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Treating Trauma-Related Dissociation: A Practical, Integrative Approach (Norton Series on Interpersonal Neurobiology)

Author: Kathy Steele

Publisher: W. W. Norton & Company

Published: 2016-11-29

Total Pages: 560

ISBN-13: 039371263X

Winner of the 2017 International Society for the Study of Trauma and Dissociation (ISSTD) Pierre Janet Writing Award. 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.

Coping with Trauma-related Dissociation

Author: Suzette Boon

Publisher: W. W. Norton & Company

Published: 2011-03-15

Total Pages: 490

ISBN-13: 039370646X

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This training manual for pateints who have suffered severe trauma includes a short educational piece, homework sheets, and exercises that promote essential emotional and life skills.

Neurobiology and Treatment of Traumatic Dissociation

Author: Ulrich F. Lanius, PhD

Publisher: Springer Publishing Company

Published: 2014-05-13

Total Pages: 537

ISBN-13: 0826106315

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Rebuilding Shattered Lives

Author: James A. Chu

Publisher: John Wiley & Sons

Published: 1998-04-30

Total Pages: 298

ISBN-13: 9780471247326

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In Rebuilding Shattered Lives, James A. Chu, MD, describes a proven approach to the assessment and treatment of post-traumatic and dissociative disorders developed at the Dissociative Disorders and Trauma Program at McLean Hospital and Harvard Medical School. Drawing on his extensive empirical research and more than a decade's clinical experience specializing in treating survivors of severe abuse, Dr. Chu also offers valuable insights into all the major areas of traumarelated symptomatology and provides the most detailed explanation of dissociative theory currently in print. And, with the help of numerous vignettes and case examples, he clearly illustrates common clinical dilemmas encountered when dealing with survivors of severe abuse as well as the most effective techniques for resolving them. Rebuilding Shattered Lives is an important working resource for mental health workers of all levels of experience. Throughout, the writing style is clear, and complex theories are explained with an emphasis on how they provide the conceptual basis for a rational, responsible, and safe approach to treatment.

Intensive Psychotherapy for Persistent Dissociative Processes: The Fear of Feeling Real (Norton Series on Interpersonal Neurobiology)

Author: Richard A. Chefetz

Publisher: W. W. Norton & Company

Published: 2015-04-06

Total Pages: 496

ISBN-13: 0393710904

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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.

Understanding Trauma and Dissociation

Author: Lynn Mary Karjala

Publisher:

Published: 2023-07-25

Total Pages: 0

ISBN-13: 9780998454504

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Understanding Trauma and Dissociation is a groundbreaking guide to unraveling the mysteries of trauma and dissociation and offering real hope for the chance to heal. Dr. Lynn Karjala, a renowned therapist, provides a comprehensive understanding of the debilitating physical and psychological effects of trauma ... Her innovative approach employing both conventional and mind-body techniques for trauma treatment makes this book a must-read for anyone interested in helping trauma survivors heal and recover.--Publisher.

Haunted Self

Author: Onno van der Hart

Publisher: W. W. Norton & Company

Published: 2006-10-17

Total Pages: 452

ISBN-13: 9780393704013

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Life is an ongoing struggle for patients who have been chronically traumatized. 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.

