive dream and create a reality in my room that's basically my safe space so DID makes a lot of sense to me
My last therapist ignored me and then eventually ghosted me without referring me to anyone else… It was pretty traumatic with my already pretty bad fear of dealing with doctors. It took me some time to even want to look for a new person But I just did an evaluation for a new therapist so hopefully I’m placed with someone who understands. that doctor really left me when I was in a bad place, why is it not possible to sue people for these kinds of things…
Do you know of any clinics like yours that specialize in dissociative disorders, in the United States? Also, thank you for sharing these things. There are psychologists on youtube who seem to have an obsession with debunking these disorders and maligning doctors who diagnose them. I really appreciate these fact-based videos about how the treatment process ACTUALLY works. I've already sent a couple of your videos to my own therapist, who hasn't worked with dissociative disorders but is doing an amazing job learning, talking to mentors, and working with me. This channel has had a big impact on my treatment already, so thank you!
DemolitionDevon thank you so much for passing the videos along, I am so glad they are helpful. Please get in touch with Bethany Brand’s organisation for assistance in finding the right support for you in the U.S.
Could you do a video (or series?) on how to support a dissociative person in different contexts? (Helpful strategies for parenting a system versus being married to one, employing a system or working with one, and the like?)
Yes, please. I would like you to also address how to BE a parent while dealing with complex PTSD and possibly DID/OSDD (not sure yet). Especially teenagers, who are supportive, but still can't fully understand. Mine know about the PTSD, but not the DID (yet). How/if to explain it to older teens would be appreciated. Thanks for your channel and all that you do to help people recover and live life fully.
Thank you for explaining the care that goes into ruling out other conditions and confirming DID. Several people on social media are saying that within the U.K., only a psychiatrist can officially diagnose DID. But perhaps this is incorrect since you, as a psychologist, diagnose DID? Maybe you can clear this up?
Ceridwen Taliesin Sure, in the UK, clinical psychologists are able to diagnose along with psychiatrists. The BPS has a position paper on it. Many psychologists specialise in specific fields (as do medical doctors) and establish competency to diagnose via CPD and experience. Psychologists, such as myself, offer diagnostic assessment by invitation of the NHS and court proceedings. I help train psychiatrists and psychologists in diagnosing dissociative disorders as I have working in this area for over 10 years.
@@thectadclinic I have always been told by councillors and GPs that only psychiatrists can diagnose. I've been fighting for years to get a diagnosis, to no avail. My life is in complete shambles already at age 34 and can't even have a job anymore, but I've given up on the NHS and I resent them for not helping me at all. Advice please?
My DES score was 71 🤦♀️ thats well functioning for me! It used to be so much worse and having gone thru a huge mess last year im pretty dang proud of how life is. Sort of
Thank you for shedding light on how dissociative disorders are diagnosed! It's crucial to raise awareness about these conditions and promote understanding. Your efforts contribute to destigmatizing mental health issues and helping individuals receive the proper care they deserve. Keep up the important work! #MentalHealthMatters #SupportAndAdvocacy
I had an angry agressice alter pop up in therapy session to be imediately replaced with a young boy alter and felt the switch like physically. still learning about it ty for this video
Very interesting video! It was nice to knock off the steps the clinic takes in comparison to my own very unexpected, and private, experience with a diagnosis many years ago. (Long story short - friend was having sessions with someone who also happened to be an expert in this field. Friend asked me to come for moral support. I'd been openly multiple (but not knowing it existed) for years, overt, and the expert noticed and asked if we could talk and ... yeah, some months later, after some strange chats I didn't even know were relevant but now recognise as assessments for the disorder, boom. Diagnosis. Uh, thanks for the diagnosis I didn't know I needed!) I enjoy how you talk about WHY the diagnosis takes a long time, even when directly referred to the clinic because of dissociation. It should give sceptics some reassurance that the diagnosis isn't thrown out with no basis, stuff like that. It'll also give people with symptoms reassurance that yeah, the process may be lengthy, but that doesn't mean it's going nowhere.
in the usa, we have to start with a licensed therapist go through a year or more of therapy then they tell your GP dr. to refer to psychology who also tries therapy first and then refers out for scid-D by a 3rd party. All of this is gatekept by insurance companies. Legally a therapist is not allowed to diagnose DID/OSDD (they can give provisional diagnosis only), only a psychologist can write it down on a piece of paper, but not all insurances agree and will stop a person from getting the referral. We're dealing with that right now. I (host) had a full conversation with the RN case manager for our insurance that lied and said our therapist didn't write down anything about DID. We had seen the notes ourselves so we know what was sent over. And that he didn't understand why a therapist wouldn't be allowed to diagnose. I was told I was lying and the therapist just didn't want to, but I could find with a 30 second search the actual law that prevents my therapist from giving a full diagnosis. In some rare cases if you get to a psychologist who happens to be like you and work with DID they can diagnose without the Scid-D based on what they see in session. Access to care is very limited and based entirely on economic status, insurance policy, and where you live. That's why we love your channel so much. It is resource for other american systems that don't have access to accurate help and even our therapist watches and has learned a lot. Even she has no access to experts in DID to help her learn how to help us because of state licencing laws. She cannot receive training or guidance from anyone outside of our state. The C19 changes opened up tellahealth and dropped the state boundaries so she's finally able to talk to another therapist that has DID clients. When she went through message boards half the USA drs. said this is real and read x books. The other half want to push for putting DID under schizophrenia. I'm not joking. We are in the dark ages of DID/OSDD research over here DSM aside.
Yes health care in this country is cave man shit. (Sorry). The level of knowledge required to truly fight for yourselves in the USA is criminal. Hopefully we are on the edge of changes that will make things a bit better. I did not search out a specific type of therapist because I did not know about it. But she is a PhD & has other colleagues & a psychiatrist within practice. Oh but she is a Trauma specialist so. Her 1st diagnosis I believe was CPTSD..
