The CTAD ClinicIn this video, Dr Mike Lloyd describes the organisation of structural dissociation, drawing upon clinical expertise and research by established authors in the field of dissociation. The key signs of structural dissociation are also highlighted, including attachment perspectives.
References for this video:
Ellert Nijenhuis, Onno van der Hart , & Kathy Steele (2010) TRAUMA-RELATED STRUCTURAL DISSOCIATION OF THE PERSONALITY, Activitas Nervosa Superior 52:1, pp1-23
Ellert Nijenhuis, Onno van der Hart , & Kathy Steele (2006) The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization
Janina Fisher, Ph.D. (2014) The Treatment of Structural Dissociation in Chronically Traumatized Patients; In Anstorp & Benum (in press). Trauma treatment in practice
Introduction to Structural DissociationThe CTAD Clinic2020-05-29 | In this video, Dr Mike Lloyd describes the organisation of structural dissociation, drawing upon clinical expertise and research by established authors in the field of dissociation. The key signs of structural dissociation are also highlighted, including attachment perspectives.
References for this video:
Ellert Nijenhuis, Onno van der Hart , & Kathy Steele (2010) TRAUMA-RELATED STRUCTURAL DISSOCIATION OF THE PERSONALITY, Activitas Nervosa Superior 52:1, pp1-23
Ellert Nijenhuis, Onno van der Hart , & Kathy Steele (2006) The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization
Janina Fisher, Ph.D. (2014) The Treatment of Structural Dissociation in Chronically Traumatized Patients; In Anstorp & Benum (in press). Trauma treatment in practiceWhy Simple PTSD is not simple at all - what is it?The CTAD Clinic2024-10-06 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses how the term 'Simple PTSD' is used in clinical practice, how this could be misleading and what the real meaning of PTSD is. Comparisons are drawn with 'Complex PTSD' as the diagnostic criteria for PTSD is described. #ptsd #SimplePTSD #complexptsdThe Triad of Treatment for trauma and dissociationThe CTAD Clinic2024-09-29 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses a as important aspect of therapy, the 'Triad of Treatment'. This is a process that is fundamental in progressing towards 'chaotic dissociation' to control, and is underatken and worked through in the therapeutic space. The 'Triad of Treatment' is used when working with forms of dissociation such as Other Specified Dissociative Disorder (OSDD) or Dissociative Identity Disorder (DID) as well as #derealisation and #depersonalisation. This is a technique recommended within therapy settings. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapyA Patient-Therapist Perspective on Autism and Dissociative Identity Disorder (DID)The CTAD Clinic2024-09-22 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) meets with M, an autistic patient who has Dissociative Identity Disorder (DID). Mike and M talk about life with DID as an autistic person, including the challenges, needs, positives and sense of self. The 'Patient and Therapist Perspective' format aims to give patients a voice to disseminate true patient experiences of an aspect of their condition, such as therapy, management or quality of life. These can be beneficial for both patients and therapists as they allow a point of view to be shown that may not have been considered previously.
Bits of the audio are not always in sync with the video, so if this is difficult, please look away and hear the video like an audio podcast!
