Psychotherapy is considered the first choice and gold standard in the treatment of dissociative disorders. At the moment, different treatment options are available. For complex dissociative disorders, guidelines of the International Society for the Study of Trauma and Dissociation recommend a phase-oriented staged approach, which is integrative, flexible, and preferably long-term. Modifications of personality disorder treatments and trauma-focused treatments have also been found to effectively treat individuals with severe dissociation. Several modified protocols are currently tested. For BPD, clinical staging models are recommended instead of a one-fits-all approach. Treatment guidelines for BPD recommend that co-occurring disorders, such as dissociative disorders, should be managed concurrently with BPD-specific treatment and should only be prioritized if the co-occurring disorder prevents effective psychotherapy or leads to a life-threatening situation. There is evidence that dissociative symptoms can be effectively targeted with established or modified versions of specialized treatments for BPD, such as dialectical behaviour therapy, mentalization-based treatment, transference-focused therapy, and schema therapy. Dissociative symptoms should be carefully assessed at different stages of the therapeutic process. Depending on the individual triggers and functions of dissociation, different practical skills and personalized interventions can be used to counteract dissociative symptoms within and outside of therapy sessions.