Its almost the same here in australia. You need to go to a dr (straight up 80$) who gives you a referral thats covered by about 40% i think? by the government (3 sessions and only if you're under the levy amount. If you earn over it you have to pay a fee with your taxes AND have private health insurance) for THERAPIST only (each session is between 200 and 500$). Then the therapist writes a letter to the dr saying nope, can't fix this, please refer to a psychiatrist. So you've gotta pay another 80$ to go see the gp again to get another referral...Then you have to pay the psychiatrist 500-900$ per 15minute appointment. Wait 3 months for said appointment and then play your cards to see if the pdoc even knows what DID is. Most don't. And most like you said- try to label you as schizophrenic and send you out the door with 55 scripts for antipsychotics always seroquel first. as well as antidepressants with sedating factors in them. I (host) spent over 4 grand between therapy and psychiatrists only to get a quack (who like yours, is the only one in the entire area, if i wanted a specialist i'd have to drive 14hrs to the state capital and see someone there- all out of pocket too.) That said, the best therapist i ever had were psychologists working in sexual health clinics in the assault department. Gave me free counselling for years and were highly trained in trauma and sexual abuse etc. (obviously lol, its their entire job lolol). Evey other 'counselor' or psychologist we've ever seen has had 0 idea what DID is but is more than happy to take the 300$ per 45 min session that no insurance or government will cover you for.
I'm a licensed clinician LPCC in the US and the first part of your post is not accurate. I'm wondering if there was confusion with the insurance company and the therapist?? Or perhaps it is a state issue. Either way, anyone who gets licensed (or has completed their degree and is working on their hours fort licensure) can make a diagnosis from the DSM 5. There are some diagnoses that require more training or a medical/psychiatric/psychological assessment, but DID/OSDD is not one of them. However, that being said, it does take someone with knowledge and training to make a proper diagnosis of DID/OSDD. As long as the therapist documents the steps taken for the diagnosis, they can make the diagnosis.
@@catinreno9797 each state has different regulations as to what license/certification educations can do what exactly.... something completely okay for you to do in California (example purposes only), are not necessarily the same as what you could do in the state of North Carolina, Arkansas, Montana, etc. Each states professional practice board governs differently and thats why if you move, you can't just start practicing immediately... deemed status is not freely issued based on past credentialing in another state.
The process is very much the same in australia, with the whole referral thing. Cept that here you have to pay for everything along the way and psychiatrists run about 500-1200$ per 15mins. lol. Mine scoffed when i mentioned the DSM and said "We don't use that here, we're australian and that's american". She also didn't mention the scid test either and shoved me out the door with a fist full of seroquel and said its not DID cos my alters don't spend my money behind my back and or have different friends than i did. I swear people like you Dr Mike, are a VERY rare find. There's a dissociative specialist ward at a hospital in my state but i've also been told from friends that have gone there, that the psychiatrists just diagnose you with schizophrenia and force you to take antipsychotics and or valium etc. i was gobsmacked...this is mental health treatment in australia tho. pills first, education on the dr's behalf is always last. Easier to drug the patient into submission i guess.
Wibble Wobble sadly, this is replicated here too, according to stories I have been told of people’s experience in the UK. Part of why I and colleagues are working to get things changed, and I am seeing change. Australia has some wonderful people pushing for greater awareness of dissociative conditions, so it is always sad hearing your account, and those similar.
is it possible that you could create a video addressing the types of hallucinations (audio and visual) that people with DID or ddos may have experience? Perhaps with examples? That seems to be misunderstood.
Thank you once again for this very informative video! In your clinical experience, it is unusual that some dissociative symptoms like identity confusion/alteration don´t show up in the screening and the interviews much or at all at the very beginning but start to appear after months in therapy when the therapeutic relationship starts to form and the feeling of not being safe is decreasing slowly?
Bug Bean That is exactly what can happen, so any diagnosis made initially is open to variation as more trust is developed and different aspects of the system may emerge. I think we have to always keep an open mind and be prepared that not everything can be seen and understood from what is essentially the limited time frame of an assessment.
Thank you so much for taking the time to do these videos! They're really informative and useful. I do have one question- when using the screening tools, would it be best if just one alter in the system answers? Or if all of them took it separately? We have used them before to give us more information about what was going on for us, but we noticed some differences in our perception when answering questions that might be relevant, like some alters were more amnesic of symptoms and of amnesia itself and so their answers would unintentionally downplay the effects of symptoms for us, but some alters are in a consistently heightened state of anxiety and seemed to have a much more catastrophic view of some symptoms and questions. This made it seem to me, like one wouldn't get an accurate balanced result if only one of us took it, but one possibly might from collating all of our responses together? Thanks for your time, I really appreciate it.
Ari At Last. Because it is a screening tool, any of the kind of responses you describe would likely indicate a sufficient level of dissociation to warrant further investigation. These tools are purely to give an idea of what is happening, a more thorough assessment would develop the kind of variation you experience.
Thank you because this is helpful in a calm way. Do you have more tips (I’ve found your other videos have them) for self help along the way of the journey towards recovery and healing for people who may be a long way into their journey? Things/ways a person can help themselves a lot? Thanks again!
I feel like I do have DID, I don’t know which type, but, I have been forgetting a lot about the past, and just recently. I was just sitting on the couch, now I’m in my bed, but I completely forgot about my personality and what I thought. I did have some mental trauma, and now I have like some problem where I think my personality change. A LOT. And it makes me very worried like somethings bad
DID Hatchery Of course, all these type of medications work to reduce effect, so dissociation would be no different to stress/depression/hearing voices etc.