#dissociativeidentitydisorder #did #therapy #autism #asdOSDD: The Importance of ListeningThe CTAD Clinic2024-09-16 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses ways of being able to understand, decode and manae inernal communication from within Other Specified Dissociative Disorder (OSDD). This is a technique recommended within therapy settings. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapyDissociation in the USAThe CTAD Clinic2024-09-09 | Dr Mike Lloyd, Consultant Clinical Psychologist and Director of the CTAD Clinic, shares an invitation to a series of free lectures on #dissociation #dissociativeidentitydisorder #osdd taking place at Wright State University, Ohio, on Wednesday 13th November 2024. To book a place, please go to: postermywall.com/index.php/posterbuilder/view/ecd914ef1c1d0f1300f6645531857549/0 or frontporchcounseling.comTips for Trauma TherapyThe CTAD Clinic2024-09-08 | In this part one video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses some difficulties when working in trauma therapy, from both the perspective of the therapist and the person seeking the therapy. Mike looks at how to set pace and understand the unique needs of each person seen. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy7 Types of Toxic ParentThe CTAD Clinic2024-09-01 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses 7 types of Toxic Parent, and a brief introduction on why they can be damaging to the development of a child. Please leave comments below for which of these you would like more information on. Mike will also be adding another video about growing up with parents who may have complex dissociative conditions (some who are toxic, and those who are not). Based on ‘Toxic parents: overcoming their hurtful legacy and reclaiming your life’, by Susan Forward and Craig BuckThe Mouse TapThe CTAD Clinic2024-08-24 | Mouse (one the CTAD Clinic cats), is Huckleberry's sister. They both love water from the tap, so here is one minute of Mouse doing what she loves. Enjoy!The Importance of Other People...in understanding dissociationThe CTAD Clinic2024-08-24 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses a useful skill in therapy to gain understanding about the nature of dissociation. This is a technique recommended within the context of therapy settings. #dissociation #dissociativeamnesia #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapyhelpsCan Alters Touch? In OSDD and DIDThe CTAD Clinic2024-08-18 | In this part one video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses how a person/system may experience their alters using touch. With examples from clinical practice, Mike talks about how alters in Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder (OSDD) can apply touch, looking also at the therapeutic skills and outcomes of this. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #didOSDD: When Alters Influence (and how diagnosis can get confused)The CTAD Clinic2024-08-09 | In this part two video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses how a person/system may experience their alters in a way that can lead to diagnosis of conditions that are not about dissociation. Referencing examples from Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder (OSDD) across these two videos, Mike looks at how people with OSDD and DID may attract diagnoses such as Borderline Personality Disorder and Bipolar Disorder through the emergence of alters. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #borderlinepersonalitydisorder #bipolardisorderDID: When Alters Intrude (and how diagnosis gets confused)The CTAD Clinic2024-08-09 | In this part one video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses how a person/system may experience their alters in a way that can lead to diagnosis of conditions that are not about dissociation. Referencing examples from Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder (OSDD) across these two videos, Mike looks at how people with OSDD and DID may attract diagnoses such as Borderline Personality Disorder and Bipolar Disorder through the emergence of alters. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #borderlinepersonalitydisorder #bipolardisorder9 Features of Borderline Personality DisorderThe CTAD Clinic2024-08-04 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses 9 key features of Borderline Personality Disorder. In addition, Mike looks at the history, cause and possible overlap with Dissociation. #borderlinepersonalitydisorder #dissociation #diagnosis
Other references include: Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P, Salzer S, Spitzer C, Steinert C. Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry. 2024 Feb;23(1):4-25. doi: 10.1002/wps.21156. PMID: 38214629; PMCID: PMC10786009.
Ellison WD, Rosenstein LK, Morgan TA, Zimmerman M. Community and Clinical Epidemiology of Borderline Personality Disorder. Psychiatr Clin North Am. 2018 Dec;41(4):561-573. doi: 10.1016/j.psc.2018.07.008. Epub 2018 Oct 16. PMID: 30447724.
Krause-Utz A. Dissociation, trauma, and borderline personality disorder. Borderline Personal Disord Emot Dysregul. 2022 Apr 19;9(1):14. doi: 10.1186/s40479-022-00184-y. PMID: 35440020; PMCID: PMC9020027.Podcast IntroductionThe CTAD Clinic2024-07-31 | Dr Mike Lloyd (CTAD Clinic Director) was featured on a podcast being published on 1st August, all about things dissociative, like #osdd and #did Links to this podcast, 'Healing My Parts', are below: podcasts.apple.com/us/podcast/healing-my-parts-substack-podcast/id1727411790 healingmyparts.substack.com/podcast open.spotify.com/show/0KRcLU6PVPa2rJYjRVZw84What is...Bipolar Dissociation?The CTAD Clinic2024-07-27 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses how Bipolar Disorder and Dissociation can overlap, working through research and clinical presentations. Mike talks about the possible causes for both conditions and whether they are separate (co-morbid) conditions, as wll as problems that can occur if dissociation is not understood. #bipolar #bipolardisorder #dissociation
Steardo L Jr, Carbone EA, Ventura E, de Filippis R, Luciano M, Segura-Garcia C, De Fazio P. Dissociative Symptoms in Bipolar Disorder: Impact on Clinical Course and Treatment Response. Front Psychiatry. 2021 Oct 25;12:732843. doi: 10.3389/fpsyt.2021.732843. PMID: 34759848; PMCID: PMC8572831.
