I call myself a psychology nerd because even beyond what’s necessary for my career as a therapist I love to learn about psychology-related matters. I choose to constantly learn about such matters through books, podcasts, and other forms of media.

I recently had the opportunity to receive copies of two amazing psychology books in exchange for providing honest reviews about them. It occurred to me that people might be interested in my thoughts about the books beyond sites where the books are sold, so I decided to write lengthier reviews for my blog. This is the first one. Be sure to keep an eye out for the second one in coming months if what I share is of interest.

Although I have followed and admired the work of Dr Jamie Marich (she/they) for a few years, I had not read any of her books prior to reading Dissociation Made Simple. Now that I have read it and enjoyed it so much, I want to read their other books even more!

The book explores dissociation, including demystifying it and breaking the stigma of it. For those not familiar with dissociation, Dr Jamie provides a definition that says the word derives from the Latin word meaning “to sever” or “to separate”. It can refer to the tendency to sever from the present moment when it is unpleasant or overwhelming. It can also refer to severed or separated parts of the self.

I often refer to the movie Precious when explaining dissociation. The main character fantasizes about being famous and adored during the act of being sexually abused. Her mind severs from the present moment because it is too painful. It is in this way that dissociation is helpful and protective.

As Dr Jamie points out in the book, this adaptive coping skill can become maladaptive (meaning that what once was helpful becomes unhelpful) when it occurs too frequently or too intensely, especially when occurring long after traumatic experiences have stopped. For many people who have experienced trauma, dissociation becomes maladaptive in this way. Dr Jamie explains the most current diagnoses for various dissociative experiences and addresses how they used to be known as things like Multiple Personality Disorder, multiple personalities, and split personalities. Like Dr Jamie, I dislike the medical model’s tendency to use the word “disorder” in diagnoses because the symptoms are normal responses to distressing situations. Thus, I like Dr Jamie’s use of the term dissociative experiences instead of calling such experiences disorders and will use that language in this review.

Please note that this is lengthy for a review. I made this choice in hopes of educating people about dissociation, getting people interested in reading the book, and giving people a chance to learn more about my own approach to therapy. Also note that while it is lengthy, I am aware that I am only briefly touching on some major concepts that might leave some readers feeling confused or wanting more information. These are topics that I’m passionate about and can talk about for hours, but I didn’t want this to be so long that it loses peoples’ interest! I encourage you to seek out information about trauma (especially complex trauma), polyvagal theory, drama therapy, creative/expressive arts therapies, or any other topics I mention that you are curious about. I’ll include a list of favorite resources at the end of the review.

