A patient-oriented manual for complex trauma survivors.
A patient-oriented manual for complex trauma survivors.
A patient-oriented manual for complex trauma survivors. This training manual for patients who have a trauma-related dissociative disorder includes short educational pieces, homework sheets, and exercises that address ways in which dissociation interferes with essential emotional and life skills, and support inner communication and collaboration with dissociative parts of the personality. Topics include understanding dissociation and PTSD, using inner reflection, emotion regulation, coping with dissociative problems related to triggers and traumatic memories, resolving sleep problems related to dissociation, coping with relational difficulties, and help with many other difficulties with daily life. The manual can be used in individual therapy or structured groups.
They typically have a wide array of symptoms, often classified under different combinations of comorbidity, which can make assessment and treatment complicated and confusing for the therapist. Many patients have substantial problems with daily living and relationships, including serious intrapsychic conflicts and maladaptive coping strategies. Their suffering essentially relates to a terrifying and painful past that haunts them. Even when survivors attempt to hide their distress beneath a facade of normality—a common strategy—therapists often feel besieged by their many symptoms and serious pain. Small wonder that many survivors of chronic traumatization have seen several therapists with little if any gains, and that quite a few have been labeled as untreatable or resistant. In this book, three leading researchers and clinicians share what they have learned from treating and studying chronically traumatized individuals across more than 65 years of collective experience. Based on the theory of structural dissociation of the personality in combination with a Janetian psychology of action, the authors have developed a model of phase-oriented treatment that focuses on the identification and treatment of structural dissociation and related maladaptive mental and behavioral actions. The foundation of this approach is to support patients in learning more effective mental and behavioral actions that will enable them to become more adaptive in life and to resolve their structural dissociation. This principle implies an overall therapeutic goal of raising the integrative capacity, in order to cope with the demands of daily life and deal with the haunting remnants of the past, with the “unfinished business” of traumatic memories. Of interest to clinicians, students of clinical psychology and psychiatry, as well as to researchers, all those interested in adult survivors of chronic child abuse and neglect will find helpful insights and tools that may make the treatment more effective and efficient, and more tolerable for the suffering patient.
Winner of the International Society for the Study of Trauma and Dissociation's (ISSTD) Pierre Janet Writing Award, 2015. What really happens in dissociation. Winner of the International Society for the Study of Trauma and Dissociation's (ISSTD) Pierre Janet Writing Award, 2015. What really happens in dissociation. Winner of the International Society for the Study of Trauma and Dissociation's (ISSTD) Pierre Janet Writing Award, 2015. What really happens in dissociation. Winner of the International Society for the Study of Trauma and Dissociation's (ISSTD) Pierre Janet Writing Award, 2015. What really happens in dissociation. Dissociative processes have long burdened trauma survivors with the dilemma of longing to feel “real” at the same time as they desperately want to avoid the pain that comes with that healing—a dilemma that often presents particularly acute difficulties for healing professionals. Recent clinical and neurobiological research sheds some light into the dark corners of a mind undergoing persistent dissociation, but its integration into the practice of talking therapy has never, until now, been fully realized. Intensive Psychotherapy for Persistent Dissociative Processes brings readers into the consultation room, and into the minds of both patient and therapist, like no other work on the treatment of trauma and dissociation. Richard A. Chefetz marries neuroscientific sophistication with a wealth of extended case histories, following patients over several years and offering several verbatim session transcripts. His unpacking of the emotionally impactful experience of psychodynamic talking therapy is masterfully written, clearly accessible, and singularly thorough. From neurobiological foundations he builds a working understanding of dissociation and its clinical manifestations. Drawing on theories of self-states and their involvement in dissociative experiences, he demonstrates how to identify persistent dissociation and its related psychodynamic processes, including repetition compulsion and enactment. He then guides readers through the beginning stages of a treatment, with particular attention to the psychodynamics of emotion in both patient and therapist. The second half of the book immerses readers in emotionally challenging clinical processes, offering insight into the neurobiology of fear and depersonalization, as well as case examples detailing struggles with histories of incest, sexual addiction, severe negativity, negative therapeutic reactions, enactment, and object-coercive doubting. The narrative style of Chefetz’s casework is nearly novelistic, bringing to life the clinical setting and the struggles in both patient and therapist. The only mystery in this clinical exposition, as it explores several cases over a number of years, is what will happen next. In the depth of his examples and in continual, self-reflexive analysis of flaws in past treatments, Chefetz is both a generous guide and an expert storyteller. Intensive Psychotherapy for Persistent Dissociative Processes is unique in its ability to place readers in the consultation room of psychodynamic therapy. With an evidence-focused approach based in neurobiology and a bold clinical scope, it will be indispensible to new and experienced therapists alike as they grapple with the most intractable clinical obstacles.
