In my experience of the British psychotherapy world there is a general interest in the implications of dissociation but the need to sharply vary technique is less well understood. Without attempting to be comprehensive, this paper surveys recent clinical writing on the techniques and management required when faced with dissociation in general and clients with dissociative identity disorder in particular. In this article I describe the example of a misdiagnosed client, discuss ways of diagnosing dissociation, and ways of working with clients whose main way of protecting themselves is through dissociation. I draw on a variety of approaches including: psychoanalysis, sensorimotor psychotherapy, ego state therapy, and neuroscience.