Things I like about the book

• It normalizes dissociation (instead of pathologizing it, as the medical model does). As Dr Jamie points out, everyone experiences dissociation on some level. For some people it presents as things like forgetting where they placed their keys because they were distracted when putting them down or arriving somewhere after driving and realizing that they were zoned out for the entire drive. These types of experiences tend to be more frequent and more intense for people who have experienced complex trauma, which as mentioned above is a normal and adaptive way of coping that sometimes becomes maladaptive. Dr Jamie rightfully points out the harm that is caused when mental health professionals don’t believe it exists and when people who experience it are portrayed as evil in entertainment media.
• It presents dissociation as a skill, protector, and superpower. As mentioned above, dissociation is the brain’s way of protecting us from physically and emotionally painful experiences so is positive in that way. It helps us compartmentalize difficult things, like pushing aside what stresses us in the present moment in order to go about our work day. The different parts of us allow us to see different perspectives, and certain parts can help us master certain skills or tasks. Dr Jamie points out these many strengths while also acknowledging that dissociation can sometimes cause major disruptions in peoples’ lives, regarding things like memory and awareness.
• It addresses how diagnoses can be both helpful and not helpful. They can be helpful in that they give language to one’s experiences and can help people feel less alone in their experiences. They can be unhelpful in that they can be stigmatizing. This is true of any mental health diagnosis, but dissociation tends to be even more so because of the aforementioned reasons of some professionals not believing in it and the unrealistic portrayals of it in media.
• It’s very personable and easy to understand. Dr Jamie is warm, compassionate, and open in her writing. They write in a way that is easy to understand even when tackling dense subjects like neuroscience and trauma. In addition to Dr Jamie being open about their own experiences, the contributors to the book are also quite open about their experiences. These qualities likely help people with dissociative experiences feel less alone in their experiences.
• It’s helpful for people who have dissociative experiences, their loved ones, and mental health professionals. Unlike some books about psychology-related matters, this one is not only geared towards professionals or made to be only a self-help book. It provides information that is helpful for anyone who wants to know more about dissociation and their relationship to it or to support someone who experiences it.
• The thorough glossary provided towards the beginning of the book.
• The encouragement to allow people to choose which terminology to use to describe themselves and their experiences. This includes pronouns that people with dissociative experiences use, such as sometimes using they/them pronouns and identifying as “plurals” to include their various parts. This also includes acknowledging that “parts” does not feel fitting for everyone and that terms like roles, selves, or aspects might feel more fitting. The book also explores other terms that might be preferred over “systems” to refer to the collection of one’s parts (e.g. collective, constellation, or dimensions). It also explores other terminology for “grounding”, such as anchoring, riding the waves, or settling. I also appreciate the exploration of the idea of a “wheel of tolerance” instead the “window of tolerance”, as this leaves more room for mixed feelings and mixed states of fight/flight/freeze. As a therapist who specializes in trauma and knows how important it is to empower trauma survivors who have often had power taken from them in various ways, I really appreciate the encouragement for people to use what feels fitting.
• It normalizes that everyone has internal parts. As a note: as mentioned above it’s okay to use other terminology for this, but I will use “parts” to refer to the different aspects of ourselves that we all have. For many people this might be experienced as having “mixed feelings” or thinking something like, “Part of me is sad about my loved one’s death, and part of me is relieved because they’re no longer in pain.” Or it might be the sense that we have an inner child part. For some people their parts might be more distinct or more fragmented. They might have parts that are of different ages, genders, races, or even species. Dr Jamie’s exploration of parts as being on a spectrum and each having a purpose resonates with me since I’m a drama therapist who constantly thinks about the various roles we all have internally and externally. The book confirms my approach that all parts have purpose (by attempting to help us somehow) and thus ought to be welcomed.
• It points out that dissociation isn’t always as obvious as people tend to think it is. It explains that people with dissociative experiences often don’t show their different parts until they feel safe with someone.
• It acknowledges that there is no single healing modality or model. It also acknowledges that dissociation is a complex subject despite the title. Dr Jamie points out that because dissociation is so fluid that therapists need to be fluid in treating it. They point out that rapport, validation, trust, and the therapist’s sense of hope for the client are more important than a therapist strictly adhering to any single modality or model. They also point out the importance of psychoeducation to help normalize clients’ experiences and help them feel less alone. This affirmed how I approach my work.
• It provides practical activities for readers to understand their own relationship with dissociation and to practice grounding. I especially love the use of expressive arts to do so!
• It provides helpful questions that readers can ask mental health professionals to ensure that they are getting care from professionals who either have experience helping people with dissociative experiences or are willing to learn about it to better serve clients. These questions helped me think about my own responses and helped me feel affirmed in how I was already approaching working with dissociation.
• It provides thoughtful information on how to best come out as someone who experiences dissociation. It acknowledges how difficult it is because of stigma while gently encouraging people to do so when it feels safe enough in order to decrease the stigma. I appreciate the courage it took Dr Jamie and the many contributors of the book to be so open about their diagnoses and experiences. I hope to continue to see more people be open about such experiences, especially in the mental health field.
• It rightfully points out that trauma includes feeling misunderstood, marginalized, or unable to be one’s authentic self. This is a topic that I am incredibly passionate about, as my own traumas related to feeling different play a large part in why I enjoy working with clients dealing with that theme. While people often think of things like abuse and natural disasters as trauma, they often don’t think of feeling different as trauma. What often gets overlooked is that humans are biologically wired for social connection and feel unsafe when we don’t feel that we are part of a group. Think of it this way: if a baby is rejected from the group taking care of them (e.g. their family or community), can they survive on their own? No, because they physically and emotionally are not capable of doing so. Although we rationally know as we get older that we won’t die if we’re rejected, there’s a primitive and often unconscious part of our brain that still thinks we will. Therefore, it’s extremely important to feel accepted, validated, and loved, and it makes sense that people struggle when they don’t feel these things.
• It addresses the intersection of dissociation and neurodiversity. I found myself wishing that more was said about this but appreciate that it touches on the overlaps between trauma, dissociation, attention/focus, ADHD, and autism. I appreciate that it addresses how being neurodiverse can be traumatizing since this is something else that I often talk about with clients that seems to get ignored by others. If this sounds odd to you, think about what I mentioned above about feeling different as being traumatic. Consider how overwhelming it often can be for people with neurodiversity to navigate constant overstimulation, not be able to process stimulation as quickly or in the same way as someone who is neurotypical, and to figure out how to express themselves in ways that neurotypical people might understand. Consider also that neurodiverse people are typically expected to conform to neurotypical standards and often experience shame for not meeting those standards. Thus, they might experience trauma, dissociation, and inattention from the neurodiverse executive functioning itself as well as from not being accepted for their neurodiversity.
