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A review by akemi_666
Understanding and Treating Dissociative Identity Disorder: A Relational Approach by Elizabeth F. Howell
5.0
Possibly the most important book on trauma I've read.
Touches on:
Janet: maladaptive behaviours were vital for survival at their time of development (trauma), but are actively harmful now (ptsd).
We consist of plural identities that in a healthy environment share information amongst one another, giving us the sense of a singular self, bodily/psychic autonomy. Trauma is the dissociation of these identities from one another.
All trauma involves dissociation (disconnections between identities, which lead to amnesia and emotional dysregulation), but not all dissociation is caused by trauma (dissociation can be a healthy psychic reaction to stress).
Children who have been traumatised have a strong attachment to their abusers because when children experience abuse they respond with attachment, the need for a site of security. The abuser, who is often also the carer, becomes a site of intense terror and need, and this relationship, of defenseless child and powerful persecutor, is reconstituted in the psyche of the child (bpd characterology).
The pathway to system resiliency/self-integration involves: 1) symptom reduction (of emotional dysregulation [depression, anxiety, rage], depersonalisation/derealisation, suicidality, helplessness), 2) internal reconnection (of identities and memories) and grieving (for what was lost due to trauma), 3) rebuilding of an (external) social base.
All psychic phenomena are embodied and relational: the therapist and patient form a third analytic, a site where they co-create the therapeutic environment. It is not the patient alone who projects and transfers their past relationships onto the present moment, the therapist also primes certain behaviours, and falls into certain roles the patient expects or switches into. Maladaptations are relationally generated and, therefore, must involve relational change.
Janet again: all identities are useful. They emerged at particular times to protect the self from a particular threats. Though some may appear self-destructive and helpless, and others appear malevolent and wrathful, they are all important (and vital) aspects of the patient, and through a compassionate understanding of their various roles in protecting the self, these identities move out of their hopeless or resentful states, find pride in their capacities to protect, and begin to heal, to respect other identities whom they once may have seen as pathetic or terrifying. This is not a blind acceptance of what some of these identities have done (they have certainly made extended periods of the patients' lives excruciating and disorienting), but rather an attempt to revision their roles, to accept what they were so that they may change (dialectical behaviour therapy: both acceptance and change are necessary for healing).
More organised review incoming.
Touches on:
Janet: maladaptive behaviours were vital for survival at their time of development (trauma), but are actively harmful now (ptsd).
We consist of plural identities that in a healthy environment share information amongst one another, giving us the sense of a singular self, bodily/psychic autonomy. Trauma is the dissociation of these identities from one another.
All trauma involves dissociation (disconnections between identities, which lead to amnesia and emotional dysregulation), but not all dissociation is caused by trauma (dissociation can be a healthy psychic reaction to stress).
Children who have been traumatised have a strong attachment to their abusers because when children experience abuse they respond with attachment, the need for a site of security. The abuser, who is often also the carer, becomes a site of intense terror and need, and this relationship, of defenseless child and powerful persecutor, is reconstituted in the psyche of the child (bpd characterology).
The pathway to system resiliency/self-integration involves: 1) symptom reduction (of emotional dysregulation [depression, anxiety, rage], depersonalisation/derealisation, suicidality, helplessness), 2) internal reconnection (of identities and memories) and grieving (for what was lost due to trauma), 3) rebuilding of an (external) social base.
All psychic phenomena are embodied and relational: the therapist and patient form a third analytic, a site where they co-create the therapeutic environment. It is not the patient alone who projects and transfers their past relationships onto the present moment, the therapist also primes certain behaviours, and falls into certain roles the patient expects or switches into. Maladaptations are relationally generated and, therefore, must involve relational change.
Janet again: all identities are useful. They emerged at particular times to protect the self from a particular threats. Though some may appear self-destructive and helpless, and others appear malevolent and wrathful, they are all important (and vital) aspects of the patient, and through a compassionate understanding of their various roles in protecting the self, these identities move out of their hopeless or resentful states, find pride in their capacities to protect, and begin to heal, to respect other identities whom they once may have seen as pathetic or terrifying. This is not a blind acceptance of what some of these identities have done (they have certainly made extended periods of the patients' lives excruciating and disorienting), but rather an attempt to revision their roles, to accept what they were so that they may change (dialectical behaviour therapy: both acceptance and change are necessary for healing).
More organised review incoming.