Rajkumar RP. Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review. Front Psychiatry. 2022 May 26;13:925983. doi: 10.3389/fpsyt.2022.925983. PMID: 35722564; PMCID: PMC9199377.
Tekin A, Özdil Demiryürek E, Güleken MD, Bakım B, Özer ÖA, Karamustafalıoğlu O. Investigation of the comorbidity of dissociative disorders in patients with bipolar disorder. Eur Res J. July 2019;5(4):667-672. doi:10.18621/eurj.412272
Aas, M., Henry, C., Andreassen, O.A. et al. The role of childhood trauma in bipolar disorders. Int J Bipolar Disord 4, 2 (2016). doi.org/10.1186/s40345-015-0042-0Losing to the ducks in a raceThe CTAD Clinic2024-07-21 | It’s bedtime and the ducks are outrunning me to get to their tea!Chronic Fatigue Syndrome: cause, treatment and impactThe CTAD Clinic2024-07-17 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses Chronic Fatigue Syndrome (also known as ME) and how it can present to health services, often masking underlying causes. This is part of a series looking at conditions associated with trauma (and dissociation, such as Other Specified Dissociative Disorder (OSDD) or Dissociative Identity Disorder (DID). Mike looks at research-led information on risk factors, and different ways of approaching treatment, via techniques recommended within therapy settings.
#otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #comorbidityThe Stranger in the Mirror - recommended readingThe CTAD Clinic2024-07-07 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) recommends a book by Marlene Steinberg (SCID-D author) and Maxine Schnall about dissociative conditions, causes and case studies. #dissociativedisorder #dissociation #traumaDenial and Dissociation: 10 things to considerThe CTAD Clinic2024-06-29 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses how denial within dissociation can affect many aspects of life. 10 points are considered, from why denial is present to what to do with it, within conditions such as Other Specified Dissociative Disorder (OSDD) or Dissociative Identity Disorder (DID) #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #dissociation #denialAlters and DerealizationThe CTAD Clinic2024-06-23 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses the potential for alters within conditions such as Other Specified Dissociative Disorder (OSDD) and Dissociative Identity Disorder (DID) being able to manifest derealization symptoms as a coping strategy against anxiety and trauma.
#otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #anxiety #traumaDID and OSDD: Remembering the BasicsThe CTAD Clinic2024-06-10 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) reflects on a brief illness and the importance of managing health in the context of trauma and dissociation. Mike looks at some of the basic messages for progressing through trauma, even when it feels impossible to do so. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #didDID: How Parts ReactThe CTAD Clinic2024-06-01 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses what can happen when a trigger event occurs, and different parts/alters within #otherspecifieddissociativedisorder #osdd and #dissociativeidentitydisorder #did react in different waysWhat is Derealization? An outline of essential features.The CTAD Clinic2024-05-26 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses what Derealization is in terms of diagnostic categories, and what needs to be taken into account when working out whetehr it is present or not within the spectrum of dissociation. #dissociation #derealization #derealisation #diagnosisThe clinic ducks having breakfastThe CTAD Clinic2024-05-21 | The clinic ducks always love getting breakfast every morning. It gets a bit hectic, but they all eat and are ready for a day in the garden!Partial DID or OSDD? Classifying and Diagnosing Types of DissociationThe CTAD Clinic2024-05-19 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses the different classification systems for diagnosing dissociation, with a focus on sorting out how to diagnose #PartialDID or #otherspecifieddissociativedisorder #OSDD or #dissociativeidentitydisorder #did using the DSM-V and ICD-11How to answer the question, Is DID a real thing?The CTAD Clinic2024-05-10 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) outlines a way of answering the question , 'is DID (Dissociative Identity Disorder) even a real thing. A subscriber asked Mike to answer this, and he goes through five ways of answering this question. #dissociativeidentitydisorder #didThe Therapy Trap...and how to get out of itThe CTAD Clinic2024-05-05 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses a question raised about how to prevent trauma from previous therapies entering into new therapeutic relationships. Mike describes how this problem can form, and what can be done to avoid such a 'therapy trap'. #therapyWhat Types of Therapist are there? Choosing a Therapist, part twoThe CTAD Clinic2024-05-03 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) continues the mini-series on choosing a therapist by looking at the non-medical therapy profesions. Mike discusses the types of therapist and the way they are or are not regulated. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #therapists
