The Cost of Not Knowing

Written by Colette Lord, PhD

Dr. Colette Lord (she/her) is an EMDRIA Certified Therapist and Consultant with over a decade of experience treating Dissociative Identity Disorder in both private practice and community mental health settings. A Diplomate of the American Academy of Experts in Traumatic Stress and a member of the International Society for the Study of Trauma and Dissociation, she brings deep expertise and a lifelong passion for learning to her clinical work and consultation. Drawing on extensive advanced training and years of study, Dr. Lord offers grounded, accessible education for EMDR clinicians ready to better recognize and respond to dissociation in their clients.

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Dissociation Is Common—But Our Training Doesn’t Reflect That

We don’t see dissociation because we weren’t taught to look. And when we do look, it’s often too late.

Like many EMDR clinicians, I left Basic Training believing I had the foundation I needed—until I found myself working with someone who, in retrospect, had every textbook symptom of Dissociative Identity Disorder.

And I didn’t realize it.

Not because I wasn’t paying attention. But because I hadn’t been trained to see it.

What I had been taught was limited. Despite the DSM’s own statistics reporting a prevalence rate higher than OCD, Dissociative Identity Disorder never came up in my PhD program.  

And, in EMDR Basic Training, the instruction to use the DES for dissociation screening was not accompanied by an explanation of what responses to look out for or how to assess deeper.

And in that gap, I missed what was right in front of me.

I learned that we cannot afford to overlook what we have not been trained to see.

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Stigma and Silence: How Dissociation and DID Are Still So Often Dismissed

When we aren’t trained to see it, we’re more likely to avoid it.

In the early years of my work as an EMDR therapist, I was already treating dissociation—I just didn’t know it. The symptoms were there: memory issues, internal conflict, inconsistent affect. But I didn’t have a framework to recognize what I was seeing.

Eventually, through consultation and deeper training, I started putting the pieces together.

But as I began talking with colleagues about what I was seeing, I encountered something I didn’t expect: disbelief, discomfort, dismissal, and even subtle mocking that I was now one of  “those clinicians seeing Dissociative Disorders everywhere.”

Despite the research, despite the prevalence, there was a quiet but real stigma around dissociative disorders. It wasn’t necessarily malicious. But it was rooted in discomfort. In fear. In not knowing what to do with this material.

And it lit something in me. A kind of social justice fire.

Because here’s the truth: Clients with dissociative disorders are already on our caseloads.

The question is not whether we’ll encounter them. It’s whether we’ll recognize it when we do. And when we miss it, we risk harming the clients we most want to help.

In the absence of training and support, avoidance becomes the norm. And that avoidance leaves clients misdiagnosed, misunderstood or mistreated.

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A Starting Place for Learning: Why I Created This Introduction to DID

When we miss dissociation, we risk retraumatization. But when we see it, we can offer something transformative.

Once I realized I had been missing signs of dissociation, I knew I needed more training. But the options available to me were overwhelming: long, expensive intensives that required significant time and financial commitment, or academic texts that didn’t translate easily into practical interventions.

What I couldn’t find was a way to begin. A grounded, accessible starting point for treating dissociation with EMDR in a safe, respectful, and attuned way.

That’s why I created the course Introduction to Working with Dissociative Identity Disorder: Understanding through and EMDR Lens.

Not as a replacement for intensive programs—but as a bridge.

A place to begin for EMDR clinicians who are already doing the work, but haven’t had a map.

A training that offers both structure and flexibility—so you can start recognizing dissociation in your clients and responding with confidence instead of fear.

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The Power of Consultation in EMDR and Dissociation Work

You don’t have to figure it out alone—and you shouldn’t.

Consultation was what helped me recognize dissociation in my client—and in many others. It gave me the language I didn’t have, and the lens I didn’t know I needed.

It’s also how we protect our clients from the unintended harm that comes from practicing in isolation.

Absorbing all we can from trainings and textbooks is a must, but consultation allows us to sort through the tangles of theory, connect concepts to human experience, and develop skills needed for effective practice.

Consultation is where EMDR therapists can explore these questions—without shame, without stigma, and with the support of a mentor who has been there.

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Final Thoughts: Dissociation, EMDR Therapy, and the Clients We’re Missing

Understanding dissociation is not a specialty skill—it’s a clinical necessity.

Dissociation is not rare. It’s not fringe. It’s common—especially in clients with complex trauma.

As EMDR therapists, we are already working with dissociation. The question is whether we’re prepared to recognize it—and to respond with attunement and skill.

And if we’re not trained to see it, we will miss it. We’ll pathologize. We’ll retraumatize. Or we’ll simply not treat it effectively—leaving clients with some of the deepest wounds without the healing that is possible for them.

Training and consultation are essential for those of us who want to see more clearly. Who want to approach dissociation not with fear or avoidance, but with grounded clinical presence.

The cost of not knowing is too high. And our clients deserve better.

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‍References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.

Brand, B. L., Loewenstein, R. J., & Spiegel, D. (2014). Dispelling myths about dissociative identity disorder treatment: An empirically based approach. Psychiatry: Interpersonal and Biological Processes, 77(2), 169–189. https://doi.org/10.1521/psyc.2014.77.2.169 (https://psycnet.apa.org/doi/10.1521/psyc.2014.77.2.169)

Burdzik, E., & Burdzik, M. (2023). Dissociative identity disorder as interdisciplinary problem. Part 1—Psychiatric and psychological aspects. Psychiatria Polska, 57(1), 147–162. https://doi.org/10.12740/PP/146969

Leeds, A. M., Madere, J. A., & Coy, D. M. (2022). Beyond the DES-II: Screening for dissociative disorders in EMDR therapy. Journal of EMDR Practice and Research, 16(1), 25–38. https://doi.org/10.1891/EMDR-D-21-2021-00019 (https://psycnet.apa.org/doi/10.1891/EMDR-D-21-2021-00019)

Resources

• To access the On-Demand Training: Introduction to Working with Dissociative Identity Disorder: Understanding through and EMDR Lens (8 EMDRIA + APA + NBCC CE Credit Hours Available): https://www.precisionemdr.com/dissociation

• To contact Colette Lord, PhD for Therapy and Consultation focused on EMDR, Dissociation, Transgender and Non-Binary Issues: https://colettelordphd.com