Establishing safety and working with dissociative parts in complex trauma therapy. Therapists around the world ask similar questions and struggle with similar challenges treating highly dissociative patients. This book arose not only out of countless hours of treating patients with dissociative disorders, but also out of the crucible of supervision and consultation, where therapists bring their most urgent questions, needs, and vulnerabilities. The book offers an overview of the neuropsychology of dissociation as a disorder of non-realization, as well as chapters on assessment, prognosis, case formulation, treatment planning, and treatment phases and goals, based on best practices. The authors describe what to focus on first in a complex therapy, and how to do it; how to help patients establish both internal and external safety without rescuing; how to work systematically with dissociative parts of a patient in ways that facilitate integration rather than further dissociation; how to set and maintain helpful boundaries; specific ways to stay focused on process instead of content; how to deal compassionately and effectively with disorganized attachment and dependency on the therapist; how to help patients integrate traumatic memories; what to do when the patient is enraged, chronically ashamed, avoidant, or unable to trust the therapist; and how to compassionately understand and work with resistances as a co-creation of both patient and therapist. Relational ways of being with the patient are the backbone of treatment, and are themselves essential therapeutic interventions. As such, the book also focused not only on highly practical and theoretically sound interventions, not only on what to do and say, but places strong emphasis on how to be with patients, describing innovative, compassionately collaborative approaches based on the latest research on attachment and evolutionary psychology. Throughout the book, core concepts—fundamental ideas that are highlighted in the text in bold so they can be seen at a glance—are emphasized. These serve as guiding principles in treatment as well as a summing-up of many of the most important notions in each chapter. Each chapter concludes with a section for further examination. These sections include additional ideas and questions, exercises for practicing skills, and suggestions for peer discussions based on topics in a particular chapter, meant to inspire further curiosity, discovery, and growth.
First published in 2001. Routledge is an imprint of Taylor & Francis, an informa company.
Dr Paulsen's narrative and 100 cartoons assist therapists and clients to understand trauma and dissociation, from giving a voice to disowned parts of self, to stabilizing and detoxifying memories.
The Child Survivor is a clinically rich, comprehensive overview of the treatment of children and adolescents who have developed dissociative symptoms in response to ongoing developmental trauma. Joyanna Silberg, a widely respected authority in the field, uses case examples to illustrate hard-to-manage clinical dilemmas such as children presenting with rage reactions, amnesia, and dissociative shut-down. These behaviors are often survival strategies, and in The Child Survivor practitioners will find practical management tools that are backed up by recent scientific advances in neurobiology. Clinicians on the front lines of treatment will come away from the book with an arsenal of therapeutic techniques that they can put into practice right away, limiting the need for restrictive hospitalizations or out-of-home placements for their young clients.
