What is dissociation?

Dissociation refers to a disruption in the usual integration of experience. A person may feel disconnected from their thoughts, emotions, body, memory, surroundings, or sense of identity. For some, this shows up as depersonalisation, in which the self or body feels unreal or strangely distant. For others, it appears as derealisation, where the external world feels dreamlike, foggy, flat, or oddly altered. Some people experience significant memory gaps, episodes of shutdown, or trauma-related states that can resemble absence, collapse, or non-epileptic seizure-like episodes.

Dissociation is not always dramatic from the outside. It may instead appear as inconsistency, withdrawal, confusion, numbness, difficulty staying present, or a disturbing sense that parts of life are happening at a distance.

Why a proper dissociation assessment matters

Dissociation is often overlooked or mistaken for something else. Some people are told they are simply anxious. Others are labelled as unstable, inattentive, avoidant, emotionally dysregulated, or resistant. In reality, dissociation may be a central part of the clinical picture.

A careful assessment can help clarify whether dissociation is present, how severe it is, what form it takes, how it relates to trauma or stress, and whether other conditions may also need to be considered. It can also help guide treatment. This matters because therapy for dissociation often requires particular care around pacing, stabilisation, grounding, and trauma work. In some cases, it may be important to establish more safety and internal stability before beginning deeper trauma processing.

Signs that a dissociation assessment may be helpful

You may benefit from a dissociation assessment if you experience any of the following:

• feeling detached from your body, thoughts, or emotions
• a sense that the world feels unreal, foggy, flat, distant, or dreamlike
• memory gaps or losing track of time
• periods of shutdown, collapse, freezing, or going blank under stress
• trauma symptoms that seem more complex than standard PTSD alone
• a history of chronic trauma, emotional abuse, neglect, coercive control, or repeated relational trauma
• uncertainty about whether symptoms reflect trauma, dissociation, neurodivergence, mood disorder, personality dynamics, or an overlap of several factors
• previous therapy that has felt overwhelming, destabilising, or confusing rather than containing

What my dissociation assessment involves

My assessments are thoughtful, trauma-informed, and tailored to the person. They do not rely on a single checklist. Instead, they bring together symptom assessment, clinical formulation, developmental understanding, and functional impact.

Depending on the referral question, a dissociation assessment may include:

• a detailed clinical interview exploring symptoms, history, and current functioning
• careful exploration of trauma history, attachment history, and periods of overwhelm, collapse, or disconnection
• psychometric measures where clinically appropriate
• assessment of depersonalisation, derealisation, memory disturbance, identity disruption, and trauma-related dissociative responses
• consideration of overlap with PTSD, complex PTSD, depression, anxiety, functional neurological symptoms, autism, ADHD, and related presentations
• evaluation of how symptoms affect work, study, relationships, and day-to-day life

Following the assessment, I provide a clinical opinion and recommendations. Depending on the service agreed in advance, this may include feedback only, a brief summary letter, or a fuller written report.

My approach

I specialise in the assessment and treatment of complex trauma, PTSD, complex PTSD, and dissociation. My approach is both clinically rigorous and deeply human. I work psychodynamically and relationally, with strong expertise in trauma, attachment, and the deeper structure of symptoms. I also integrate trauma-focused approaches where appropriate, including EMDR and broader stabilisation-based work.

This means I do not see dissociation as merely a symptom to be ticked off on a list. I look at what it may mean, how it developed, what function it has served, and what kind of treatment is likely to be safest and most effective. For many people, dissociation is not random. It is an adaptation to overwhelm.

Who this assessment is for

This service is for adults who are seeking clarity about possible dissociation, trauma-related shutdown, depersonalisation, derealisation, or more complex post-traumatic symptoms. It may be especially useful for people who:

• have a trauma history and suspect dissociation may be part of the picture
• have been given previous diagnoses that do not fully explain their experience
• want diagnostic clarification before beginning therapy or trauma treatment
• need a clearer clinical formulation to guide the next stage of care

Appointments

Assessments are available online and in central London. If you would like to enquire about a dissociation assessment, please get in touch with a brief outline of your concerns and whether you are seeking diagnostic clarification, treatment recommendations, or a written report.