Dissociatives Books

brilliant psychiatrist, I recommend That's How the Light Gets In: Memoir of a Psychiatrist by Susan Rako, M.D. The title comes from a song by Leonard Cohen: "There is a crack, a crack in everything. That's how the light gets in." Rako's book is remarkably candid, freshly insightful, and wonderfully well-written. It is a great read. The writing just flows.

This is a must read for counsellors working with dissociative clients. It is well-written, easy to understand (although the problem of dissociative disorder is very complex) and gives practical advice and strategies.

Treating people with dissociative disorders is a very difficult enterprise for which most mental health professionals are poorly prepared. Education programs neglect the area and even otherwise reputable textbooks are unhelpful. Many members of the community and even quite senior mental health professionals display a lack of understanding and even scepticism and antagonism to the very concept of dissociation. This is directed towards those who suffer from dissociative disorders and those who try to treat them. Thus sufferers are often isolated from effective help and clinicians also are isolated, poorly prepared and often at a loss as to how to embark on the complex task of therapy when they do encounter people with such problems.

"The Haunted Self" provides a scholarly, comprehensive and practical work for everyone interested in the area and is particularly helpful as a guide and a resource for poorly isolated clinicians. It is a wonderful work of creative synthesis of 150 years of work in the field of dissociation. While not neglecting the work of more contemporary thinkers, the authors own their great debt to the work Pierre Janet carried out 100 years ago. With some important exceptions, Janet's brilliant insights into the field of "hysteria" and dissociation have been neglected in the English speaking world. The authors' enviable command of European languages gives them access to his and other important works not published or neglected in English.

The book provides an excellent balance of the theoretical and the practical. It is set out in 3 sections. The first deals with the authors' concept of structural dissociation, the second deals with chronic traumatisation and links it to Janet's theories while the third sets out an approach to treatment.

Traumatic experiences at any age can have serious consequences and this is covered in the book. In childhood,in particular, early trauma such as abuse and neglect, of a physical, sexual or emotional nature, exert pervasive, destructive effects, which may extend far into adult life. The authors point out that children have pathetically inadequate resources with which to cope with the horrors to which, tragically, they are sometimes subjected. They refer to Janet's concept of their having an inadequate "mental level" i.e. integrative capacity to cope adaptively with these experiences. They coined and developed the term "structural dissociation" to describe the complex response to such abuse.

The authors develop the concept of of "action systems." These are psychobiological responses which can be divided into two major groups - those in response to attractive stimuli and those which defend against noxious ones. Traumatic situations in childhood often evoke both responses simultaneously e.g. a response to an abusive caregiver in which fear and attraction are mingled giving rise to intolerable conflict. Such intense feelings and the unbearable terror and arousal produced by trauma are referred to as "vehement emotions."



The book describes the impact of these powerful feelings in producing a loss of integration and cohesion in the personality. As a result intolerable feelings and memories are segregated from complete awareness and traumatised people move between different identity states. In some states they are locked into traumatic events which are constantly re-experienced with their associated overwhelming emotions. In other states they are cut off from the memories and experiences of the trauma and are phobic and avoidant towards anything that threatens to remind them of the trauma and of the internal states which carry the trauma experiences.

Charles Myers' work with soldiers from World War I is recalled. He described splits into what he called "Apparently normal personalities" and "Emotional personalities" in response to combat trauma giving rise to structural dissociation.

The second section focuses on Janet's theories in relation to trauma. As the authors say, "the inclusion of Janet's work is not a romantic flight into history. His ideas on actions are most helpful and practical in understanding the plight of trauma survivors"

And so they are although, initially, I myself had to exert a fair amount of effort to understand and start to apply these concepts. I think most people unfamiliar with Janet's work would have similar problems but the effort is very worth while. Interestingly, although clinicians brought up with other theoretical models may share my problem, I have found that the concepts, are easily grasped and make perfect sense to people struggling with trauma related disorders. Concepts such as synthesis, presentification, personification and action tendencies and their hierarchies are discussed in depth and applied to clinical problems.

The final section on treatment begins with a useful section on assessment. It then outlines a three phase approach to treatment. The first phase involves stabilisation and symptom reduction, the second the treatment of traumatic memories and the third personality integration and rehabilitation.

