When the Self Feels Fractured or Far Away

Dissociative Disorders

Dissociative Identity Disorder

Formerly known as: Multiple Personality Disorder

Dissociative Identity Disorder is one of the most misunderstood conditions in all of psychiatry — shaped by decades of sensationalized media portrayals that bear little resemblance to the clinical reality. DID is not a dramatic performance. It is a complex trauma response — a survival mechanism that develops, most often in early childhood, when overwhelming experience exceeds the developing mind's capacity to integrate.

DID involves the presence of two or more distinct identity states — each with its own pattern of perceiving, relating to, and thinking about the world — along with significant gaps in memory that cannot be explained by ordinary forgetting. These identity states are not separate people. They are dissociated parts of a single person's experience, separated by the same psychological process that allowed the person to survive what happened to them. DID is not a disorder of having too many personalities. It is a disorder of not enough integration.

DID almost always develops in the context of severe, chronic early trauma — typically before the age of nine, when identity is still forming. The dissociation that develops is adaptive — it allowed the child to function despite what was happening. In adulthood, that same dissociation becomes the disorder, because the threat is gone but the fragmentation remains. Treatment is long-term, trauma-focused, and aimed at integration — the gradual bringing together of dissociated parts into a more cohesive sense of self.

Dissociative Disorders

Depersonalization/Derealization Disorder

Also known as: DPDR

Depersonalization/Derealization Disorder involves persistent or recurrent experiences of feeling detached from one's own mind, body, or sense of self — and/or feeling as though the surrounding world is unreal, dreamlike, or distant. These experiences cause significant distress and are not explained by substance use, another medical condition, or another psychiatric disorder.

Depersonalization is the experience of being an outside observer of one's own thoughts, feelings, body, or sensations. The person may feel like they are watching themselves from outside their body, that their thoughts are not their own, or that they are going through the motions of life without actually inhabiting it. Derealization is the experience of the external world feeling unreal — objects may look flat, colors muted, surroundings dreamlike or artificially constructed. The person knows these perceptions are not accurate — reality testing remains intact — but the experience is deeply unsettling and often terrifying.

DPDR is more common than many people realize. Brief episodes of depersonalization or derealization are experienced by a significant portion of the general population, particularly in the context of stress, sleep deprivation, or anxiety. When these experiences become persistent, distressing, and impairing, a clinical diagnosis is warranted. DPDR frequently co-occurs with anxiety disorders, depression, and trauma-related conditions, and responds to targeted evidence-based approaches.

Dissociative Disorders

Dissociative Amnesia

Also known as: psychogenic amnesia

Dissociative Amnesia involves an inability to recall important autobiographical information — typically related to traumatic or stressful experiences — that is too extensive to be explained by ordinary forgetting. Unlike neurological memory disorders, dissociative amnesia is psychological in origin: the memory is not gone, it is inaccessible. It is the mind's protective response to experiences it was not able to fully process. Treatment is trauma-focused and aimed at helping the person safely access and integrate what their mind has been holding at a distance.

Clinical Expertise

Why Dr. Fitzgerald González's expertise matters

51,000 hours of clinical and research experience including complex trauma and dissociative presentations

Dr. Fitzgerald González has assessed and treated dissociative disorders across clinical settings where these presentations are most concentrated and most clinically complex — correctional and forensic psychiatric environments where trauma histories are severe, chronic, and often begin in early childhood. Dissociative disorders are among the most frequently missed diagnoses in clinical practice — regularly mistaken for psychosis, borderline personality disorder, or treatment-resistant depression by clinicians without specific training in trauma and dissociation.

Accurate identification of dissociative disorders requires distinguishing dissociation from psychosis, genuine amnesia from malingering, and DID from other presentations involving identity instability or internal conflict. These distinctions require a clinical psychologist with direct experience across all of them — and with the diagnostic precision to get the picture right before treatment begins.

Dissociative disorders are among the most undertreated conditions in all of psychiatry — largely because they go unrecognized. Accurate identification is the foundation of every treatment decision that follows.

Clinical Relevance

Why it matters for you

The right diagnosis changes everything that follows

If you have spent years in treatment that addressed symptoms without ever reaching what produces them — if you have experienced gaps in memory, episodes of unreality, or a persistent sense of fragmentation that no one has ever fully explained — a comprehensive evaluation that includes dissociative disorders may provide the first accurate account of what you are experiencing.

Dissociative experiences are real, they are recognized, and they are treatable. What the mind separated in the service of survival, treatment can help bring back together.

An accurate diagnosis and evidence-based treatment changes everything.