Links to the Professional Registers are as foolows: HCPC hcpc-uk.org/check-the-register BACP bacp.co.uk/search/Register NCPS ncps.com/about-us/accredited-register USA counselling by state onlinecounselingprograms.com/become-a-counselor/counseling-licensureHow to Know if Your Therapist is Good at Working with DissociationThe CTAD Clinic2024-04-26 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses a questions raised frequently, that of how can a person approaching therapy know if the therapist is going to be good at working with their dissociation or not. Mike answers this questions from a personal opinion perspective, as well at from conversations had with patients and therapists in the field over the years. Mike offers examples of questions to ask, ways of measuring information available, and red flags that need to be understood.
This video is for anyone looking at therapy, but expecially relevant for those with conditions such as Other Specified Dissociative Disorder (OSDD) and Dissociative Identity Disorder (DID).
#therapy #therapists #dissociationChoosing a Therapist for Dissociation: Part OneThe CTAD Clinic2024-04-20 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) begins the series on how to choose a therapist to treat dissocation. Folllowing an overview, Mike looks first at psychiatrists, as they are highly likely to feature in a lot of healthcare settings where diagnosis of dissociation is made. #dissociation #therapy #psychiatryHow Do I Find a Therapist for Dissociation? - mini-series introductionThe CTAD Clinic2024-04-17 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) introduces a mini-series looking at how people with dissociation can make good, informed choices about who their therapist should be. As part of this mini-series, Mike is asking people to leave questions that they would like answered on this topic in the comments section of this introduction. #therapy #therapists #dissociationSupporting a Person with DissociationThe CTAD Clinic2024-04-01 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) recommends an information resource for those helping a person they know with a complex dissociative condition, such as Other Specified Dissociative Disorder (OSDD) and Dissociative Identity Disorder (DID). This is linked to a previous CTAD video on ways to communicate with the parts held by someone with DID/OSDD. A link for this information sheet will be made available on the clinic's Resource page via cheshirepsychology.com/resources and via ISST-D: isst-d.org/wp-content/uploads/2022/03/2022-Support-Sheet-Supporting-a-Loved-One.pdf
#dissociativeidentitydisorder #did #otherspecifieddissociativedisorder #osddWalking the Clinic DucksThe CTAD Clinic2024-03-28 | In this video, we walk the clinic ducks from the patio, across the garden and into their enclosure, ready for their tea!How to manage Money with DID?The CTAD Clinic2024-03-23 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) answers a subscriber question about trying to manage money / spending when having conditions such as Other Specified Dissociative Disorder (OSDD) and Dissociative Identity Disorder (DID). #dissociativeidentitydisorder #dissociativedisorder #osdd #dissociationA Visual Depiction of What is Important in Therapy for Complex Trauma and DissociationThe CTAD Clinic2024-03-12 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) offers a visual approach to show the way that key elements of trauma therapy combine. Mike looks at both tangible and intangible components of therapy to highlight how they can combine and produce the right outcome for conditions such as Other Specified Dissociative Disorder (OSDD) and Dissociative Identity Disorder (DID), among other trauma-related conditions.Dissociative Identity Disorder Awareness Day 2024The CTAD Clinic2024-03-05 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) takes a moment to reflect on and appreciate the experience of people with Other Specified Dissociative Disorder (OSDD) or Dissociative Identity Disorder (DID). Mike also mentions a new charity in the UK which the CTAD Clinic supports, the Dissociative Disorders Alliance, who have a purpose to increase awareness, understanding and support for people with dissociation.