Those who read The Haunted Self will quickly discern that it is the work of highly skilled clinicians not simply theorists. All who have battled with the problems of trauma affected people will recognise that the authors have travelled the same paths and will find their guidance very valuable.

I have stressed the worth of this excellent book to clinicians but a number of my more sophisticated patients have also found reading it very valuable. It is certainly a wonderful validation of this body of work that it does make so much sense to those very people who have to live their lives with the consequences of trauma.

David Leonard

This book is just wonderfull! I deeply enjoyed reading it - and much more :) - applying its concepts and practical guidelines into the complex clinical work with traumatized individuals. Myself, psychotherapist, child and adolescent psychiatrist in Ukraine - I found this book most clinically useful book I have read in few last years about trauma-related disorders. It gives clarity into this very complex dimensions of inner and outer lives of chronically traumatized individuals and it helps to empathically understand their suffering. From this empathic understanding well-paced and well-structured therapy can take place. And from my clinical practice I saw how useful and effective are concepts and practical therapeutic guidelines from this book. So I highly recommend this book for everyone working in the field of trauma-related disorders, and I also highly recommend this book to publishers for translations and publication in other languages. This knowledge must become widely available so we can better assist traumatized individuals in their inner healing. Special thanks to authors for their great work!

What an exceptional book! The step-wise didactic clarity and innovative content of The Haunted Self alone would suffice to justify making the book required reading material for all health professionals encountering trauma victims. However, it is also a remarkably thrilling reading experience, reminiscent of the "haunted-house" stories of my youth. One finds oneself led to familiar areas through "hidden stairways" and suddenly comes to perceive and comprehend things from unexpected angles.
As a psychiatrist specializing in trauma as a clinician, a lecturer and a researcher for nearly 20 years, I found this book to be a fitting and eloquent summary of over 25 years of innovative thought, thorough research and ongoing re-assessment of the theoretical and clinical applications of Trauma-Related Structural Dissociation of the Personality by Van der Hart, Nijenhuis and Steele, whose ongoing publications in leading journals I have followed avidly. The theoretical basis is coherently and systematically presented in the opening section, followed by a section which concisely and didactically addresses the clinical applications, from guidelines for patient assessment and formulation of the treatment plan, and then deals in detail with each stage, with ample guidance and clinical examples. The lay-out of the book also conveniently enables selective reading of independent sections and topics. There is a refreshing undercurrent of humility to the book - the reader feels encouraged to examine and comment freely.
Without seeking to replace or compete with other trauma theories or treatment modalities, the authors present an over-arching and unifying conceptual approach to comprehending the psycho-biological underpinnings of a highly variable and challenging population of patients, who quite commonly present with a complex and confusing array of atypical and changeable clinical and therapeutic issues, only partly addressed by current diagnostic criteria and treatment guidelines.
The structural conception of dissociation enhances ones understanding not only of PTSD and Complex PTSD, Dissociative Identity Disorder and cases of severe protracted physical and sexual abuse, but clarifies the contribution of trauma to Borderline Personality Disorder, Somatoform Disorders and certain physical syndromes characteristically associated with emotional trauma and stress.

Dr Mike Matar, MD (Psych)

Almost the bible in relation to the chameleon complex resulting from forced submission and assimilation and pathological identification with chronic abusive adults.

Writing with a keen mind and a bright and passionate heart, Harvey Schwartz distills his years of professional experience as a clinician, mentor and teacher into this book. It is a gift, a gem of a book, for those who work with people who have endured the worst that mankind can inflict. Schwartz gives us a review of the literature in this field, many examples of his own work, illuminating quotes from clients, and much-needed clarity in this time when the issues of healing terribly-abused people have been siderailed into a senseless debate over whether such abuse actually exists. It does, and Harvey Schwartz provides a helpful, essential road map back to sanity and health over the difficult terrain of dissociation. This is a necessary book for healers who work with abuse. It is by far the best book on the topic that I, who have worked and studied in this field for twenty years, have read.

Schwartz's book is a gift for clinicians, most of whom were never adequately trained to work with patients who have complex dissociative disorders. If you're a therapist, and you haven't read this book, then you are missing out on critical theory about how to work fearlessly and respectfully with these patients who have suffered severe harms as children.

I also think the book should be read as cultural commentary. Schwartz discusses the complicity of groups such as the False Memory Syndrome Association in the sexual abuse of children.
Dialogues with Forgotten Voices also has carefully documented evidence regarding ritual abuse - where highly organized groups of pedophiles and their lawyers and doctors make a religion out of torturing children.

