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PubMed1996

Cognitive therapy of dissociative symptoms associated with trauma.

The presentation of dissociative symptoms is not uncommon in clinical settings, particularly when the client has suffered trauma. The phenomenon of dissociation ranges from benign incidents, such as daydreaming, to potentially life-threatening experiences when it precipitates self-harm. Its presentation may be subtle, belying the distress which it can provoke. Cognitive therapists are well equipped to help clients formulate a working conceptualization of the dissociative episode and to develop a range of coping skills to manage and overcome the experience. This paper discusses practical ways in which the cognitive therapist can use standard and schema-focused cognitive therapy to help clients to better deal with the distressing aspects of dissociation.

Adaptation, Psychological↗
PubMed1975

Behavior cytogenetics and Turner's syndrome: a new principle in counseling and psychotherapy.

In the orthodox theory and practice of psychotherapy and counseling, each case is considered to be unique or idiodynamic in terms of psychodynamic history. According to a new and still unorthodox principle, a syndrome may have a common psychodynamic denominator, shared by all or most carriers of the syndrome. As illustrated with reference to Turner's (45,X) syndrome, application of this new principle expedites the psychodiagnostic and psychotherapeutic procedures.

Androgens↗
PubMed1981

Multiple personality in India: comparison with hysterical possession state.

This article reports probably the first case of multiple personality from India and compares and contrasts it with the hysterical possession syndrome. Attention is drawn to the apparent rarity of multiple personality in contrast to the great prevalence of the possession syndrome in India (and other underdeveloped societies), while the reverse applies to Western Europe and North America. It is postulated that the disparity of frequency between the two manifestations of personal-identity disturbance derives from certain basic cultural differences. It is argued that polytheism and belief in reincarnation and spirits may be related to the possession syndrome, whereas high social approval of deliberate role-playing may foster the multiple personality syndrome.

Adult↗
PubMed1996

Repressed memories: some clinical data contributing toward its elucidation.

This article offers two case reports that strongly support the clinical notion that under certain circumstances some persons can dissociate from their executive ego traumatic memories of sexual abuse. The patients had absolutely no conscious memory of their childhood abusive experiences and in both cases I obtained definite and clear-cut independent corroboration of the realities of the abuse. I think that a series of several well-documented case reports, like the ones reported in this article, could represent persuasive preliminary evidence for the existence of dissociative memories, at least in some specific cases. I hope that the publication of these two cases will stimulate other clinicians or researchers to report, in as much detail as possible, other similar experiences. Only through the publication of clear-cut cases can the debate about repressed memories be settled in an empirical way.

Adult↗
PubMed1996

Collusion and entanglement in the therapy of a patient with multiple personalities.

S.'s therapy demonstrates some of the ways in which countertransference interferes with therapy of a case presenting with multiple personalities. Fascination with S.'s alter personalities and the desire to prove their genuineness, made her therapist search for them and then repeatedly invoke their appearance. Part of the reason was his inexperience with such cases that induced him to "play it by the book," and use "personality-centered procedures" (looking for a different part, giving it a name, speaking to it, etc.) that have yet to be scientifically validated, instead of adhering to the basic principles of psychotherapy. At a deeper level, however, his excessive preoccupation with S.'s personalities was one kind of collusion with her resistance to deal with the focal issue of her sexual ambivalence. Proof of this resistance also surfaced later as a motivated shift of focus in therapy, and a weakening of the therapeutic alliance. By the time this was evident, sabotage of therapy had already occurred.

Adult↗
PubMed1996

On trauma, perversion, and "multiple personality".

The role of perverse sexuality as an organizing influence in "multiple personality" is explored in this paper. Following a brief review of psychoanalytic thinking on sexual trauma and perversion, the author discusses his own views on dissociation and "multiple personality." A clinical case is then presented in which transsexualism, homosexuality, and sadomasochistic heterosexual practices were manifested during altered ego states. Analysis of the transference revealed the centrality of sadomasochism in this patient. It is hypothesized that various perverse structures may be formed within these seemingly autonomous, amnestic states, in order to contain anxiety and encapsulate the aggression which resulted from early psychic trauma. Issues relating to diagnosis, countertransference, reconstruction, and psychoanalytic technique are discussed also.

Adult↗
PubMed2005

Who is 'who' in dissociation?: A plea for psychodynamics in a time of trauma.

Contemporary theories of dissociation and trauma for the most part have evolved outside of psychoanalysis. Psychoanalytic writings have also been regarded as being in opposition to trauma-based notions of human psychopathology. The specific psychoanalytic contribution--the emphasis on unconscious conflict and meaning--is for the most part excluded from the discourse on dissociation, often resulting in a 'mechanic' conceptualisation of trauma. In this paper, based on clinical material, the author argues in favour of including conflict, unconscious intention and personal meaning in understanding the kind of dissociation we see in cases of multiple personality pathology. Textual analysis of letters written to the analyst illustrates how events of abuse are defensively elaborated. The author demonstrates that patterns of affect regulation and dominant object-relational strategies can be captured through analysis of the discourse structure. She focuses on how an organised character pattern, revealed mainly through narrative style and the analyst's countertransference, serves protective purposes as well as wish-fulfillment. She argues that dissociation in the form of multiple personalities may imply an active, strategic agent.

Adult↗