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.
