Dissociative Disorders Therapy and Counseling in Michigan

Home » Dissociative Disorders Therapy and Counseling in Michigan

What dissociation really is (and why it can be hard to describe)

Dissociation is a disruption in the usual integration of consciousness, memory, identity, emotion, perception, body awareness, and behavior. Some people experience dissociation as feeling foggy or numb; others describe it as watching themselves from the outside, feeling as if the world isn’t real, or discovering gaps in memory that can’t be explained by ordinary forgetfulness. Dissociation exists on a spectrum—many people briefly “zone out” when stressed—but dissociative disorders are different because the pattern is persistent, distressing, and interferes with life, relationships, or safety.

Dissociative symptoms can be confusing because they may come and go, intensify under stress, or overlap with anxiety, depression, PTSD, panic, sleep problems, substance use, or medical concerns. A careful clinical evaluation helps separate what’s happening and creates a treatment plan that fits the person—not just the diagnosis.

Common types of dissociative disorders and how they may show up

Depersonalization/derealization experiences

Depersonalization can feel like being detached from your body or emotions—like you’re on autopilot or watching yourself in a movie. Derealization can involve the outside world feeling unreal, distant, or dreamlike. Many people still know intellectually that something is “off,” which can be frightening and can trigger more anxiety. Therapy often focuses on grounding, stress regulation, and addressing underlying trauma or chronic overwhelm.

Dissociative amnesia (with or without “fugue”)

Dissociative amnesia involves gaps in memory that are inconsistent with normal forgetting—often related to distressing or traumatic periods. In some cases, people may travel or wander in a confused state and later have limited recall of how they got there. Because medical issues, seizures, head injury, substance effects, and certain sleep disorders can also affect memory, competent assessment is essential.

Dissociative identity presentations

Some individuals experience significant identity fragmentation or distinct self-states that may have their own perspectives, emotions, and ways of coping. This can include finding evidence of actions they don’t recall, feeling like “different parts” take over under stress, or experiencing internal conflict that feels bigger than ordinary mood shifts. Ethical, evidence-informed therapy prioritizes safety, stabilization, and integration of experience over time—without sensationalizing symptoms.

Signs and symptoms across different stages of life

In children and adolescents

Kids and teens can dissociate differently than adults, and their symptoms are sometimes mistaken for defiance, attention problems, or “drama.” Children may not have words for what’s happening, so dissociation often shows up in behavior, play, and relationships. Signs can include:

Frequent “spacing out” or staring spells, especially during conflict or transitions
Sudden shifts in mood or behavior that seem disproportionate or “out of character”
Memory gaps for events, schoolwork, or conversations; inconsistent recall
Regression (acting younger than their age) under stress
High startle response, sleep disruption, nightmares, or fear of being alone
Somatic complaints (headaches, stomachaches) without clear medical explanation
Intense shame, self-criticism, or “I don’t feel real” statements
Disorganized attachment behaviors—clinging and pushing away, mistrust, or fearfulness with caregivers

For caregivers, it can be heartbreaking to watch a child disconnect. A helpful framing is that dissociation is often a protective strategy: when a child doesn’t have enough support, safety, or emotional language, the nervous system finds a way to endure.

In adults

Adults may report symptoms more directly, but many still minimize them due to embarrassment or fear of being misunderstood. Adult signs can include:

Time loss (hours or days that are hard to account for)
Feeling unreal, numb, or emotionally distant from loved ones
Confusion about identity, values, or preferences that fluctuates with stress
Difficulty accessing memories of childhood or specific periods
Intrusive trauma memories alongside “blank spots,” emotional flooding, or shutdown
Relationship instability driven by fear, mistrust, or sudden shifts in closeness
Self-harm urges or risky behavior during dissociative states
Functional impairment at work, school, or parenting due to concentration problems and fatigue

It’s also common for adults to be misdiagnosed or treated only for surface symptoms (like panic or insomnia) without addressing dissociation. With the right clinician, it’s possible to name the pattern, reduce fear, and build a steadier relationship with your mind and body.