I was diagnosis with Split Personality when I was about 22 and was told by the Navy doctor that they did not have the ability to help me. I could not understand where he came up with this diagnosis. I thought I was in the exam room in the ER for about 5 mins when I was actually in their about 2 hours. So I continued to search for what was wrong with me. At one point I was seeing a therapist, Sue Crommelin, who happens to be Paul Dell's wife. She told me I had Multiple personality and I need to give all my parts names. This frustrated me because "my parts" aren't totally separate from me. I decided to get psych testing done so I could find out what my diagnosis was. Paul Dell did my testing. He diagnosed me with Dissociative Identity Disorder. I thought this was a load of crap. After a couple of years of treatment with a different therapist at a practice that Paul Dell work at, I decided to get retested. He came up with the same diagnosis. I felt like all this people where pushing this diagnosis on me. Whenever they would talk about dissociation, the symptoms never sound like what I experience. The terms seem to be too technical and book worthy words. I learn by visualization. I am now with another therapist who is a traumologist. I asked her what could I read to understand what I am going through. She pointed me to 'Coping with Trauma-related Dissociation. That night I Googled the book and came across your videos. I watched several of them and when you describe DDNOS/OSDD I finally felt like someone does know what I experience. You describe it in a way of how the experience feels and what happens. I am now 59 years old and I am finally trying to be okay with it. It is very hard because I remember when the movie 'Sybil" came out and all the negativity that surrounded that movie. I remember that in 1990's all the talk about how this wasn't real, how a lot of people were faking (and a lot were). I was scared to tell anyone that I thought some of the experiences that was in the movie were some that I experience. I have spent the last 37 years refusing to believe I have DID. I am trying HARD to come to terms with this diagnosis. Part of me accepts it and wants to start working on it to get better. But, there is another part of me that feels like I am faking it. Can you describe to me, so I can visualize it, what it would look like or feel like if I was to be faking this?
If people with DID (which we know from experience and what we physically feel in body), not good with wording this sentence, sorry, so alternate personalities can all have different physiological ailments or differences like eye colour or diseases etc. so how can this be classed as just emotional? or are you saying about it generally? or have we mis understood? thanks still loving the education, awareness, information these bring! xx
Niamh Deborah Snowflake Coleman I meant taking away medical explanations for variance in identity, physical symptoms etc (like tumours, drug use, head injury etc). If there are physical differences as a result of dissociation (e.g. pain, paralysis) these would then be trauma based, I.e. the systems emotional (conversion) response to life event/experience.
I get how NHS operates basically ... COMPLETELY different in USA!! Anyone who thinks there may be an issue have to advocate for themslves- not easy!! Going into therapy is hit or miss. I spent at least 10 years of therapy with an excellent therapist who did not even suspect or wasn't up for the work? Don't have a clue (I think if asking her often). in the last year or 2 with her I went to therapy & got stuck in a silence that I could not break out of. So session after session of silence. It was torture.. & I still fear that place - yes it is still here. Working on it.. Just adding to the discussion of the phase that might lead to a diagnosis... as I have said before I was diagnosed @ 10 yrs ago @ 51 I think...
@@thectadclinic ok so maybe she wasn't so good!! 🙃 I sure wish that she was willing/able to pull me out ... at present tele-sessions can make it difficult for the therapist to actually know that I am there or going there. Especially since I can't talk when it happens. But I must admit to being very jealous of UK patients who have access to you & your staff. I'd put money on the fact that every American here will agree with me!!😊
So i just went to your web site & took your survey/questionnaire. I have one question of follow up.. I made reference to "the silence" i get stuck in..& you said that this never or should not/happen in your sessions. Here's the question.. is "the silence" a form of conversion issues? I get that about being mute/blind is conversion correct? (I have twin infants that are blind/mute- don't know too much more about them yet ) but isn't the silence a similar issue? I don't know if i am explaining it right ... (i see how this might be too detailed to respond appropriately so just say so. I can figure it out another way.) Thanks
Question: Can a CAT-scan / other similar brain imaging system be used to identify Dissociation as it is occurring? If so, what do the images look like of someone who is Diagnosed having DID vs. "The normal" brain? Taking it 1 step further.... is there any difference in brain scan images from someone who is DID vs someone who may be OSDD?
Ataya Seyhun There is amazing research in this area. Have a look at the work of Simone Reinders, publishing last year in the British Journal of Psychiatry, as she has progressed this area.
Friends System Not at all, as many therapies work on symptoms rather than diagnoses, but for NHS treatment and insurance provision it is often a requirement.
Do you take referrals from private counselors? I could really do with some clarity on what my PTSD is doing, I'm really confused about what I'm actually experiencing 😣
Do you ever use the MID 6.0? It has validity scales and is a great tool in the toolbox. I haven't been trained on the SCID-D, but would love to add that one to my toolbox. However, I'm not sure how necessary that is since I utilize the MID 6.0.
Cat inreno Not really, it is an extended self-report measure (and a very thorough one). I prefer the SCID-D as it involves spending all the assessment time with the person, so observation of response plays a large part in establishing diagnosis. It also allows whatever questions seem useful to be added as follow-ups to responses, and still remains highly structured.
@@thectadclinic Thank you for your reply. I will have to look into it some more. I like to be thorough, and make sure I'm giving quality care. I appreciate your channel and the work you do here!!
What would you say are the benefits of a diagnosis other than perhaps giving your therapist a leg up at the start to get them up to speed, or sharing with your workplace to help accommodate your needs (if they are understanding, of course, since this also comes with risks)? And what are the potential negatives? (E.g. do you need to disclose it at job interviews or for insurance purposes?) My UK therapist is trained in treating dissociative disorders but she can't diagnose officially. I originally went to her for another issue, but through building trust and exploring the issues more symptoms have been uncovered, and we are sure that I have a dissociative disorder (either OSDD1b or DID) and we are therefore following this treatment plan. As she is a qualified professional I am happy to trust her opinion on this and haven't sought official diagnosis because I feel that I am getting appropriate treatment and I therefore can't see any benefit in having the diagnosis on paper and on my record. It would be interesting to hear your thoughts, though, since you seem very positive about official diagnosis being the route to take.
