Dissociation: A Clinician’s Guide 

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You are working with dissociation if you are a mental health clinician!

This course will show you how to recognise, understand and treat it.

Dissociation can be understood as a set of processes affecting

• sense of self
• consciousness/perception
• memory
• somatic/bodily experience

A one day online small-group workshop with recordings available after the event.

Dr Fiona Kennedy presents everything you need to know about dissociation: assessment, formulation, and intervention using CBT, DBT, ACT and CFT.

Dissociation involves a variety of shutting-down responses to life-threatening trauma. It can be learned in early childhood and used as a preferred response to distress throughout adulthood. It can affect perception, affective, cognitive, somatic and behavioural responding as well as the structure of the self.

Dissociation is often seen as simple a “spacing out” response that with grounding work can be overcome, In this workshop Dr Fiona Kennedy expands our awareness of the clinical importance of dissociation as a process or set of processes.

The CBT theory of dissociation was developed by Fiona along with colleagues Helen Kennerley, Glenn Waller, David Pearson and builds on the work of others. It describes three “levels’ of dissociation, or critical stages of information-processing which are altered by dissociative responding. These are 

• the perceptual level (intrusive images/hallucinationa; spacing out) involving automatic information-processing 
• the “mode” level (intrusions or absences of thoughts, feelings, behaviours and somatic responses) involving strategic information-processing
• the “between-mode” level, where different self-states exist with lack of or low levels of awareness, acceptance and control by the individual (often labelled as BPD/EUPD and DID), involving structural dissociation of the ‘personality’ or self.

The extent and effects of dissociative responding are large and significant in most clinical work, 

especially with severe presentations such as psychosis, personality disorder, cPTSD, depersonalisation disorder. but also in severe anxiety, depression, OCD, non-epileptic seizures, somatic symptoms, amnesia and fugue. Dr Kennedy explains the need to understand and formulate the part played by dissociation in many clinical presentations.

Assessing dissociation can be challenging

as our assessment will depend on what we understand by dissociation and how we choose our measures. Fiona describes the pros and cons of various dissociation psychometrics and how to use them clinically, including the Wessex Dissociation Scale (WDS)* developed from the CBT theory.

Treating dissociation can also be challenging

despite the prevalence of dissociation in clinical presentations, very few of us have received training in spotting, formulating and treating it. Without effective treatment, dissociation interferes with therapy, for example by reducing the client’s ‘presence’ in the therapy session; causing amnesia for sessions; producing  out-of-control switching between self-states inside and outside of sessions. Clinicians and clients  are often daunted by the fact that symptoms lie outside of the client’s conscious awareness and control and so get stuck on how to proceed. Fiona will describe how to use techniques and strategies from CBT, DBT, ACT and CFT to intervene with dissociation. She will present material from her own work to illustrate treatment and encourage you to apply it to your own cases.

Who will benefit from this course?

Anyone working with clients with potential trauma/neglect in their background. Since trauma is a subjective experience, people with autism/Asperger’s are often traumatised more easily because of their heightened sensitivity and vulnerability. Even if your client has no apparent trauma/neglect, it is important to be aware that amnesia for past events is a dissociative response. If you are working with depersonalisation, ‘personality disorder’, DID, unexplained medical symptoms, non-epileptic seizures, hallucinations and delusional thinking, eating disorders, PTSD and cPTSD this will also be relevant to you. You should have a background in therapy or mental health work.

Course content

We look at the definition of dissociation, the CBT theory of dissociation, assessing dissociation and explaining dissociation to clients. Formulating case presentations using clinical examples and vignettes.

We explore formulating your own case and developing a treatment plan. We also spend time on BPD and DID: working with dissociation when it affects a person’s sense of self.

Learning methods

We will use instruction, demos, role-plays in breakout rooms, and video material to create a workshop with a small group of highly engaged participants, and we will make it fun!

What You Will Learn

• Defining dissociation
• The CBT model of dissociation
• The neurobiology of dissociation
• Assessing dissociation
• Formulating dissociation in a variety of clinical contexts: PTSD; psychosis, depersonalisation, BPD/EUPD, DID, anxiety disorders, eating disorders, self-harm, somatic disorders
• Explaining dissociation to clients
• Intervening to reduce dissociation when appropriate

Take Aways

• The Wessex Dissociation Scale (WDS) and scoring template
• A FREE chapter from Dr Kennedy’s book
• Networking with other therapists working with dissociation

The Trainer

Fiona Kennedy is a respected and knowledgeable, fun trainer with a knack of making complex concepts accessible without losing their richness. She has many years’ experience in managing and delivering services in the NHS, as well as writing and researching especially on trauma and its consequences. She now runs her own training, supervision and therapy company, GreenWood Mentors Ltd.

She has written several books, including the self-help/guided therapy book Get Your Life Back: The Most Effective Therapies for a Better You, shortlisted for the BMA Popular Medical Book Of The Year 2018. In 2020 a therapist’s companion to this appeared as part of the Routledge CBT Distinctive Features series: Integrating CBT and Third Wave Therapies. She co-edited Cognitive Behavioural Approaches to the Understanding and Treatment of Dissociation and developed the CBT theory of dissociation. Fiona and her husband have volunteered in India for the past 14 years, enabling volunteers and NGO staff to work with children and young people from severe disadvantage as well as with tribal groups from rural areas.