Why dissociative symptoms often intensify under stress

Dissociation is frequently triggered by a sense of threat—external or internal. Conflict, criticism, intimacy, sensory overload, sleep deprivation, anniversaries of traumatic events, or even positive life changes can activate survival responses. When the nervous system detects danger and doesn’t have enough capacity to process it, it may move into:

Hyperarousal (anxiety, agitation, panic, racing thoughts)
Hypoarousal (numbing, shutdown, “freeze,” feeling absent)
Mixed states (agitated numbness, impulsive disconnection, feeling trapped)

Therapy helps people identify early cues, track patterns, and practice skills that keep the system within a tolerable “window” where thinking, feeling, and connecting remain possible.

How clinicians assess dissociative disorders with care and precision

A responsible evaluation is thorough, paced, and respectful. Many people with dissociation have had experiences where they were dismissed, blamed, or misunderstood. A licensed clinician may explore symptom history, trauma exposure, medical factors, sleep, substance use, and family context. They also look closely at risk, including self-harm, suicidality, and safety during time loss.

Depending on needs, assessment can include:

Structured clinical interviews for dissociation and trauma-related symptoms
Psychological testing when clarity is needed around attention, memory, personality patterns, or differential diagnosis
Screeners and symptom measures to track dissociation, anxiety, depression, and functioning over time
Collaboration with medical providers to rule out neurological or medication-related contributors when indicated

Good assessment doesn’t rush to label. It aims to understand the function of dissociation in your life so treatment targets the right mechanisms.

Therapy that helps: evidence-based and trauma-informed approaches

Effective treatment typically follows a phase-based, skills-forward approach: build safety and stabilization first, then process unresolved traumatic material when appropriate, and finally strengthen integration, identity cohesion, and relational functioning. The pace matters. Too much too soon can increase dissociation; too little structure can leave people stuck. Skilled therapy finds a middle path.

CBT-informed strategies (for triggers, beliefs, and coping)

While standard CBT alone may not resolve complex dissociation, CBT-informed work can be powerful when adapted for trauma and dissociation. It may focus on:

Identifying dissociative triggers and early warning signs
Challenging catastrophic interpretations (e.g., “I’m going crazy”) with accurate psychoeducation
Behavioral routines that stabilize sleep, nutrition, and daily structure
Skills for grounding and present-moment orientation

For teens, CBT strategies often include caregiver involvement to support routines and reduce environmental stressors that amplify symptoms.

DBT skills (for emotion regulation and safety)

Dialectical Behavior Therapy (DBT) skills are frequently helpful, especially when dissociation occurs alongside intense emotions, self-harm urges, or relationship instability. DBT can support:

Distress tolerance without dissociating or escalating
Mindfulness that is carefully adapted so it doesn’t become triggering
Emotion regulation to reduce rapid shifts and emotional flooding
Interpersonal effectiveness to navigate conflict, boundaries, and repair

Many clinicians integrate DBT skills into trauma treatment even if the full DBT program isn’t required.

Trauma-focused therapies (used thoughtfully)

Trauma therapies can be effective when dissociation is stabilized and the person has reliable coping strategies. Options may include trauma-focused CBT for youth, EMDR with modifications for dissociation, or other evidence-based trauma processing methods. In dissociative disorders, the clinician often prioritizes:

Resourcing and grounding before memory work
Titration (approaching trauma in small, manageable pieces)
Dual awareness (staying connected to the present while touching the past)
Parts-informed work that reduces internal conflict and increases cooperation

The goal is not to force recall or relive details. It’s to reduce the power of traumatic material over the nervous system and help life feel coherent again.

Somatic and nervous-system-based interventions

Because dissociation is often a body-based defense, many people benefit from approaches that include interoception (sensing internal states), grounding through movement, breathwork tailored for trauma, and strategies that increase a sense of safety in the body. Therapy may incorporate:

Orienting practices (using the senses to reconnect to the room and time)
Gentle movement to reduce freeze responses
Tracking activation so the person learns how arousal rises and falls

For children, somatic work is often play-based and integrated into developmentally appropriate activities.

Medication as a supportive tool (not a cure)

There is no medication that “treats dissociation” directly, but medication can help with related symptoms such as depression, anxiety, sleep disruption, or PTSD hyperarousal. A prescriber can collaborate with a therapist to ensure medication supports stability rather than masking important clinical signals. For some people, improving sleep and reducing panic can significantly reduce dissociative episodes.

