Dissociative identity disorder (DID) involves a sophisticated systematic structural dissociation which occurs in childhood. It manifests most commonly as a protective mechanism in the event of extreme and severe childhood abuse. The human capacity to dissociate those experiences which occur that are so horrendous and overwhelming, to an alternate consciousness (or identity), provides a way of functioning in “normal life”. However, as an adult, it can also mean mysterious lapses and disconnection in the present, long after the events that led to their creation, have come to an end.

Kate, 40 years of age, has a DID, but this is not what brought her to psychological treatment. Indeed, for Kate, with the exception of memory lapses, which she largely dismissed as normal, she was unaware of her DID. She initially presented with issues in relation to depression in the context of past workplace bullying. It was after approximately two years of psychological treatment and a decision to terminate that it became clear that there was further psychological treatment needed. What has emerged in the psychological treatment since are a number of identities including; the “littles” (up to four or five years of age), seven- year- old parts, teenage parts and adult parts.

The primary treatment for DID is psychological. This presentation will focus on the treatment of Kate using a structural dissociation lens and individual psychotherapy.