This book has been on the shelf closest to my computer ever since it came out, and I refer to it constantly. A must-read.

I found this to be an excellent book on this subject. I am a layman in this area, but it helped me to understand more of the dynamics at play in some people who are very dear to me. I would recommend this book to anyone who wishes an indepth consideration of this area. It is not easy reading, but it is very clear and pays back the time put into its study. I found myself something reading and rereading passages and gainingmore from each reading. There are many layers to understanding the types of individuals that Dr. Schwartz describes, and I found that the text delicately and with compassion, revealed this depth and gave keys to treatment that were as sensitive as they were insightful.

Having read extensively on childhood trauma and dissociation, I can easily recommend this book as one of the most impressive works on a very misunderstood mental disorder. Dr. Schwartz writes with tremendous compassion and insight about the real needs and struggles of his patients who face ridicule and outright hostility because of the many myths and disinformation surrounding DID. As an author and clinical psychologist, Dr. Schwartz breaks new ground in this bold, unblinking look at the pathology, courage and brokeness of these clients. Most have survived horrific abuse that essentially amounts to the torture of children by parents, other relatives, the government and cults.
Dr. Schwartz, unlike many experts in this field, clearly and truthfully points out how society and institutions collude with perpetrators in the rape, beating and sexual torture of our most vulnerable citizens. Well-written, clinically and scientifically accurate.

Dear Reader, this is an excerpt, sans introductory paragraphs, of a published review I wrote of Dr. Howell's book in the American Psychological Association Division 56 Newsletter in January 2007. Her book is excellent and "required" reading for anyone seriously interested in understanding dissociative processes.