Hannah Sharples Thanks for the question, Hannah. The diagnosis for our clinic is the gateway for treatment, so it is essential, but in many individual cases, treatment can progress without it being official if the person is not looking for a diagnosis in this format. An experienced therapist can treat dissociation, like they would other diagnoses such as anxiety or depression, I.e. on the basis of symptoms and impact. The main thing is that any treatment should be based on a thorough evaluation of what is going on for the individual.
@@thectadclinic Thanks for the reply! I'd been in therapy once a week for over a year with her before we began to tentatively discuss other parts and influence, and it was probably nearer two years before the disorder names popped up, when I started panicking about whether I needed to get diagnosed to rule out other disorders, like schizophrenia, and she very firmly told me that I was not psychotic, I was dissociative. That was a big relief!! I think the professionalism of getting a diagnosis can be very validating for the client as well as an inroad to therapy, but I'm pleased that my situation has worked out like this.
Please can I ask whether the current SCID-d diagnosis terms are going to be updated in line with the DSM 5? I am in the UK and was given the SCID-d assessment a couple of months ago. My diagnosis was:- "Dissociative Disorder Not Otherwise Specified (DDNOS), which covers cases that are similar to Dissociative Identity Disorder but that do not meet full criteria for this disorder. Examples include cases in which ‘there are not two or more distinct personality states’, or ‘amnesia for important personal information does not occur’". But I have since seen your videos that use the term OSDD Many thanks for your help
Bean Pole yes, Marlene is currently working on the update. Even so, we should be using DSM-V or ICD-11 diagnoses when using the older materials (which remain the gold standard), so the DDNOS category is no longer viable for new diagnoses, though many with this diagnosed before will still keep it.
International patients: you will receive an excellent assessment. But CTAD WILL absolutely give you this diagnosis, and you will not receive ANY referral/treatment assistance. Exactly what Dr. Llyod describes may happen: my dissociative symptoms/parts were clearly "seen" and described in a lovely report. And then, you are left alone with the aftermath. brutal, foks. brutal
Hi Jamy, we are very sorry you feel this way after such a successful assessment. A link was given to help find a therapist in your country as we cannot offer treatment locally as you asked for. It is very kind of you to be positive about the diagnostic process, even though receiving such information can be tremendously upsetting. Please get in touch to discuss this further.
Whenever something triggers me I lose all memory of what happened or the sparse memories don't feel like mine, like they didn't happen to me or I didn't do that which sucks considering I oftentimes do something horrible when I'm like that
I am slightly concerned about our own therapy... I am the host of a system that I am pretty certain is endogenic, but there are enough signs of a disorder, particularly OSDD-1b, that I want to be able to rule it out. But if my therapist isn't capable of evaluating for dissociative disorders, we might have a problem, as we do not trust my parents to help us find someone who could or even that that we are a system, and we do not trust our location to have any such specialists, especially for an affordable price.
@@thectadclinic We won't fit many of the symptoms as we probably have OSDD so I'm just wondering what to do. Our therapist totally shot us down and changed the subject every single time I brought it up. I've known her since I was 8. It's really sad.
@@wowitslena Yes, I don't understand why this would be happening with your therapist. OSDD is fully represented within the DES, so I would fill it out anyway and see.
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Tbh every time I brought it up it always baffled my therapists and we never felt we could be candid about the whole thing because of it.
Thank you for posting this. It gives so many systems the help need to get the level of therapy they deserve.
I'm in that same seat now, idk how to bring up my "storyline and characters" to my therapist. Mainly because I've always pushed them off as that but I'm now starting to think I might have DID or OSDD 1-b. Especially with some of the chats we've had during and after school.
I moved on from my previous therapist which was a referral and did just get me to therapy. But she was not helpful for answers to why I was dissapearing for a couple of days at a time in reaction to dental appointments, seemingly random songs, movies at least quarterly
This time I interviewed the therapists to explore to specifically getting some answers I don't care what's wrong I just want to be useful and as whole and happy as I can be now that I'm in a safe part of life,
I am very happy with the new therapy person and style and am really making progress.
I wish I had been ready to be vulnerable and move sooner..but it is what it is
The UK NHS are far behind of the game when it comes to recognising, or acknowledging C-PTSD, Dissociation and so-on. My experience is that despite repeated 15 one hour therapies which supposedly were to address my mental collapse, these disorders were not even entered onto my notes, or even discussed. This despite reporting a mountain of causation events and unknowingly at the time, describing the many symptoms of these disorders time and time again.
I left the so-called healing talking therapies feeling un-changed, un-resolved and still fundamentally damaged and in ruin. Those experiences went on to further the sense of solitude and hopelessness.
Same here! I'm done with the nhs, I resent their ignorance to my pleads for help.
Is Elizabeth Lofthus known about out there?
Having been diagnosed in this way, this RUclips video is very accurate and a good account of the process.
Our closest clinic near us in the States is 4 hours away. We are a covert system, who've been in therapy off and on several years with only limited success, despite our host working very hard. Our wonderful current therapist of 3 years gave us the MID when things started happening that pointed to DID/OSDD. We also took the DES and then when results agreed with his suspicion, he began treating in consult with a couple of specialists. Too many therapists here also think DID/OSDD is bunk.
Thank you for this info Dr. Mike. We wish there was more support and a greater knowledge about this where we live.
I know what I am about to type will be uncomfortable (NOT A TW) or whatever but I cannot NOt say this:
Hopefully with a new President in the States we can see improved health care & more support for mental health. Please please please vote people/systems ... we need to get rid of this "person" - which I use sparingly - who would rather put his own needs over the peoples'. Ok- I'm done.
As a teen, I was supposed to see a specialist and get diagnosis but my parents decided not to because it was too expensive.
@@Em_Elizabeth that's so sad. You deserved assessment, treatment, consideration, understanding 💕
Thank you. Just remembered doing all these tests, as it was many years ago now. It does take a long time. With the tests DES and the SDQ and also the SCID-D, they all took a long time, but yes as you said it was a huge relief that it was not about my past traumas as that would have broken me as it is too much to deal with during that time. It is good that you are letting people know that as it can put people off getting diagnosed properly.
