How to Advocate for Yourself in Therapy

Self-advocacy can be simple: name pacing needs, ask for clarity, bring notes, and repair ruptures before they become treatment-ending. ^{1 2 3}

Main ideas

• DID can make therapy hard to summarize, so written notes and shared agendas can help.
• Advocacy includes asking to slow down, changing topics, clarifying consent, or naming when a part feels unsafe.
• A good therapist should welcome feedback even when they also maintain boundaries.

Questions for reflection

• Can we set an agenda at the start of sessions?
• What should we do if switching or shutdown happens?
• Can we review grounding before difficult topics?

Clinical note

Advocacy is not being difficult. It is part of making treatment workable.

Footnotes

1. International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma & Dissociation, 12(2), 115-187. pp. 115-187. Full adult DID treatment guideline PDF. ↩

2. Pietkiewicz, I. J., Banbura-Nowak, A., Tomalski, R., & Boon, S. (2021). Revisiting false-positive and imitated dissociative identity disorder. Frontiers in Psychology, 12. Differential diagnosis article. Open access diagnostic caution article. ↩

3. Van der Hart, O., et al. (2012). The use of imagery in phase 1 treatment of clients with complex dissociative disorders. European Journal of Psychotraumatology, 3. Phase 1 treatment article. Open access stabilization and imagery article. ↩