Howell extensively traces the history of dissociation in psychoanalysis from the seminal work of Janet, through Freud, Ferenczi, Fairbairn, Sullivan, Bromberg, Davies, Frawley-O'Dea, and Donnel Stern over several chapters. She takes great pains to show the specific ways in which earlier psychoanalytic theory was built upon an unacknowledged foundation of dissociative processes. She unearths what is not so deeply buried: Freud borrowed heavily from Janet, Fairbairn built object relations from explorations of the minds of children with dissociative identity disorder, Sullivan's selective inattention referred to dissociative process, and the schizoid personality is also essentially a construct built upon dissociative process. What she shows with clarity, though doesn't specifically state, is that the dissociative mind is an intrapsychic reflection of a dissociative world, a world where, as Stern would have said in regard to his concept of "weak dissociation," effort is required to generate a coherent view of self and other. The world is dissociative? Yes, the world is a collection of snips of experience that flow into each other, but we don't have the capacity to see it all at once. We can take it in as chunks. As Howell points out, a "unitary mind" is a creative bit of illusory self-deception that aids the formation of identity. Howell believes we all have a relationally based mind that must work hard to piece together both internal and external experience into a coherent picture of living. It is in the quality of relating that has been called right-brain to right-brain communications (Schore, 2003) that infants take in the nuances of experience like those described as the "transformational object," the parent who provides what the infant needs as the need arises so that the infant changes state smoothly (Bollas, 1987). Early in her text Howell shows how a multiplicity of theoretical models such as those proposed by Putnam (based upon Wolf's work), discrete behavioral states, and the states of mind model of Daniel Siegel, are part and parcel of more relational psychoanalytic models (Putnam, 1997) (Siegel, 1999). She develops the powerful implications of a psychoanalytic theory based upon organizations of states rather than more traditional structural, ego psychological, or object relational theories. While she credits Davies and Frawley for bringing trauma theory to psychoanalysis (Davies, 1994), Howell's exploration fills in the landscape of that earlier map in great detail and adds territory for additional thought both for psychoanalysts and traumatologists .
Howell completes her review of theoreticians in a discussion not usually emphasized, or even entertained in psychoanalytic or traumatologic literature by looking at the work of Anthony Ryle and Ernst Hilgard. Ryle developed a cognitive analytic therapy (CAT) that focused its attention on the reciprocal role procedure (RRP), a kind of procedural memory that serves as an action script for relationships (Ryle, 1999). Like the internal working models (IWMs) of Bowlby, these implicit action scripts remain outside awareness, isolated from consciousness (dissociated), but nevertheless seeking confirmation/disconfirmation of hypotheses about the self in relation to others that were learned through early relationships. Painful RRPs seek resolution just like any other psychic pain motivates behavioral solutions when there is no explicit knowledge of these RRPs. Developing consciousness for actions scripts, such as feelings of being deprived and seeing others as depriving (deprived-depriving) or feeling hated, and seeing others as hateful (hated-hateful) undermines enacting the scripts of childhood as an adult. Simultaneous multiple RRPs may be active and lead to complex and confusing behaviors that are grossly disadvantageous for the now fully grown child. Yet, like an addiction, the behaviors relentlessly repeat themselves in search of resolution. The notion of the behavioral script and the RRP is a powerful tool. Likewise, Ernst Hilgard's neodissociation theory, familiar to those who study hypnosis (Hilgard, 1986). The theory describes how in each of us there is an observing capacity that is somehow isolated from the main flow of consciousness. This "hidden observer" is a not-conscious reservoir of personal information that implicitly influences thought, action, and feeling. It is part of a system of multiple levels of cognitive control that may be isolated from each other, dissociated. It is part of the depth of Howell's combined traumatologist/psychoanalyst perspective that allows this kind of synthesis of related literature that has been professionally "dissociated" from psychoanalytic and traumatologic theory building. Psychoanalytic theory talks most eloquently about this influence of isolated information and psychodynamic lacunae through the theory of enactment. Howell appropriately explores the work of Bromberg, Davies and Frawley, and Stern to show how enactment is generated by dissociative process. It is the call to action by isolated, unresolved, incoherent (dissociated) fragments of experience that generates enactment and repeats the past on a modern stage with unsuspecting participants. Howell unequivocally shows the dissociative roots of enactment and the likelihood of the generation of boundary crossing and violation. As she points out, Bromberg describes the ways in which "not-me states" in both patient and analyst participate in the choreography.
Perhaps you are uncomfortable with thinking about a clinical world that does not mainly rely upon instinct, drive, and conflict? I recommend that you carefully read Howell's chapter on attachment as a way to assuage your concerns. Linking the work of Bowlby, Ainsworth, Main, and Lyons-Ruth with Bromberg and others, she matter-of-factly builds a clear case for the relative congruency of self-states and IWMs. These constructs are made from particular world views, beliefs, ideational references, associated affects and have tenacious persistence. She shows how children with disorganized attachment (Type D) have similar behaviors as compared to dissociative adults, that dissociation in adults is best predicted by the same emotional unresponsiveness as is productive of disorganized attachment, and that in longitudinal studies of Type D children it can be shown that children maintain their attachment style into adulthood. In other words, attachment theory provides a very interesting evolutionary-developmental model with massive predictive power for adult dissociative experience. Freud worked backwards from the case of the Wolfman, making connections from adult function to a reconstructed infantile neurosis. I find attachment theory and states of mind a more compelling parsimonious explication for adult behavior. Perhaps you will too, and especially so with an appreciation that you need not give up thinking about the explanatory power of intrapsychic conflict at all if you consider the inherent conflictual nature of isolated (detached, dissociated) self-states.
Howell spells out how Bowlby initially conceptualized insecure attachments as representing a full detachment of feeling and thought, in the case of avoidant attachment, and a partial disconnection in anxious-ambivalent. Both these intrapsychic maneuvers represent dissociative process. Moreover, in her discussion on splitting, Howell shows how alternation between internal working models related to the positions of Karpman's drama triangle map out the traditional inability of severely disturbed persons to reconcile and merge the "good" with the "bad" qualities of a single person (Karpman, 1968). Attachment based dissociation is a robust model of a dissociative mind.
Are there things in Dr. Howell's work that I would wish be improved and clarified? Yes, there are several, and most fall into a similar realm of the struggle to shift from a traditional Freudian psychology to one that is relational and respects dissociative process. I am referring to her efforts to find new ways to redefine repression and splitting so that the terms are not lost. I would rather she had concluded that these terms are not only archaic, but misleading, and need to become part of the rich history of psychoanalytic theory rather than continue to accrue additional meanings. After clearly showing how splitting is a concept that fails to have any particular logical developmental basis, she tries to make a case for retaining the term by reformulating the oscillations between good/bad perspectives, and the separation of this "good" from "bad" through the use of an apt attachment model that reflects contradictory behavior in a caretaker. She eventually states that the clashing internal working models in the child must be "dissociated" from each other in order to maintain attachment. While she essentially says that splitting is just a synonym for dissociation, I don't know why she doesn't just say that splitting is too general a term, too loosely used and we ought to use better terms that better describe the dissociative processes of which we are speaking. Likewise, I simply have not found a reason to continue to use the term repression. It is, for me, an historical footnote of real importance. It does not seem to have any more explanatory power about how a mind works than the term dissociation, and in fact, has much less. Is Howell trying to make the paradigm shift to including dissociative process in our formulations easier, or less threatening, by not calling for the relegation of these familiar terms, repression and splitting, to history? Maybe. Some of the same conceptual baggage shows up in an otherwise insightful reframing of projective identificatory processes as essentially dependent upon dissociative process, what she calls "blind foresight." However, this detracts minimally from the accuracy of her reframing projective processes through an implicit process lens, a shift that is overdue in our literature.
Howell's text ends with three chapters that push the envelope on understanding personality disorders, gender, and psychopathy. She shows how childhood dissociative processes neatly predict adult organizations. For example, she calls attention to the cultural sanctions that in boys facilitates the relegation of sensitivity to emotion into a disowned aspect of self, and in girls does the same with assertive and aggressive tendencies. Why is this useful? A "states of mind" model dependent upon the tension between associative and dissociative processes makes plain that the disowning of aspects of self eliminates the experience of intraspsychic conflict over, for example, aggressive wishes. If the affects associated with aggression are isolated from consciousness, then a young woman will be able to tolerate living in her traditional family without conflict with her traditional mother and father, and without a threat to patterns of attachment that preserve valued relatedness. For patient and clinician, a "states of mind" model is a solid and understandable explanation for looking at behavior that occurs, or is obviously inhibited, in a much more user friendly model than a drive model. A central goal of a treatment is to make conflict not only conscious, but possible. By working with language that fits a person's experience, for example, referring to another state as a "different way of being you," there is much less of a sense of threat than to talk about an unconscious mind where there are longings to be aggressive that have been denied and disavowed (which by the way are both dissociative processes) by mysterious unconscious processes (Chefetz, 2005).
Elizabeth Howell's book, The Dissociative Mind, is a long overdue addition to both the traumatologic and psychoanalytic literature. It has many strengths and few weaknesses. Dr. Howell's clear voice is taking its rightful place amongst the leading clinician/theoreticians of our time. I look forward to her future work, and I highly recommend this book to you as essential reading.