I have been having this ongoing storyline with a few characters in my head that has been going on for years. Because I know that I have extended childhood trauma, most of which I can't even remember, I'm thinking that I might have OSDD1-b, after doing a bit of research on different dissociative disorders stemming from my hearing about DID. How do I bring this up to my therapist without sounding... a bit weird. These characters and settings have been growing and evolving with me from childhood, I think about 10 - 11 is as far back as I remember but probably for longer, in fact I remember a few times that I was called by a different name than my own and I've had to correct myself when getting my name wrong. How do I bring this up to my therapist?
crystal kirlia Perhaps exactly how you have done here?
Same
have you heard of maladaptive daydreaming disorder? If its not osdd, it could be that
i've been experiencing the same things and my therapist diagnosed me with it
I do this too.
I was always questioning DID because I couldn't wrap my head around it when I was younger but now I maladaptive dream and create a reality in my room that's basically my safe space so DID makes a lot of sense to me
My last therapist ignored me and then eventually ghosted me without referring me to anyone else…
It was pretty traumatic with my already pretty bad fear of dealing with doctors.
It took me some time to even want to look for a new person
But I just did an evaluation for a new therapist so hopefully I’m placed with someone who understands.
that doctor really left me when I was in a bad place, why is it not possible to sue people for these kinds of things…
Do you know of any clinics like yours that specialize in dissociative disorders, in the United States? Also, thank you for sharing these things. There are psychologists on youtube who seem to have an obsession with debunking these disorders and maligning doctors who diagnose them. I really appreciate these fact-based videos about how the treatment process ACTUALLY works. I've already sent a couple of your videos to my own therapist, who hasn't worked with dissociative disorders but is doing an amazing job learning, talking to mentors, and working with me. This channel has had a big impact on my treatment already, so thank you!
DemolitionDevon thank you so much for passing the videos along, I am so glad they are helpful. Please get in touch with Bethany Brand’s organisation for assistance in finding the right support for you in the U.S.
@@thectadclinic Thank you so much!
any in toronto?
ISSTD
Could you do a video (or series?) on how to support a dissociative person in different contexts? (Helpful strategies for parenting a system versus being married to one, employing a system or working with one, and the like?)
Yes, please. I would like you to also address how to BE a parent while dealing with complex PTSD and possibly DID/OSDD (not sure yet). Especially teenagers, who are supportive, but still can't fully understand. Mine know about the PTSD, but not the DID (yet). How/if to explain it to older teens would be appreciated. Thanks for your channel and all that you do to help people recover and live life fully.
you take care of yourself too!
Thank you for explaining the care that goes into ruling out other conditions and confirming DID. Several people on social media are saying that within the U.K., only a psychiatrist can officially diagnose DID. But perhaps this is incorrect since you, as a psychologist, diagnose DID? Maybe you can clear this up?
Ceridwen Taliesin Sure, in the UK, clinical psychologists are able to diagnose along with psychiatrists. The BPS has a position paper on it. Many psychologists specialise in specific fields (as do medical doctors) and establish competency to diagnose via CPD and experience. Psychologists, such as myself, offer diagnostic assessment by invitation of the NHS and court proceedings. I help train psychiatrists and psychologists in diagnosing dissociative disorders as I have working in this area for over 10 years.
@@thectadclinic I have always been told by councillors and GPs that only psychiatrists can diagnose. I've been fighting for years to get a diagnosis, to no avail. My life is in complete shambles already at age 34 and can't even have a job anymore, but I've given up on the NHS and I resent them for not helping me at all. Advice please?
@@magusl9628 it isn’t true that only psychiatrists diagnose, others can with the correct training and competency.
@@thectadclinic and how can I get some help?
My DES score was 71 🤦♀️ thats well functioning for me! It used to be so much worse and having gone thru a huge mess last year im pretty dang proud of how life is. Sort of
Thank you for shedding light on how dissociative disorders are diagnosed! It's crucial to raise awareness about these conditions and promote understanding. Your efforts contribute to destigmatizing mental health issues and helping individuals receive the proper care they deserve. Keep up the important work! #MentalHealthMatters #SupportAndAdvocacy
I had an angry agressice alter pop up in therapy session to be imediately replaced with a young boy alter and felt the switch like physically.
still learning about it ty for this video
Very interesting video! It was nice to knock off the steps the clinic takes in comparison to my own very unexpected, and private, experience with a diagnosis many years ago. (Long story short - friend was having sessions with someone who also happened to be an expert in this field. Friend asked me to come for moral support. I'd been openly multiple (but not knowing it existed) for years, overt, and the expert noticed and asked if we could talk and ... yeah, some months later, after some strange chats I didn't even know were relevant but now recognise as assessments for the disorder, boom. Diagnosis. Uh, thanks for the diagnosis I didn't know I needed!)
I enjoy how you talk about WHY the diagnosis takes a long time, even when directly referred to the clinic because of dissociation. It should give sceptics some reassurance that the diagnosis isn't thrown out with no basis, stuff like that. It'll also give people with symptoms reassurance that yeah, the process may be lengthy, but that doesn't mean it's going nowhere.
in the usa, we have to start with a licensed therapist go through a year or more of therapy then they tell your GP dr. to refer to psychology who also tries therapy first and then refers out for scid-D by a 3rd party. All of this is gatekept by insurance companies. Legally a therapist is not allowed to diagnose DID/OSDD (they can give provisional diagnosis only), only a psychologist can write it down on a piece of paper, but not all insurances agree and will stop a person from getting the referral. We're dealing with that right now. I (host) had a full conversation with the RN case manager for our insurance that lied and said our therapist didn't write down anything about DID. We had seen the notes ourselves so we know what was sent over. And that he didn't understand why a therapist wouldn't be allowed to diagnose. I was told I was lying and the therapist just didn't want to, but I could find with a 30 second search the actual law that prevents my therapist from giving a full diagnosis. In some rare cases if you get to a psychologist who happens to be like you and work with DID they can diagnose without the Scid-D based on what they see in session. Access to care is very limited and based entirely on economic status, insurance policy, and where you live. That's why we love your channel so much. It is resource for other american systems that don't have access to accurate help and even our therapist watches and has learned a lot. Even she has no access to experts in DID to help her learn how to help us because of state licencing laws. She cannot receive training or guidance from anyone outside of our state. The C19 changes opened up tellahealth and dropped the state boundaries so she's finally able to talk to another therapist that has DID clients. When she went through message boards half the USA drs. said this is real and read x books. The other half want to push for putting DID under schizophrenia. I'm not joking. We are in the dark ages of DID/OSDD research over here DSM aside.