http://www.thedissociativedisordersalliance.org.uk @TheDDAGlobalDissociation and TimingThe CTAD Clinic2024-03-02 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses the importance of understanding timing when working with or experiencing dissociation. #dissociation #therapy10 Things That Make Getting Through a Dissociative Day HarderThe CTAD Clinic2024-02-18 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) goes through 10 things that are commonly described during therapy as things which make getting through normal days as a dissociative person/system harder. In managing, or trying to improve these things, it is always recommended that people do this within therapy settings. This is not an exhaustive list, there are others! #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #amnesia #depersonalization #derealizationWhat is the Dissociative Surface?The CTAD Clinic2024-02-11 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses how the 'Dissociative Surface' is represented and understood within Other Specified Dissociative Disorder (OSDD) and Dissociative Identity Disorder (DID). Mike reference the work of Richard Kluft (2009) in how this is unerstood in clinical settings. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapyWhat is Often Missing in Therapy for DID?The CTAD Clinic2024-02-03 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses an observation from clinical practice where people who have had previous therapy have revealed a gap in their therapy.
#otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #depersonalization #derealizationOne minute of Huckleberry with a tapThe CTAD Clinic2024-01-29 | Huckleberry found the tap in the clinic utility room and had some fun. Enjoy!Pain and Dissociation: Alters and DID part threeThe CTAD Clinic2024-01-29 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) continues the mini-series on pain in dissociation, focusing on how pain can be caused by the way alters present in Dissociative Identity Disorder (DID). Mike also looks at how this can be reduced, discussing stabilisation techniques (recommended within therapy settings). #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #painPain and Dissociation: Alters ( part two)The CTAD Clinic2024-01-05 | In this part two video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) continues to look through the importance and relevance of pain when looking at trauma and dissociation. This video focuses more on the way pain is manifested through alters within Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder (OSDD). #dissociation #trauma #pain #therapy #dissociativeidentitydisorder #did and #otherspecifieddissociativedisorder Specified Dissociative Disorder #osddPain in Trauma and Dissociation: part oneThe CTAD Clinic2023-12-29 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses the im[ortance and relevance of pain when looking at trauma and dissociation. THis is the firts of three videos focusing on what pain means, why is it present and how can it be resolved within therapy for complex trauma. #dissociation #trauma #pain #therapyPutting the Muscovy ducks to bedThe CTAD Clinic2023-12-28 | Each evening, we count and walk the clinic muscovies down for their tea and bedtime!Muscovy Clinic Ducks by the lakeThe CTAD Clinic2023-12-17 | This is a short relaxation video from the CTAD Clinic, where one of the clinic Muscovy ducks sits by the lake and has wash. Enjoy!Integration and Fusion in DID/OSDD: part twoThe CTAD Clinic2023-12-17 | In this part two video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) continues discussing the conept of integration within Other Specified Dissociative Disorder (OSDD) and Dissociative Identity Disorder (DID). Mike looks at the defining characteristics of integration and fusion, as well as developing an understanding of why these are important when considering treatment for dissociation. #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #integration #fusion #finalfusionTraining Doctors about DissociationThe CTAD Clinic2023-12-10 | In this video from the CTAD Clinic, Dr Mike Lloyd (Clinic Director) feeds back from a conference in Romania last week where he presented about dissociation to the medical students of the IMSCB (International Medical Students Congress of Bucharest). Mike has taken this experience to consider and start planning for a training schedule in 2024 which will include webinar training for doctors about the field of dissociation. Please keep an eye on the training part of our website for details!
#dissociationIntegration in DID/OSDDThe CTAD Clinic2023-11-26 | In this video from The CTAD Clinic, Dr Mike Lloyd (Clinic Director) discusses a common topic within Other Specified Dissociative Disorder (OSDD) or Dissociative Identity Disorder (DID) - that of the role or purpose of integration. The clinic receives many questions about this, and this introductory video answers one of them. As this is a large topic, Mike introduces the terms for reference, and will be doing a 'mini-series' on this! #otherspecifieddissociativedisorder #osdd #dissociativeidentitydisorder #did #therapy #integration