Got PTSD? Treating It Can Help Your Whole System
(Summary) Many people with dissociative identity disorder (DID) or other specified dissociative disorder (OSDD) also live with post-traumatic stress disorder (PTSD). One evidence-based treatment for PTSD, called Cognitive Processing Therapy (CPT), may offer relief for some systems by reducing triggers and the chaos of frequent switching. CPT is a structured, 12-session approach that helps survivors work through beliefs shaped by trauma—without requiring them to retell their entire story. While CPT won’t “cure” DID or OSDD, it can reduce PTSD symptoms, improve functioning, and provide lifelong coping skills. For systems with enough stability to engage, CPT can be a practical option, whether with a therapist trained in the method or, with caution, through an affordable workbook.
A significant portion of people who have DID or OSDD also qualify for a diagnosis of PTSD. This isn’t really surprising because DID and OSDD usually involve a lot of trauma.
What I want to talk about today is one potential way to help your system to reduce the chaos that comes from being triggered frequently and switching frequently. Now I need to be clear that this a potential path for some of you, but not all.
Cognitive Processing Therapy, CPT, was developed to treat PTSD and it’s a very effective treatment that takes around 12 sessions. When a system can identify a major trauma, or an early one that is representative of later traumas, this therapy can help reduce your PTSD. And that can reduce how much your system is triggered and how severe your other symptoms are. This can offer significant relief in a fairly brief period of time.
Another potential benefit to this is if you have access to therapy but haven’t found a therapist who seems to understand DID or OSDD. You can look for a therapist who offers CPT for treating PTSD and see if you can get some relief from this without ever officially working on the DID or OSDD.
What I love about CPT, aside from the fact that it works so well, is that it does not ask you to tell the story of the trauma. All the therapist needs to know is kind of a title, like “My uncle raped me” or even “My uncle hurt me.” During the course of CPT, you will learn about how PTSD works and you will be given a series of worksheets that teach you skills that you will be able to use for the rest of your life for everyday life issues and events. CPT says it teaches you to be your own therapist. These worksheets and skills will walk you through your trauma and what you believe about it and yourself. You will begin to see where your beliefs are inaccurate. For instance, a woman who is raped might believe if she just hadn’t worn that outfit, nothing would have happened to her. CPT would help this woman realize what she wore had little to do with the assault and therefore she is blaming herself needlessly. This is just one example. The point is that you will still have to confront the memory of the trauma, and this is not easy, but you will do it through the worksheets, little by little, and in the comfort and privacy of your own home. The therapist will learn some details as you work through the worksheets, but you’ll never have to tell the whole painful story to them unless you choose to do the story-telling version of CPT which is optional.
I have found that clients who had DID or OSDD and who I treated with CPT benefited a great deal. They still had DID or OSDD, but they had a lot less triggering. They were able to function better overall. I want to emphasize that this treatment will not be appropriate for every system. You will need to have an everyday life part who can consistently show up to therapy, be present to learn the information, and who can do the daily homework. Or you need to have a system where enough other parts are able to listen in and work together to share the information from the sessions and to complete the daily homework. If your system switches uncontrollably, especially if it rolodexes or switches rapidly, CPT is not a treatment I would recommend for you.
But what if the cost of therapy is a barrier? If you have no insurance, go to the Open Path Psychotherapy Collective, where you can obtain access to reduced-fee therapy from $30 to $60 per session. If this is not possible, then you may want to look at the workbook Getting Unstuck from PTSD. This workbook was written by one of the developers of CPT and it is excellent. I want to urge you to be cautious if you try to do this on your own. As I said moments ago, if your system switches rapidly and uncontrollably, then I would discourage you from trying this workbook. For systems with more stability, go slowly and carefully so you can see if your symptoms get worse after starting the workbook. If your symptoms get worse, stop working on the workbook and seek a therapist who will work with you pro bono for even a few sessions. My preference is for any system interested in CPT to work with a therapist who can work with you to respond to symptoms that worsen, if they were to do so. But I also want people to be able to help themselves recover. It’s the whole reason I started this channel and am starting my community. I know it can be hard to get affordable or knowledgeable therapy for DID and OSDD, so I’m trying to fill in some of that gap with CommuniDID. And this workbook is another way to fill in that gap. And just to be clear: I do not benefit financially or in any other way for telling you about this workbook or for telling you about Open Path.
For more information about CPT, you can visit their website: https://cptforptsd.com/about-cpt/
The Open Path reduced-fee therapist directory is at: https://openpathcollective.org/
Frequently Asked Questions
Can Cognitive Processing Therapy (CPT) help people with DID or OSDD?
Yes, indirectly. CPT was developed to treat PTSD, but since many people with DID or OSDD also have PTSD, reducing PTSD symptoms can lessen triggers and chaos in the system, improving system stability. While CPT doesn’t treat DID directly, it can make daily life more manageable for some systems.
Do you have to tell your whole trauma story in CPT?
No. One of the benefits of CPT is that you don’t need to share the full details of your trauma. The therapist only needs a short “title” for the event, like “My uncle hurt me.” Processing happens through structured worksheets that guide you in challenging trauma-related beliefs.
How long does CPT take?
CPT is typically a short-term treatment lasting about 12 weekly sessions. Each session builds on the previous one, and you’ll also use worksheets at home. The skills you learn can be applied beyond trauma work and used for everyday challenges.
Is CPT safe for all DID or OSDD systems?
Not always. CPT works best for systems that have an everyday-life part who can reliably attend sessions and complete homework, or for systems that can cooperate enough to share the material. If switching is rapid and uncontrollable (such as rolodex switching), CPT may not be a good fit.