• It addresses the intersection of dissociation and eating disorders. Again, I found myself wishing that more was said about this but appreciate the exploration of the overlap between these issues, especially the idea that both involve dissociation from emotions and the body.
• It addresses the intersection of dissociation and Borderline Personality Disorder. Please note that I am the kind of therapist that dislikes this diagnosis and prefers to look at it as attachment trauma. This intersection makes sense to me because of the overlap between complex trauma, easily feeling rejected, and easily going into freeze mode.
• It addresses the intersection of dissociation and Traumatic Brain Injury. I also found myself wishing for more to be said about this, but it makes sense to me that some dissociation might be caused more by a biological reason than a psychological reason or a combination of these reasons.
• It addresses the relationship between dissociation, psychosis, and addiction. I again wish more was explored regarding this. It makes sense to me that they share experiences of hypoarousal, avoidance, and difficulties comprehending reality at times.
• It rightfully points out the difficulties that people often experience with mindfulness and grounding. People who have experienced trauma to their bodies, including physical and sexual violence, often have difficulties feeling safe and comfortable in their bodies. Their inner and outer worlds can feel unsafe, and they might frequently experience extremes of hyperarousal (such as feeling emotionally flooded) and hypoarousal (such as feeling frozen). Therefore, traditional mindfulness techniques like focusing on one’s breath or on the chest rising might be uncomfortable. Even being told to close one’s eyes can feel triggering since that’s a vulnerable act. This section of the book affirmed my approach to using mindfulness techniques with clients with trauma histories, such as encouraging the following: using guided imagery meditations instead of just focusing on thoughts or breath, focusing on neutral body parts during meditation, or sighing instead of deep breathing (since longer exhales soothe the nervous system more). I also appreciate sections that address the importance of making sure to choose trauma-informed healers who understand this (including mental health professionals, yoga teachers, practitioners of Indigenous healing ways, and spiritual leaders).
• It encourages mental health professionals and other people trying to be supportive of people with dissociative experiences to use the term “safe enough” instead of saying “safe”. The fact of the matter is that trauma survivors may never fully feel safe because their experiences have taught them otherwise. It is important for people supporting trauma survivors to acknowledge and be comfortable with this.
• It acknowledges that therapists who feel unprepared to work with dissociation are likely not at fault because of the widespread lack of training about it. I hate to admit that I myself fall into this category, though now I feel better equipped because of this book! It was not mandatory to take a class about trauma in my master’s program, none of my internships addressed trauma directly, and my first few jobs as a therapist also didn’t address trauma directly. It wasn’t until I worked at an agency for domestic violence, sexual abuse/assault, and human trafficking that I learned about trauma… and that was largely due to me choosing to read about it constantly and attend trainings about it. Even in those trainings, dissociation would occasionally be mentioned but not really focused on. EMDR training provided me with the most training on it, but even that was not a lot. Here it is 15 years into my career, and this book has by far taught me the most about dissociation! And as I said at the start of this review I constantly devour psychology-related information, so it’s really sad that in all these years I wasn’t able to get this much great information about dissociation. Furthermore, the information I had gotten about it generally seemed impersonal and very clinical/dense since it was from people who do not have dissociative experiences themselves (or are not open about it).
• It rightfully acknowledges intersectionality and how systems and institutions cause harm to people. As mentioned above, it points out that marginalization is traumatic. It also points out the fact that power structures benefit from trauma and dissociation, especially by keeping people disembodied or disoriented. It also points out systemic issues regarding highly skilled trauma therapists often not being easily accessible, which typically occurs because therapists often get burned out by the low pay and frustrating tendencies of working at community mental health centers and with insurance companies. Therapists working at community mental health centers also often don’t receive trauma-informed training unless they seek it out.
• It acknowledges how the legal system often causes harm to people who have dissociative experiences (and trauma survivors in general). Police and lawyers often aren’t trauma-informed. They often don’t understand that trauma memories tend not to be linear and tend to be more sensory-based (e.g. remembering snippets of sights, sounds, smells, etc. instead of a cohesive narrative). They also often don’t understand that dissociation exacerbates these experiences. This is why victims of crimes are often mistakenly seen as unreliable, which then further traumatizes victims by causing them to feel dismissed or disbelieved.
• It’s culturally sensitive. The book includes perspectives from eastern and western cultures. It acknowledges the limitations of western perspectives, which as one contributor points out is “inherently dissociative” (since it tends to focus so much on science and the brain instead of on spirituality and the mind-body connection). It acknowledges that therapy doesn’t work for everyone and that there are many other tools for healing. It addresses the spiritual nature of trauma and, thus, the importance of incorporating spiritual elements into the healing process (whether through therapy or not). It also encourages the inclusion of Indigenous practices. This all fits into my own lens in the following way: I’ve come to understand spirituality (feel free to choose a more fitting word for it, if you’d like!) as one’s sense of meaning/purpose and sense of connection to oneself, others, and the world at large. This may or may not be related to religious beliefs. Because interpersonal trauma so often impacts these areas, it is important to tend to these issues in the healing process. Furthermore, one thing that excites me in recent years is how science constantly confirms what many ancient traditions have long known to be healthy and healing. Some examples of this are the benefits of mindfulness, meditation, deep breathing, repetitive movement, and connection/co-regulation. Science and spirituality can work well together for health and healing!
• It encourages viewing dissociation in ways other than as a continuum. This was particularly interesting to me because I had always read about or heard it described as a continuum. Again, I appreciate that Dr Jamie gives people permission to describe their dissociative experiences in whichever way fits for them.
• It points out that social media addressing dissociative experiences can be helpful and not helpful. It can be helpful by providing psychoeducation, normalization, and validation while also breaking the stigma. It can be unhelpful by possibly being retraumatizing for viewers (especially if they don’t have informed healers to process the information with) and by only addressing causes and symptoms while not addressing how to heal.
• The appendix section for professionals. This section made me feel very validated in my approach to my work. Some examples: I tell clients that I understand that me and my office are not automatic safe spaces because of their experiences of the world as being unsafe. I encourage incorporating the body in ways that feel manageable or safe enough. I provide psychoeducation about techniques I choose to use in addition to psychoeducation about trauma, emotions, symptoms, etc. I share dark humor when appropriate. I validate self-injury and suicidal ideation as normal experiences and inform clients that I only break confidentiality around these things or recommend hospitalization when intent and planning are present. I don’t require that clients ever tell me their trauma narratives and use the metaphor that I don’t need to know what started a fire to help put the fire out (and thankfully drama therapy and EMDR are wonderful tools to heal through metaphor, emotions, and sensations with or without verbal narrative). Lastly, I’m committed to doing my own healing and learning to do the least harm possible to clients, including participating in my own therapy and peer supervision groups at various points in my life.
• The appendix section for loved ones who are trying to better understand and support people who have dissociative experiences. I especially liked the suggested structure of educating oneself, validating the person who has dissociative experiences, and helping them with grounding (especially through co-regulation).

