Why Therapists Often Miss DID: 4 Common Reasons
(Summary) Many survivors wonder: If I had DID or OSDD, wouldn’t my therapist have told me? The truth is, not necessarily. Therapists can and do miss dissociative disorders for several reasons. Some don’t believe DID is real, others lack training in dissociation, and many assume it’s too rare to consider. Because DID is designed to stay hidden, even well-meaning therapists may not recognize the signs. Understanding why this happens can help you advocate for yourself and seek out trauma-informed care.
Perhaps you’ve had questions at times about whether you might have dissociative identity disorder, or OSDD, but you decide that you surely must not because your therapist would have told you, right? Well, maybe not. It’s quite possible that you can have DID or OSDD, be in therapy, and the therapist be unaware of it. Here are four reasons why.
First, your therapist doesn’t believe in DID: doesn’t believe it’s a real disorder. Because they believe DID is not real, they aren’t going to consider it as a possibility and will therefore explain your symptoms in other ways, such as deciding you have borderline personality disorder instead.
Second, a lack of training. Although I believe it’s starting to change, most graduate programs do not teach about dissociation or dissociative disorders. Your therapist might miss the subtle clues that you have a dissociative disorder simply because they’re lacking knowledge.
Third, your therapist might believe, mistakenly, that DID is quite rare, see the lack of training above, and therefore, it doesn’t even occur to them as a possibility.
DID is a master of disguise. DID is intended to go unnoticed and is generally very successful at this.
This is true with therapists too, particularly when the therapist is lacking training and understanding When there is good therapeutic rapport, a DID system may choose to make itself known to the therapist, but when good therapeutic rapport is lacking, the system will do its utmost to remain hidden and unnoticed. One indication that DID or other dissociative disorder should be considered is when someone has been in therapy for years without much in the way of results or progress to show it.
Frequently Asked Questions
Can I have DID or OSDD without my therapist knowing?
Yes. It’s possible to be in therapy and still have DID or OSDD go unnoticed. Many therapists lack training in dissociation, and DID itself is designed to remain hidden until the system feels safe enough to be recognized.
Why wouldn’t a therapist diagnose DID?
Some therapists don’t believe DID is real, others assume it’s too rare to consider, and many were never trained to recognize dissociative symptoms. As a result, they may misdiagnose symptoms as borderline personality disorder, bipolar disorder, or another condition.
How does lack of training affect DID diagnosis?
Most graduate programs have historically provided little or no education on dissociation. Without specific training, therapists may miss subtle signs, leaving dissociative disorders undiagnosed for years.
Why might DID stay hidden during therapy?
DID is a survival strategy meant to disguise itself. Parts may avoid being noticed, especially if trust with the therapist is low. Even with strong rapport, systems may reveal themselves gradually rather than all at once.
What’s one sign DID might be present in therapy?
If you’ve been in therapy for years with little progress despite consistent effort, a dissociative disorder may be worth exploring. Lack of results can sometimes point to missed dissociative symptoms.