Affect Regulation Theory: A Clinical Model

Author: Daniel Hill

Publisher: W. W. Norton & Company

Published: 2015-08-31

Total Pages: 208

ISBN-13: 0393711323

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The rich, complex theory of affect regulation boiled down into a clinically useful guide. Affect regulation theory—the science of how humans regulate their emotions—is at the root of all psychotherapies. Drawing on attachment, developmental trauma, implicit processes, and neurobiology, major theorists from Allan Schore to Daniel Stern have argued how and why regulated affect is key to our optimal functioning. This book translates the intricacies of the theory into a cogent clinical synthesis. With clarity and practicality, Hill decodes the massive body of contemporary research on affect regulation, offering a comprehensible and ready-to-implement model for conducting affect regulation therapy. The book is organized around the four domains of a clinical model: (1) a theory of bodymind; (2) a theory of optimal development of affect regulation in secure attachment relationships; (3) a theory of pathogenesis, in which disordered affect regulation originates in relational trauma and insecure attachment relationships; and (4) a theory of therapeutic actions targeted to repair the affect regulating systems. The key themes of Hill’s affect-focused approach include: how and why different patterns of affect regulation develop; how regulatory patterns are transmitted from caretakers to the infants; what adaptive and maladaptive regulatory patterns look like neurobiologically, psychologically, and relationally; how deficits in affect regulation manifest as psychiatric symptoms and personality disorders; and ultimately, the means by which regulatory deficits can be repaired. Specific chapters explore such subjects as self states, mentalization, classical and modern attachment theory, relational trauma (and its manifestations in chronic dissociation, personality disorders, and pervasive dissociated shame), supporting self-development in therapy, patient–therapist attunement, implicit and explicit therapeutic actions, and many more.

Trauma and Dissociation Informed Psychotherapy: Relational Healing and the Therapeutic Connection

Author: Elizabeth Howell

Publisher: W. W. Norton & Company

Published: 2020-04-28

Total Pages: 195

ISBN-13: 0393713741

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A fresh look at the importance of dissociation in understanding trauma. A new model of therapeutic action, one that heals trauma and dissociation, is overtaking the mental health field. It is not just trauma, but the dissociation of the self, that causes emotional pain and difficulties in functioning. This book discusses how people are universally subject to trauma, what trauma is, and how to understand and work with normative as well as extreme dissociation. In this new model, the client and the practitioner are both traumatized and flawed human beings who affect each other in the mutual process that promotes the healing of the client—psychotherapy. Elizabeth Howell explains the dissociative, relational, and attachment reasons that people blame and punish themselves. She covers the difference between repression and dissociation, and how Freud’s exclusive focus on repression and the one-person fantasy Oedipal model impeded recognition of the serious consequences of external trauma, including child abuse. The book synthesizes trauma/dissociation perspectives and addresses new structural models.

Mind-Brain-Gene: Toward Psychotherapy Integration

Author: John Arden

Publisher: W. W. Norton & Company

Published: 2019-01-15

Total Pages: 384

ISBN-13: 0393711854

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An exploration of the ways the immune system, epigenetics, affect regulation, and attachment intersect in mental health. The evolution of psychotherapy in the 21st Century demands integration. Instead of choosing from the blizzard of modalities and schools of the past, therapists must move toward finding common denominators among them. Similarly, today’s psychotherapy necessitates the integration of the mind and body, not the past practice of compartmentalization of mental health and physical health. This book contributes to the sea change in how we conceptualize mental health problems and their solutions. Mind-Brain-Gene describes the feedback loops between the multiple systems contributing to the emergence of the mind and the experience of the self. It explains how our mental operating networks “self”-organize, drawing from and modifying our memory systems to establish and maintain mental health. Synthesizing research in psychoneuroimmunology and epigenetics with interpersonal neurobiology and research on integrated psychotherapeutic approaches, John Arden explores how insecure attachment, deprivation, child abuse, and trauma contribute to anxiety disorders and depression to produce epigenetic affects. To help people suffering from anxiety and depression, it is necessary to make sense of the multidirectional feedback loops between the stress systems and the dysregulation of the immune system that lead to those conditions. Successful psychotherapy modifies the feedback loops among the self-maintenance systems. Through the orchestration of the mental operating networks, psychotherapy promotes the re-regulation of immune system functions, stress systems, nutrition, microbiome (gut bacteria), sleep, physical inactivity, affect regulation, and cognition. This book makes a strong case for healthcare and psychotherapy to be combined—together they can revolutionize the way we conceive of, and attain, optimal health in the 21st Century.