Navigating Change in Individuals with CDD: Restoring the Sense of Next

Abstract
Purpose
This study aims to examine the experiences of change for individuals with Complex Dissociative Disorders (CDD) over four years, focusing on how longings influence change processes. By identifying patients’ longings for the future, the research seeks to explore how these longings shape their journeys and contribute to personal transformation.

Methods
Employing a longitudinal qualitative design, this study involved 18 semi-structured interviews with six participants at three intervals: immediately following diagnosis (T1), six months post psychoeducative skills training (T2), and two years later (T3). Longitudinal Interpretative Phenomenological Analysis (LIPA) was utilized to explore the participants struggles and longings at T1 and the evolution of participants' experiences of change according to their longings. The analysis focused on elucidating group experiential themes reflective of participants’ longings and observed changes over time. Interviews were designed to capture a holistic view of each individual's journey, integrating both retrospective insights and forward-looking aspirations.

Findings
The findings illuminate profound longings at T1 encompassing five group experiential themes corresponding to their principal struggles: 'knowing who I am,' 'trusting myself,' 'inner peace and safety in surroundings,' 'being authentic and present in relationships,' and 'being part of and contributing to society.' Over the study period, changes from their struggles in direction of their longings evolved into three overarching areas of change: restoring the self, restoring safety, and restoring connectedness. These transformations collectively fostered the core theme of 'restoring the sense of next,' encapsulating participants’ renewed perceptions of future possibilities. Participants reported increased self-awareness, enhanced self-efficacy, and improved social interactions, leading to a more integrated sense of self and deeper interpersonal connections. Crucially, the study highlights how navigating conflicting longings was integral to establishing autonomy and effective decision-making.

Conclusions
The study underscores the importance of future-oriented therapeutic approaches, suggesting that aligning treatment with individuals’ longings can yield substantial benefits, fostering lasting change beyond symptom management. The insights gained emphasize the potential for personalized interventions that embrace clients' longings, promoting self-discovery and empowering decision-making. Recognizing personal longings as central to therapeutic progress, this research advocates for strategies that rejuvenate individuals’ sense of agency, enriching recovery pathways for those with CDD.