Bollas, C. (1987). The Shadow of the Object: Psychoanalysis of the Unthought Known. New York, Columbia University Press.

Chefetz, R. A. (2005). "A cognitive psychoanalytic perspective on the treatment of complex dissociative disorders." Psychiatric Annals 35(8): 657-665.

Davies, J. M., and Frawley, Mary G. (1994). Treating the Adult Survivor of Childhood Sexual Abuse. New York, Basic Books.

Hilgard, E. R. (1986). Divided Consciousness: Multiple controls in human thought and action. New York, John Wiley & Sons.

Karpman, S. B. (1968). "Fairy tales and script drama analysis." Transactional Analysis Bulletin 7(26): 39-43.

Putnam, F. W. (1997). Dissociation in Children and Adolescents. New York, The Guilford Press.

Ryle, A., Ed. (1999). Cognitive Analytic Therapy: Developments in Theory and Practice. New York, John Wiley & Sons.

Schore, A. N. (2003). Affect Regulation and Repair of the Self. New York, W.W. Norton & Co.

Siegel, D. J. (1999). The Developing Mind: Toward A Neurobiology of Interpersonal Experience. New York, Guilford Press.

This book is succinct and well-written by a woman with a clear, keen mind and I enjoyed it immensely. Dissociation is a subject whose time has finally arrived. I appreciated her careful inclusion of other work that is being done in this area. I hope this book will become part of a fundamental shift in understanding the human personality and how it becomes disordered by trauma. If we have people of the caliber of Elizabeth Howell working in the field of trauma, I have far more confidence that the issue won't be shoved under the table with embarrassment and fear, as has been done over and over throughout history.