What working with a licensed specialist adds

Dissociative disorders require more than generic stress-management advice. A licensed mental health professional with training in trauma and dissociation offers:

Accurate differential diagnosis so symptoms aren’t misread as “attention seeking,” bipolar disorder, or simple noncompliance
A structured, paced treatment plan that reduces crisis cycles
Risk assessment and safety planning for self-harm, suicidality, and time loss
Skills coaching adapted to dissociation (including grounding that actually works for you)
Support for identity and self-understanding without shame or sensationalism

In many cases, progress comes from consistency: a stable therapeutic relationship, predictable sessions, and a shared language for what’s happening. Over time, clients often report fewer episodes, less fear, improved memory continuity, and more choice in how they respond to stress.

How dissociation affects family life, school, work, and relationships

Dissociative symptoms rarely impact only the individual. Parents may feel like they’re “walking on eggshells,” unsure which version of their child will show up. Partners may misinterpret emotional numbing as rejection. Employers and teachers may see inconsistency—high performance one day, shutdown the next—without understanding the underlying protective mechanism.

Common relational and functional impacts include:

Misattunement and conflict (others feel ignored; the person feels overwhelmed)
Communication breakdown due to memory gaps or altered states
Parenting stress when an adult is coping with dissociation while caring for children
School avoidance or academic inconsistency in teens
Intimacy difficulties, including fear, shutdown, or feeling disconnected during closeness

Therapy often includes relational repair: learning to name dissociation early, creating practical agreements (like checking in before important conversations), and building routines that decrease nervous system overload.

Support for parents and caregivers: what helps at home

When a child dissociates, caregivers often try to “snap them out of it” with urgency or frustration. It’s understandable—and usually not effective. A trauma-informed approach emphasizes calm, connection, and predictability.

Prioritize safety cues: steady tone, simple language, reduced stimulation
Use gentle grounding: invite the child to name five things they see, hold a comforting object, or feel their feet on the floor
Reduce shame: avoid statements like “You’re being weird” or “Stop ignoring me”; instead try “I think your mind is protecting you right now”
Create predictable routines around sleep, meals, homework, and transitions
Collaborate with treatment: ask the therapist for a home plan that matches your child’s triggers and developmental level

Caregivers also deserve support. Watching dissociation can evoke fear, helplessness, or anger—especially when it disrupts school or causes conflict at home. Family sessions or caregiver coaching can reduce stress and align everyone around a shared plan.

Support for adults: rebuilding trust in your own mind and body

Adults commonly carry a double burden: the symptoms themselves and the fear of what they “mean.” Many people wait to seek help until they feel desperate. Treatment can be effective even if you don’t remember everything that happened in the past, even if you feel uncertain about labels, and even if you’re functioning on the outside while struggling privately.

In therapy, adults often work on:

Stabilization skills for grounding, sleep, and daily structure
Trigger mapping to reduce time loss and increase predictability
Building internal cooperation (especially when different self-states react differently to stress)
Addressing shame and rebuilding self-compassion without minimizing pain
Relational healing including boundaries, intimacy pacing, and communication

Progress is usually incremental and deeply meaningful: noticing earlier signs, staying present a few minutes longer, remembering more of a conversation, feeling connected during conflict, or experiencing emotions without being swallowed by them.

What to look for when choosing a therapist for dissociative disorders

Because dissociation can be mismanaged by rushed or under-informed treatment, it’s appropriate to ask direct questions. A good fit often includes:

Training in trauma and dissociation and comfort discussing dissociative symptoms
A phase-based approach that prioritizes safety and stabilization
Clear boundaries and consistency that increase security
Willingness to collaborate with caregivers, schools, or medical providers when needed (with consent)
Respect for your pace, including careful pacing around trauma processing

If you’re a parent, ask how the therapist involves caregivers and how they tailor treatment to developmental needs. If you’re an adult, ask how they handle dissociation during sessions and what strategies they use when you begin to feel unreal, numb, or fragmented.

You don’t have to keep guessing what’s happening or manage it alone. With the right professional support, dissociative symptoms can become understandable, treatable, and far less controlling—opening space for steadier relationships, safer coping, and a more connected sense of self. When you’re ready, take a confident step and Find a therapist near you.