Healing the Fragmented Selves of Trauma Survivors integrates a neurobiologically informed understanding of trauma, dissociation, and attachment with a practical approach to treatment, all communicated in straightforward language accessible to both client and therapist. Readers will be exposed to a model that emphasizes "resolution"—a transformation in the relationship to one’s self, replacing shame, self-loathing, and assumptions of guilt with compassionate acceptance. Its unique interventions have been adapted from a number of cutting-edge therapeutic approaches, including Sensorimotor Psychotherapy, Internal Family Systems, mindfulness-based therapies, and clinical hypnosis. Readers will close the pages of Healing the Fragmented Selves of Trauma Survivors with a solid grasp of therapeutic approaches to traumatic attachment, working with undiagnosed dissociative symptoms and disorders, integrating "right brain-to-right brain" treatment methods, and much more. Most of all, they will come away with tools for helping clients create an internal sense of safety and compassionate connection to even their most dis-owned selves.
17 true stories about dissociative identity disorder and living with multiple parts, alters, identities & personalities
Winner of ISSTD's 2009 Pierre Janet Writing Award for the best publication on dissociation in 2009! Dissociation and the Dissociative Disorders is a book that has no real predecessor in the dissociative disorders field. It reports the most recent scientific findings and conceptualizations about dissociation; defines and establishes the boundaries of current knowledge in the dissociative disorders field; identifies and carefully articulates the field’s current points of confusion, gaps in knowledge, and conjectures; clarifies the different aspects and implications of dissociation; and sets forth a research agenda for the next decade. In many respects, Dissociation and the Dissociative Disorders both defines and redefines the field.
The body, for a host of reasons, has been left out of the "talking cure." Psychotherapists who have been trained in models of psychodynamic, psychoanalytic, or cognitive therapeutic approaches are skilled at listening to the language and affect of the client. They track the clients' associations, fantasies, and signs of psychic conflict, distress, and defenses. Yet while the majority of therapists are trained to notice the appearance and even the movements of the client's body, thoughtful engagement with the client's embodied experience has remained peripheral to traditional therapeutic interventions. Trauma and the Body is a detailed review of research in neuroscience, trauma, dissociation, and attachment theory that points to the need for an integrative mind-body approach to trauma. The premise of this book is that, by adding body-oriented interventions to their repertoire, traditionally trained therapists can increase the depth and efficacy of their clinical work. Sensorimotor psychotherapy is an approach that builds on traditional psychotherapeutic understanding but includes the body as central in the therapeutic field of awareness, using observational skills, theories, and interventions not usually practiced in psychodynamic psychotherapy. By synthesizing bottom-up and top down interventions, the authors combine the best of both worlds to help chronically traumatized clients find resolution and meaning in their lives and develop a new, somatically integrated sense of self. Topics addressed include: Cognitive, emotional, and sensorimotor dimensions of information processing • modulating arousal • dyadic regulation and the body • the orienting response • defensive subsystems • adaptation and action systems • treatment principles • skills for working with the body in present time • developing somatic resources for stabilization • processing
The Dissociative Mind in Psychoanalysis: Understanding and Working With Trauma is an invaluable and cutting edge resource providing the current theory, practice, and research on trauma and dissociation within psychoanalysis. Elizabeth Howell and Sheldon Itzkowitz bring together experts in the field of dissociation and psychoanalysis, providing a comprehensive and forward-looking overview of the current thinking on trauma and dissociation. The volume contains articles on the history of concepts of trauma and dissociation, the linkage of complex trauma and dissociative problems in living, different modalities of treatment and theoretical approaches based on a new understanding of this linkage, as well as reviews of important new research. Overarching all of these is a clear explanation of how pathological dissociation is caused by trauma, and how this affects psychological organization -- concepts which have often been largely misunderstood. This book will be essential reading for psychoanalysts, psychoanalytically oriented psychotherapists, trauma therapists, and students.
Dissociation, Mindfulness, and Creative Meditations explores the potential of mindfulness and explains why this level of developmental human achievement is so precarious within traumatic stress, especially traumatic dissociation. Chapters discuss the connection and disconnection between mindfulness and dissociative disorders and highlight the importance of gently creating a mindfulness practice for traumatized individuals. Readers will learn how to exercise the part of the brain that is responsible for mindfulness and how to regulate the part that is responsible for dissociation, and they’ll come away from the book with tips that will help even the most dissociative client to reap the benefits of mindfulness practices.