Working with patients with complex PTSD and dissociation is a challenging endeavor. Trauma therapists need to continually find resources to broaden their clinical thinking and strategies. EMDR has been research proven as the best approach to trauma treatment. Yet there are survivors of relational trauma who have been so badly damaged by the cruelty of others that they need additional approaches as well. They suffer from inabilities to regulate their affect, their consciousness and self perceptions. Short on trust, these survivors need an even broader approach to their suffering.The editors have gathered many experts in the field who explain in clear informative ways how to expand the clinician's abilities to work with this terribly injured population. This book blends concepts from neurobiology, hypnosis, family systems theory and cognitive therapy to enhance treating this population. It is a well written book that the novice as well as the seasoned clinician can benefit from. As a trauma therapist of 30 years I found myself enriched by the various ideas and strategies presented. The addition of ego state work in combination with EMDR treatment offers hope to therapists who have hard to reach patients.

Mental health professionals will really appreciate this informative text. Although it conveys complex concepts that will be of interest to seasoned therapists, it does so with a clarity that will appeal to the novice as well. Case examples, step by step protocols, research findings and comprehensive theoretical explanations deliver the information off the page and into the clinician's office. I bought this text because I practice both EMDR and Ego State Therapy but I have not yet seen a text that addresses both (although there are many books that cover each of these topics separately). I was not disappointed. Dissociation - a common symptom of trauma syndromes - is explained and addressed so that therapists can actually work with the phenomenon instead of pretending it doesn't exist! This is really a wonderful text with many excellent ideas and I highly recommend it to anyone who treats trauma (which means, any psychotherapist or counselor!).
Sarah Chana Radcliffe, M.Ed.,C.Psych.Assoc.
Author, Raise Your Kids without Raising Your Voice

Highly recommended. For more information on this topic, see:

Basic Information on Dissociative Identity Disorder with sections on Basic Information on DID from the DSMIVTR, The History of DID/MPD, Diagnosing DID, Responses to those that state that DID is iatrogenic or a social construct, MPD/DID connection to severe abuse, Recent information and DID resources - http://members.aol.com/smartnews/Dissociative-Identity-Disorder.htm

Recovered Memory Data with information on recovered memory corroboration, theories on recovered memory, legal information, physiological evidence for memory suppression, replies to skeptics and books and articles on memory http://members.aol.com/smartnews/recovered_memory_data.htm

Satanic ritual abuse exists all over the world. There have been reports, journal articles, web pages and criminal convictions of these horrific crimes against children and adults. http://members.aol.com/smartnews/satanic_ritual_abuse.htm

I highly recommend this book to anyone who has the slightest interest in multiple personality disorder, art therapy, puppetry, psychiatry, object relations theory, story telling or mental illness in general. Through Jenny's story Gerity simultaneously gives a fascinating accurate account of patient care in a mental health facility while also educating the reader about the various psychological theories that staff utilize for treatment. This book was a pleasure to read and would be enjoyable for everyone but I think it should be mandatory reading for anyone who works with the mentally ill population.

I have to say, I have fallen in love with Dr. Putnam's writing through reading this book. Dr. Putnam is clearly well read and is highly experienced in the field of dissociative disorders. Many consider his other book on diagnosing and treating DID to be the BIBLE of working with DID patients.

In "Dissociation in Children and Adolescents," Dr. Putnam presents an eloquent mixture of empiracle data and psychological theory. Putnam presents the DBS (Discrete Behavioral State) theory of dissociation in rich detail and also touches on other matters such as psychopharmacology and neuroscience. At times, the text can become slightly dense, but only to a degree (I feel) that makes the book all the more delightful, challenging, and interesting to read.

Overall, I found Putnam's book to be insighful, interesting, and informative. I highly recommend this book not only to those interested in treating children and adolescents, but also to clinicians and students interested in dissociation--how it develops, differential diagnosis, and testing.

Furthermore, Putnam's book includes copies of the DES-II, the A-DES, and the CDC in the back of the book with the repeated and explicit blessing to copy, distribute, and use these tests. Of course, clinicians treating dissociation are probably well aware that Putnam and Carlson are the creators of the DES and its variants.

Again, I highly recommend this book to those treating dissociative patients. I even recommend it to clinicians who are *not* specifically interested in dissociation simply because, when spotted and correctly diagnosed, dissociation is treatable. Read this book!