Things that got me thinking

• What integration and healing mean for people who have dissociative experiences. The book addresses the fact that it has long been thought that to heal dissociation people who experience it must become “integrated”, traditionally meaning that they stop experiencing frequent and intense dissociation and no longer have separate parts. The book proposes that integration might look more like dissociating less and having one’s parts work together more efficiently or collaboratively as a system. It points out that integration in the traditional sense can feel like an erasure of one’s parts, which can feel very dismissing and invalidating. In keeping with the theme of empowerment and word choice throughout the book, it also proposes that a person with dissociative experiences might have a different term or vision for their healing process. I appreciate this exploration since I had only heard of the traditional view in trainings and prior reading. I think I’m going to be mulling this over for a while since I’m still digesting the new concepts and feeling out how they fit into my approach to healing. It also got me thinking more broadly about my view of healing for mental health matters in general. It got me thinking about my sense of healing being adaptive, not necessarily thriving though that is ideal. It also reminded me that no matter what my view of healing is, it’s important to listen to and honor how other people define it.
• It confirms that drama therapy is a helpful healing tool for dissociation. I’ve long thought that my approach as a drama therapist would be a good fit for helping people who experience very defined and fragmented parts but was too afraid to do so because of feeling unequipped as mentioned above. To be clear, I wasn’t afraid of people who have such dissociative experiences… I was afraid of accidentally doing harm to them because of my lack of knowledge. Reading this book helps me feel much more equipped and confirmed that a lot of the tools I use would likely be helpful. Some things the book addresses that fit into tools I use: exploring parts we have, using metaphors, using narrative and storytelling, using somatic practices to help with embodiment, using spiritual type practices (e.g. rituals), and using techniques to distance difficult emotions when needed (such as visualizing or using objects to explore material at a distance instead of just talk about it).

Learn more through some more of my favorite resources

Many of these are helpful for both mental health professionals and anyone wanting to learn and benefit from the information.

• Therapy Chat podcast
• Trauma Chat podcast
• Ten Percent Happier podcast
• Trauma Therapist Network
• Deb Dana (Rhythm of Regulation)
• Judith Herman
• Janina Fisher
• Bessel van der Kolk
• Bruce Perry
• Dan Siegel
• Cathy Malchiodi