You sound quite rational to me. Dissociation is not a psychosis. You do have a choice. If the medicine doesn't help with the dissociation, and only bogs you down, why take the increased dosage? You wouldn't be the first patient to have to heartily urge a doctor to stop and talk and understand them!

WHO laughed? The T or the pdoc? Either way it doesn't sound good to me, like you aren't being taken seriously. Don't buy into any idea that you aren't dissociative if you know you are (and instead "psychotic." ) I'm sorry you are in this place, but don't give up. Yes, you've weathered much worse, but I hope you get smooth sailing soon.