Yes health care in this country is cave man shit. (Sorry). The level of knowledge required to truly fight for yourselves in the USA is criminal. Hopefully we are on the edge of changes that will make things a bit better.
I did not search out a specific type of therapist because I did not know about it. But she is a PhD & has other colleagues & a psychiatrist within practice. Oh but she is a Trauma specialist so. Her 1st diagnosis I believe was CPTSD..
Its almost the same here in australia. You need to go to a dr (straight up 80$) who gives you a referral thats covered by about 40% i think? by the government (3 sessions and only if you're under the levy amount. If you earn over it you have to pay a fee with your taxes AND have private health insurance) for THERAPIST only (each session is between 200 and 500$). Then the therapist writes a letter to the dr saying nope, can't fix this, please refer to a psychiatrist. So you've gotta pay another 80$ to go see the gp again to get another referral...Then you have to pay the psychiatrist 500-900$ per 15minute appointment. Wait 3 months for said appointment and then play your cards to see if the pdoc even knows what DID is. Most don't. And most like you said- try to label you as schizophrenic and send you out the door with 55 scripts for antipsychotics always seroquel first. as well as antidepressants with sedating factors in them. I (host) spent over 4 grand between therapy and psychiatrists only to get a quack (who like yours, is the only one in the entire area, if i wanted a specialist i'd have to drive 14hrs to the state capital and see someone there- all out of pocket too.)
That said, the best therapist i ever had were psychologists working in sexual health clinics in the assault department. Gave me free counselling for years and were highly trained in trauma and sexual abuse etc. (obviously lol, its their entire job lolol). Evey other 'counselor' or psychologist we've ever seen has had 0 idea what DID is but is more than happy to take the 300$ per 45 min session that no insurance or government will cover you for.
You could recommend the ISSTD to your therapist. :)
I'm a licensed clinician LPCC in the US and the first part of your post is not accurate. I'm wondering if there was confusion with the insurance company and the therapist?? Or perhaps it is a state issue. Either way, anyone who gets licensed (or has completed their degree and is working on their hours fort licensure) can make a diagnosis from the DSM 5. There are some diagnoses that require more training or a medical/psychiatric/psychological assessment, but DID/OSDD is not one of them. However, that being said, it does take someone with knowledge and training to make a proper diagnosis of DID/OSDD. As long as the therapist documents the steps taken for the diagnosis, they can make the diagnosis.
@@catinreno9797 each state has different regulations as to what license/certification educations can do what exactly.... something completely okay for you to do in California (example purposes only), are not necessarily the same as what you could do in the state of North Carolina, Arkansas, Montana, etc.
Each states professional practice board governs differently and thats why if you move, you can't just start practicing immediately... deemed status is not freely issued based on past credentialing in another state.
The process is very much the same in australia, with the whole referral thing. Cept that here you have to pay for everything along the way and psychiatrists run about 500-1200$ per 15mins. lol. Mine scoffed when i mentioned the DSM and said "We don't use that here, we're australian and that's american". She also didn't mention the scid test either and shoved me out the door with a fist full of seroquel and said its not DID cos my alters don't spend my money behind my back and or have different friends than i did. I swear people like you Dr Mike, are a VERY rare find. There's a dissociative specialist ward at a hospital in my state but i've also been told from friends that have gone there, that the psychiatrists just diagnose you with schizophrenia and force you to take antipsychotics and or valium etc. i was gobsmacked...this is mental health treatment in australia tho. pills first, education on the dr's behalf is always last. Easier to drug the patient into submission i guess.
Wibble Wobble sadly, this is replicated here too, according to stories I have been told of people’s experience in the UK. Part of why I and colleagues are working to get things changed, and I am seeing change. Australia has some wonderful people pushing for greater awareness of dissociative conditions, so it is always sad hearing your account, and those similar.
What state are you in? I'm from Australia also.
Thank you for explaining all this my mom is trying to get me tested so
is it possible that you could create a video addressing the types of hallucinations (audio and visual) that people with DID or ddos may have experience? Perhaps with examples? That seems to be misunderstood.
Thank you once again for this very informative video! In your clinical experience, it is unusual that some dissociative symptoms like identity confusion/alteration don´t show up in the screening and the interviews much or at all at the very beginning but start to appear after months in therapy when the therapeutic relationship starts to form and the feeling of not being safe is decreasing slowly?
Bug Bean That is exactly what can happen, so any diagnosis made initially is open to variation as more trust is developed and different aspects of the system may emerge. I think we have to always keep an open mind and be prepared that not everything can be seen and understood from what is essentially the limited time frame of an assessment.
Thank you so much for taking the time to do these videos! They're really informative and useful.
I do have one question- when using the screening tools, would it be best if just one alter in the system answers? Or if all of them took it separately?
We have used them before to give us more information about what was going on for us, but we noticed some differences in our perception when answering questions that might be relevant, like some alters were more amnesic of symptoms and of amnesia itself and so their answers would unintentionally downplay the effects of symptoms for us, but some alters are in a consistently heightened state of anxiety and seemed to have a much more catastrophic view of some symptoms and questions. This made it seem to me, like one wouldn't get an accurate balanced result if only one of us took it, but one possibly might from collating all of our responses together?