Even though the book will be very useful to professionals, as a beginner to the field of dissociative child psychopathology, I found this book easy to read and very comprehensive. A full overview is provided, assisting with both the identification and the treatement of the dissociative child. A recommended read for both beginners to the field, and comprehensive enough to be recommended for experts. Numerous, practical examples are provided.

the memory wars had a devastating effect on psychotherapy. they are a major reason why no one listens to us these days.

Dr. Jennifer Freyd discussed issues of sexual assault with her parents in private and they reacted by founding the False Memory Syndrome Foundation.

From as far away as South Africa, psychiatrists joined the board. I do have to say that I wonder if the Freyds, who are not psychologists or psychiatrists, had some psychiatric 'encouragement' to found the FMSF rather than talk it out with their daughter. perhaps they were told such things were unspeakable.

at any rate, a WAR was then waged about allegations of sexual abuse which quickly turned into recovered memory = bad, which then became a slam on those with continuous memory who could not be sure they were on safe ground either. not in the absence of proof.

the problem is that proof comes late in the process. there is a push-pull about the search for records. people need to be able to handle finding the information. or not finding it. and they need to be able to manage the other relatives in their lives including most likely parents who do not want this discussed, whatever the truth.

I was in therapy when this hit in 1992 and I remember it very clearly. the local newspaper started to run panicked articles about sensationalistic allegations of abuse and very quickly we (meaning patients, especially those judged ill or with recovered memory) we were targeted.

after a few years of this coverage in the local paper, in ways I found incendiary, I stopped reading the paper. I could not take it anymore. my therapy was negatively affected as well.

to this day I will not read the newspaper b/c of what happened. coverage was handled in a way that hurt vulnerable people and it happened over and over. I get my news by word of mouth or online pretty much.

this book lays out really why talk therapy is no more and it is b/c compromise solutions like 'emotional truth' are no solution at all when people are paying a lot of money and investing time and most of all, hope.

there have been many therapy wars. unfortunately, this one was quite influential and everyone lost, including the skeptics who also saw talk therapy decline due to the culture of fear that set in.

it is not OK to label one topic unspeakable and then say, but surely talk therapy will be preserved for everything else? it doesn't work that way, and especially not when the topic called off-limits affects many people. a culture of fear sets in.

when I was younger, I remember (or I think I do. this is what this therapy has done to me) getting feedback that I was poor on evaluating and I tended to make harsh and inaccurate judgments and that I should describe and not judge.

I got away from that for many years and in adult life it was directly b/c of the memory wars. there were too many times when I described an image or memory and was hit with skepticism that I thought was irrational but felt blamed for. I learned to stop describing. I started to feel that my answers had to be RIGHT ones. forms filled out perfectly, in triplicate, i's dotted and etc. and signed in blood.

that is what it feels like to depend on a person who is frightened and has stopped listening. my therapist then went to a conference, came back and announced I'd made it up. "it" was everything other than a strict present-day focus, good things as well as bad about the past. or anything that was undocumented, really.....

on this issue, we clients came into their offices and asked 'do you believe me that I was - whatever?' that this relative abused me? and very often we got 'no' as an answer except people were not honest enough to say the word no outright.

so we got:

it doesn't matter what I believe, only what you believe.

there is a difference between historical and narrative truth.

what is truth anyway?

--

well when you are discussing something like incest, it is very problematic to get answers like that.

very often 'do you believe me?' is a stand-in for another question. for me it would have been 'do you think I'm sane?' and the honest answer would have been no. but it was also, 'do you think I'm worth listening to?'

there were some therapists who attempted to reassure and say 'it is OK I will listen to whatever you say' but we are asking for more concrete reassurance.

the problem with saying 'yes I believe you' and stopping is that sometimes it is not the truth but more often, people cannot handle the information.

there is a difference between expressive and receptive language and that seems central to accepting truth in lack of insight. very often people ask questions that they are not ready to hear the answers for, and then they fight.

I did this untold thousands of times.

the only answer that worked for me was, 'yes I believe you but if you turn out to be "wrong" about this, it's OK. you don't have to have the right answer upfront.'

my therapist learned to say this. I lived in terror of not saying the right thing.

now to the book

Merskey does an overview and he criticizes MPD and historical lack of existence, or so he says, without putting in context that the same could be said for just about any psychiatric disorder on Earth, on a more than rare basis.

he considers this argument and dismisses it. that MPD is not less valid than other disorders b/c it is 'new.' but life is much more complicated these days and genes are expressed through environment.

that is a metaphor. behavior reflects environment. having a 'new' disorder is therefore not that surprising.

for example, large numbers of women have entered the workforce in the last few decades and others are conflicted about staying home. there is now a push-pull between home and work with some women happy in neither place (and some happy in both basically).

some young women don't know what to do. the experience of their mothers may not be a relevant guide for work vs. home decision. and girls look to their mothers or if not them, other female relatives. that could explain the 'overrepresentation' of white women.

