Teaching and Learning About Dissociation: The Consequences of Not, the Challenges of Doing So, and Hope for the Future

Abstract
Dissociative Disorders are underrecognized and underdiagnosed across mental health treatment settings. The average individual with a dissociative disorder is in treatment for 12 years before being accurately diagnosed (1) despite various sources claiming a prevalence of greater than 1% in various international populations (2). As psychiatrists often serve as leaders of mental health treatment teams, they play a pivotal role in determining the diagnosis and treatment trajectory for many patients. In order for psychiatrists to be reliable and accurate diagnosticians, it is essential for them to have at least a limited understanding of all psychiatric disorders. However, most psychiatrists do not have any formal, or even informal, training in dissociative disorders during their residency or beyond. This problem is not unique to psychiatric training, as providers in the disciplines of psychology, nursing, and social work also often lack adequate training in dissociation. When a patient presents with a dissociative disorder, in many settings, providers may not believe in the disorder (3) or they may have harmful misunderstandings about the condition, which have the potential to impact their treatment of individuals with these disorders (4, 5). This workshop is being offered by members of the Psychiatric Training Task Force of the ISSTD, a task force dedicated to increasing the education of psychiatrists, and other prescribers, about topics related to complex trauma and dissociative disorders. However, the educational principles discussed in this workshop will generalize to providers in all mental health disciplines, whether the “learner” is a trainee, a colleague, or provider in another specialty. The workshop will identify several consequences to patients when providers lack training in dissociation. Secondly, the workshop will explore the challenges in learning about dissociative disorders from the perspective of a current psychiatric resident, including discussing the results of a recent national survey of psychiatry residents. Lastly, the workshop will offer successful approaches for teaching providers in all mental health fields about dissociative disorders. This will include discussing strategies for supporting learners when they encounter bias or misinformation from their colleagues or mentors, and offering hope for how training and exposure to patients with lived experience of dissociation has the power to change the stigmatized culture around these disorders..