Thanks for your time, I really appreciate it.
Ari At Last. Because it is a screening tool, any of the kind of responses you describe would likely indicate a sufficient level of dissociation to warrant further investigation. These tools are purely to give an idea of what is happening, a more thorough assessment would develop the kind of variation you experience.
@@thectadclinic Thank you for your reply- that makes sense and I appreciate you taking the time to clear up my query.
Thank you because this is helpful in a calm way. Do you have more tips (I’ve found your other videos have them) for self help along the way of the journey towards recovery and healing for people who may be a long way into their journey? Things/ways a person can help themselves a lot? Thanks again!
Amanda Dales I will look into this, cheers, Amanda!
The CTAD Clinic thanks very much!
we need DID awareness
I feel like I do have DID, I don’t know which type, but, I have been forgetting a lot about the past, and just recently. I was just sitting on the couch, now I’m in my bed, but I completely forgot about my personality and what I thought. I did have some mental trauma, and now I have like some problem where I think my personality change. A LOT. And it makes me very worried like somethings bad
Another informative video. 😊 Thank you. Can medications mask DID symptoms?
DID Hatchery Of course, all these type of medications work to reduce effect, so dissociation would be no different to stress/depression/hearing voices etc.
I was diagnosis with Split Personality when I was about 22 and was told by the Navy doctor that they did not have the ability to help me. I could not understand where he came up with this diagnosis. I thought I was in the exam room in the ER for about 5 mins when I was actually in their about 2 hours. So I continued to search for what was wrong with me. At one point I was seeing a therapist, Sue Crommelin, who happens to be Paul Dell's wife. She told me I had Multiple personality and I need to give all my parts names. This frustrated me because "my parts" aren't totally separate from me. I decided to get psych testing done so I could find out what my diagnosis was. Paul Dell did my testing. He diagnosed me with Dissociative Identity Disorder. I thought this was a load of crap. After a couple of years of treatment with a different therapist at a practice that Paul Dell work at, I decided to get retested. He came up with the same diagnosis. I felt like all this people where pushing this diagnosis on me. Whenever they would talk about dissociation, the symptoms never sound like what I experience. The terms seem to be too technical and book worthy words. I learn by visualization. I am now with another therapist who is a traumologist. I asked her what could I read to understand what I am going through. She pointed me to 'Coping with Trauma-related Dissociation. That night I Googled the book and came across your videos. I watched several of them and when you describe DDNOS/OSDD I finally felt like someone does know what I experience. You describe it in a way of how the experience feels and what happens. I am now 59 years old and I am finally trying to be okay with it. It is very hard because I remember when the movie 'Sybil" came out and all the negativity that surrounded that movie. I remember that in 1990's all the talk about how this wasn't real, how a lot of people were faking (and a lot were). I was scared to tell anyone that I thought some of the experiences that was in the movie were some that I experience. I have spent the last 37 years refusing to believe I have DID. I am trying HARD to come to terms with this diagnosis. Part of me accepts it and wants to start working on it to get better. But, there is another part of me that feels like I am faking it. Can you describe to me, so I can visualize it, what it would look like or feel like if I was to be faking this?
If people with DID (which we know from experience and what we physically feel in body), not good with wording this sentence, sorry, so alternate personalities can all have different physiological ailments or differences like eye colour or diseases etc. so how can this be classed as just emotional? or are you saying about it generally? or have we mis understood? thanks still loving the education, awareness, information these bring! xx
Niamh Deborah Snowflake Coleman I meant taking away medical explanations for variance in identity, physical symptoms etc (like tumours, drug use, head injury etc). If there are physical differences as a result of dissociation (e.g. pain, paralysis) these would then be trauma based, I.e. the systems emotional (conversion) response to life event/experience.
Can we get financial support to cover the costs?
god bless you. thank you
I get how NHS operates basically ... COMPLETELY different in USA!! Anyone who thinks there may be an issue have to advocate for themslves- not easy!! Going into therapy is hit or miss. I spent at least 10 years of therapy with an excellent therapist who did not even suspect or wasn't up for the work? Don't have a clue (I think if asking her often). in the last year or 2 with her I went to therapy & got stuck in a silence that I could not break out of. So session after session of silence. It was torture.. & I still fear that place - yes it is still here. Working on it..
Just adding to the discussion of the phase that might lead to a diagnosis... as I have said before I was diagnosed @ 10 yrs ago @ 51 I think...
Rian I don’t think any person working in therapy with me has had a silent session!
@@thectadclinic ok so maybe she wasn't so good!! 🙃 I sure wish that she was willing/able to pull me out ... at present tele-sessions can make it difficult for the therapist to actually know that I am there or going there. Especially since I can't talk when it happens. But I must admit to being very jealous of UK patients who have access to you & your staff. I'd put money on the fact that every American here will agree with me!!😊
So i just went to your web site & took your survey/questionnaire. I have one question of follow up.. I made reference to "the silence" i get stuck in..& you said that this never or should not/happen in your sessions.
Here's the question.. is "the silence" a form of conversion issues? I get that about being mute/blind is conversion correct? (I have twin infants that are blind/mute- don't know too much more about them yet ) but isn't the silence a similar issue? I don't know if i am explaining it right ... (i see how this might be too detailed to respond appropriately so just say so. I can figure it out another way.) Thanks
Question:
Can a CAT-scan / other similar brain imaging system be used to identify Dissociation as it is occurring?
If so, what do the images look like of someone who is Diagnosed having DID vs. "The normal" brain?
Taking it 1 step further.... is there any difference in brain scan images from someone who is DID vs someone who may be OSDD?
Ataya Seyhun There is amazing research in this area. Have a look at the work of Simone Reinders, publishing last year in the British Journal of Psychiatry, as she has progressed this area.
@@thectadclinic thank you so much for this info; I will definitely go have a look!
Hello, and thank you for this video ❤️ Is there any such place or dedicated professionals on this topics that you know of in Belgium ?