White women in this culture have a kind of flexibility to blend home and work, or do one or the other, that many others don't have. but we also get yelled at a lot more than other people. we are pushed and pulled around. told what to do.

conflicting expectations. MPD represents conflict. conflicting expectations are central to MPD/DID.

that takes care of Merskey. that said I was very unimpressed with the quality of the letters that were written in response to him, including one by Dr. Frank Putnam, a person who strikes me as saying what is expedient rather than correct.

some of the believers were very angry and torn by this conflict and it shows, unfortunately. for example, Denise Gelinas. she went on to make generalizations in anger that were not true (I have had that problem).

August Piper is a skeptic who had some common sense. he is actually someone I respect although I do not agree with him in any way on the "MPD is rare" conclusion.

but I learned from reading him that a person can be right in his arguments, according to me, and wrong in the conclusion, again in my judgment, and still be respected.

Dr. Piper discusses the need for visual referents in a way that is clear and makes sense to me.

I have certainly done this over and over. I have refocused my therapist on the concrete when she is abstract and over my head.

Michael A. Simpson decided to make a therapeutic crusade about this for God knows what reason. He lives in South Africa and maybe he has globalization concerns. he claims to have aggressively searched for an MPD 'case.'

my question is, why did you do that? that seems a little odd. don't you have enough to do?

he seems to have issues with pretense, as he views it, and acting, again, his definition. it's very odd that someone that far away cares that much. it seems excessive.

in fact I worried about his blood pressure when I read that essay.

and in fact I do not have MPD but I have something like the dreaded SZ. actually bipolar and brain injury issues. and I really did not appreciate his comments on psychosis either. which were basically to call us weirdos.

and then there is the guy, I forget his name, who comments on the Flock. that treatment worked b/c Gordon, the therapist's husband, got the client out of talk therapy where she was tormented, and into a much less verbal "therapy."

talk therapy can be a torment when one is struggling with the inability to speak.

that seems very obvious but a generation of talk therapists has forgotten it.

moving right on, the essay at the end of the book really depressed me. two therapists comment on the case of "Laura" who does not speak for herself. and they discuss her in terms of diagnosis and etc. and not as a human being.

Laura needs to speak for herself.

now that said,

I disagree with a lot of the people in here, but this is an excellent book b/c it shows the logical contortions that people go through when they do not trust their instincts, overdefine us by diagnosis, and stop listening.

and that was pointed out.

there are therapists who listen. there are also therapists who have written books about the pull NOT to listen, even though they are paid for it.

dr. Constance Dalenberg is one such doctor. she wrote a book on countertransference that is very good. she quotes us.

that is how I judge a doctor these days. it is easy to write many words in which the doctors are quoted, and quote each other, and not ask us.

why not? it is talk therapy, isn't it?

the fact that such questions are unspeakable shows that listening is not at the level it should be but - there are plenty of people keeping it going.

can a therapist handle a difficult subject and stay calm him- or herself? that is the question. those who can do that tend to be better therapists.

those who are brusque or indifferent or too impassioned tend to not do as well. and that is true whatever they believe, or not.

I am taking a graduate course on Advanced Thereupitics Techniques. Though this book was recommended I consider to be a MUST READ book. Much basic understanding came from chapter two. It helped me understand Freud's cathexis and how it connects the conscious and unconscious mind. Cathexis is an energy that binds thoughts together.

My metaphorical understanding is as follows: Tom (Conscious) and Dick (unconscious) are in a locked room looking at each other. The lights (cathexis) are turned off and Dick moves without sound to another location in the room. In Tom's mind's eye, he pictures Dick exactly where he was before the lights went out. However, the darkness (broken cathexis) has broken the visual bond so they are no longer visually in touch with each other even though they are still in the same room.

This is just one example of the insight that I gained from reading this book. This book is helping me understand and use NLP and hipnotherapy techniques with greater effectiveness.