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Treating Dissociation: A Guide to Trauma Therapy Using Parts Work Approaches.

What is Dissociation?

Dissociation is a psychological phenomenon that involves a fragmentation or division in one's sense of self or personality. It often serves as a defense mechanism in response to overwhelming trauma. Different types of dissociation include spacing out, depersonalization, physiological shutdown, and structural dissociation.

Structural Dissociation

In particular, structural dissociation involves the fragmentation of personality into various parts, each holding traumatic memories or responsible for daily functioning. This is commonly seen in complex PTSD and disorders like Dissociative Identity Disorder (DID). The ultimate goal of therapy for structural dissociation is to facilitate communication among these divided parts and help integrate them into a coherent sense of self.

Prevalence in Context: It's important to note that dissociative disorders are more common than previously thought. Other Specified Dissociative Disorder (OSDD) has a prevalence of about 6% in the general population, comparable to major depression. DID is estimated to affect 1-2% of the general population, making it slightly more prevalent than schizophrenia.

Symptoms of Dissociation: An Expanded Look

Symptoms of dissociation can often be subtle, elusive, and easily confused with other psychological conditions. However, a keen awareness of the following symptoms can guide both clinicians and clients toward a more accurate diagnosis:

Cognitive Symptoms

  • Amnesia: Gaps in memory for past or present events.

  • Time Loss: Periods of time that are unaccounted for.

  • Disorientation: Confusion about time, place, or identity.

  • Intrusive Thoughts: Unwanted thoughts that seem disconnected from the current situation.

  • De-realization: Feeling as if the world around you is unreal.

Emotional Symptoms

  • Emotional Numbness: Reduced ability to feel emotional highs or lows.

  • Mood Swings: Rapid and extreme changes in mood.

  • Depersonalization: Feeling detached from oneself or observing oneself from an outsider’s perspective.

  • Self-puzzlement: Confusion about one’s own behaviors, emotions, or experiences.

Auditory Symptoms

  • Hearing Voices: Especially voices of parts conversing or commenting internally. These voices have specific characteristics that differentiate them from psychotic hallucinations.

Physical Symptoms

  • Numbness: Reduced physical sensation or emotional response.

  • Paralysis: Inability to move, typically in the absence of a physical cause.

  • Unexplained Pains: Somatic complaints without a clear physical origin.

  • Pseudoseizures: Episodes resembling seizures but without the typical electrical activity in the brain.

  • Unexplained Injuries: Bruises or other injuries that the person can't explain.

Behavioral Symptoms

  • Switching: Overt changes in state of consciousness, mannerisms, or speech patterns.

  • Being in a Child State: Or alternate personality states at times.

  • Fluctuations in Skills and Abilities: Such as speaking a language you haven't studied or being able to play a musical instrument you haven't learned.

Psychological Symptoms

  • Highly Fluctuating Symptoms: Like anxiety, depression, and suicidal thoughts.

  • Phobia of Inner Experience: High avoidance of exploring internal emotional states.

  • Treatment Resistance: A lack of progress despite undergoing different types of therapies.

Understanding these symptoms is crucial for identifying dissociative processes and planning effective treatment. Always consult a healthcare provider for a thorough evaluation if you or someone you know is experiencing these symptoms, especially when there is a history of trauma and lack of progress in treatment.

The Importance of a Trauma-Informed Therapist

When it comes to treating dissociation, the expertise of a trauma-informed therapist is invaluable. A therapist well-versed in trauma and its complexities brings a nuanced understanding to the table, offering a safe and empathetic space for healing. They are trained to deal with the subtle nuances of trauma and can provide specialized interventions that a general therapist may not be able to offer.

Dr. Sylvia's Expertise in Trauma Therapy

As someone who has extensive training in parts work approaches like Internal Family Systems (IFS) and the Structural Dissociation Model, Dr. Sylvia offers a depth of knowledge and practical experience in the field. Additionally, she is trained in Eye Movement Desensitization and Reprocessing (EMDR), Sensorimotor Psychotherapy, and other evidence-based modalities. This combination of training allows for a multi-faceted approach to treating dissociation, offering clients a comprehensive and tailored treatment plan.

Located in California, Dr. Sylvia focuses her practice on the San Francisco Bay Area, providing specialized trauma therapy for individuals dealing with dissociative disorders. By opting for a trauma-informed therapist with a rich background in evidence-based treatment approaches, you are taking a critical step toward holistic healing and integration.

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Are we a 

Good Fit?

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What Happens Next?



consultation call

We’ll have a brief conversation discussing your goals, needs, & challenges. I’ll also answer any questions you have for me about therapy in general & my approach.



designing our work

Our first 1-3 sessions will involve an evaluation of your needs. Together, we’ll design the goals you have for therapy & discuss the possible outcomes of our work.

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building your toolkit

We work towards your goals together, using proven approaches tailored to your needs. We’ll build a toolkit of the necessary skills and strategies needed to overcome the challenges you are facing and process the past in a productive way.

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  • will therapy really work for me?
    Therapy can be a big catalyst to your healing journey provided that you’re putting in the work & feeling safe & comfortable with the therapist you’re working with. That’s why I offer a free consultation call so you can gauge if we’re the right fit before making any commitment.
  • what is your approach to therapy?
    Therapy with me integrates evidence-based approaches, mindfulness techniques, attachment theory, somatic therapy, & advances in neuroscience to fit your unique needs, goals for therapy, & personality style. Learn more here.
  • is therapy confidential?
    YES! There are laws in place that guarantee your privacy as a client. The Health Insurance Portability and Accountability Act (HIPAA) ensures that your medical records & personal health information are protected. During our first meeting, I will explain your rights to privacy and confidentiality further, and answer any questions that you may have.
  • how long should therapy last?
    Long story short, it depends on; your goals, needs & personality style. However, clients typically begin to see positive change within 4-8 sessions. On average our work together can last anywhere from 12 sessions, to one year & beyond. For clients looking to get help with a specific concern, therapy can be shorter, while those looking to experience more in-depth personal growth & a letting go of unhelpful relational patterns may benefit from longer treatment.
  • how often would I come to therapy?
    Once a week, where sessions are 50 minutes long. We’ll set a fixed weekly time that best fits your schedule. Weekly sessions develop a strong therapeutic relationship & stay in the flow of moving towards treatment goals but I do offer different arrangements depending on your needs and goals.
  • how much does it cost? do you take insurance?
    My current rate is $250 per 50-minute session. I have a limited number of sliding scale spots. Click here to learn more about pricing & insurance.

Frequently Asked


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