How does a person answer those two scales?
Is it necessary to be dx in order to have tx? What is the advantages and disadvantages of it? Thank you again! :)
Friends System Not at all, as many therapies work on symptoms rather than diagnoses, but for NHS treatment and insurance provision it is often a requirement.
Thank you! 😊 we love your videos!
Do you take referrals from private counselors?
I could really do with some clarity on what my PTSD is doing, I'm really confused about what I'm actually experiencing 😣
Your friendly neighbourhood nobody Our referral system is explained over at www.ctadclinic.co.uk
Do you ever use the MID 6.0? It has validity scales and is a great tool in the toolbox. I haven't been trained on the SCID-D, but would love to add that one to my toolbox. However, I'm not sure how necessary that is since I utilize the MID 6.0.
Cat inreno Not really, it is an extended self-report measure (and a very thorough one). I prefer the SCID-D as it involves spending all the assessment time with the person, so observation of response plays a large part in establishing diagnosis. It also allows whatever questions seem useful to be added as follow-ups to responses, and still remains highly structured.
@@thectadclinic Thank you for your reply. I will have to look into it some more. I like to be thorough, and make sure I'm giving quality care. I appreciate your channel and the work you do here!!
What would you say are the benefits of a diagnosis other than perhaps giving your therapist a leg up at the start to get them up to speed, or sharing with your workplace to help accommodate your needs (if they are understanding, of course, since this also comes with risks)? And what are the potential negatives? (E.g. do you need to disclose it at job interviews or for insurance purposes?) My UK therapist is trained in treating dissociative disorders but she can't diagnose officially. I originally went to her for another issue, but through building trust and exploring the issues more symptoms have been uncovered, and we are sure that I have a dissociative disorder (either OSDD1b or DID) and we are therefore following this treatment plan. As she is a qualified professional I am happy to trust her opinion on this and haven't sought official diagnosis because I feel that I am getting appropriate treatment and I therefore can't see any benefit in having the diagnosis on paper and on my record.
It would be interesting to hear your thoughts, though, since you seem very positive about official diagnosis being the route to take.
Hannah Sharples Thanks for the question, Hannah. The diagnosis for our clinic is the gateway for treatment, so it is essential, but in many individual cases, treatment can progress without it being official if the person is not looking for a diagnosis in this format. An experienced therapist can treat dissociation, like they would other diagnoses such as anxiety or depression, I.e. on the basis of symptoms and impact. The main thing is that any treatment should be based on a thorough evaluation of what is going on for the individual.
@@thectadclinic Thanks for the reply! I'd been in therapy once a week for over a year with her before we began to tentatively discuss other parts and influence, and it was probably nearer two years before the disorder names popped up, when I started panicking about whether I needed to get diagnosed to rule out other disorders, like schizophrenia, and she very firmly told me that I was not psychotic, I was dissociative. That was a big relief!! I think the professionalism of getting a diagnosis can be very validating for the client as well as an inroad to therapy, but I'm pleased that my situation has worked out like this.
Please can I ask whether the current SCID-d diagnosis terms are going to be updated in line with the DSM 5?
I am in the UK and was given the SCID-d assessment a couple of months ago.
My diagnosis was:-
"Dissociative Disorder Not Otherwise Specified (DDNOS), which covers cases that are similar to Dissociative Identity Disorder but that do not meet full criteria for this disorder. Examples include cases in which ‘there are not two or more distinct personality states’, or ‘amnesia for important personal information does not occur’".
But I have since seen your videos that use the term OSDD
Many thanks for your help
Bean Pole yes, Marlene is currently working on the update. Even so, we should be using DSM-V or ICD-11 diagnoses when using the older materials (which remain the gold standard), so the DDNOS category is no longer viable for new diagnoses, though many with this diagnosed before will still keep it.
Have realized over the years I have missing gals of time..have had random times when memory comes back but so much missing information ...
International patients: you will receive an excellent assessment. But CTAD WILL absolutely give you this diagnosis, and you will not receive ANY referral/treatment assistance. Exactly what Dr. Llyod describes may happen: my dissociative symptoms/parts were clearly "seen" and described in a lovely report. And then, you are left alone with the aftermath. brutal, foks. brutal
Hi Jamy, we are very sorry you feel this way after such a successful assessment. A link was given to help find a therapist in your country as we cannot offer treatment locally as you asked for. It is very kind of you to be positive about the diagnostic process, even though receiving such information can be tremendously upsetting. Please get in touch to discuss this further.
Hello, may I ask, how rare is it to have violent 'alters'?
Whenever something triggers me I lose all memory of what happened or the sparse memories don't feel like mine, like they didn't happen to me or I didn't do that which sucks considering I oftentimes do something horrible when I'm like that
any resources in Toronto?
marz e I am sure there will be, but can’t help you directly, sorry.
I am slightly concerned about our own therapy... I am the host of a system that I am pretty certain is endogenic, but there are enough signs of a disorder, particularly OSDD-1b, that I want to be able to rule it out. But if my therapist isn't capable of evaluating for dissociative disorders, we might have a problem, as we do not trust my parents to help us find someone who could or even that that we are a system, and we do not trust our location to have any such specialists, especially for an affordable price.
Myststorm you could start with a screening tool for dissociation, like the DES, this could give an indication of possible dissociation present.
@@thectadclinic Thank you.
I wish I could get diagnosed. Nobody believes me and my therapist just beats around the bush and ignores it.
Hi Lena, could you complete the DES and take it to therapy to open up the conversation using this, if scoring high?
@@thectadclinic We won't fit many of the symptoms as we probably have OSDD so I'm just wondering what to do. Our therapist totally shot us down and changed the subject every single time I brought it up. I've known her since I was 8. It's really sad.
@@wowitslena Yes, I don't understand why this would be happening with your therapist. OSDD is fully represented within the DES, so I would fill it out anyway and see.
@@thectadclinic Do you think you could provide a link to the DES?
It’s on the website!