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"In this chapter, we provide a brief overview of the relationships between trauma-related disorders and dissociation, describe the prevalence and presentations of dissociation among trauma survivors, and discuss the challenges that contribute to trauma-related disorders (TRD) and dissociative disorders (DDs) being "hidden in plain sight". Please note that throughout this book we use the term "trauma-related disorders" (TRD) as an overarching term that includes those who have a diagnosable trauma-related DD, which means that dissociation is typically severe, frequent, and disabling. Thus, our use of TRD in this book includes individuals with posttraumatic stress disorder (PTSD), acute stress disorder, the dissociative subtype of PTSD (DPTSD), and persons with trauma-related DDs. Since many authors consider borderline personality disorder a TRD due to the frequent occurrence of trauma, childhood maltreatment, and attachment problems in this population, we include those with trauma histories in our use of TRD as well"--
"Grounding is a recovery-focused skill that offers powerful help towards managing and reducing symptoms related to trauma, including feeling too much or too little"--
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.
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.
The authors critically review memory research, trauma treatment, and legal cases pertaining to the false memory controversy. They discuss current memory science and research with both children and adults, pointing out where findings are and are not generalizable to trauma memories recovered in psychotherapy. The main issues in the recovered memory debate are covered, as well as research on emotion and memory, autobiographical memory, flashbulb memory, memory for trauma, and types of suggestions, such as misinformation suggestions, social persuasion, interrogatory suggestions, and brainwashing. Research on the reliability of memories recovered in hypnosis is reviewed and guidelines for using hypnosis with patients reporting no, partial, or full memory of having been sexually abused are outlined. The authors review the development and current practice of phase-oriented trauma treatment and present a standard of care that is effective and ethical. Their exploration of memory in the legal context includes a review of malpractice liability and current malpractice cases for allegedly implanting false memories in therapy, as well as the evolving law around legal actions by people who have recovered memories and around hypnosis and memory recovery. This is an essential reference on memory for all clinicians, researchers, attorneys, and judges.
An invaluable sourcebook on the complex relationship between psychosis, trauma, and dissociation, thoroughly revised and updated This revised and updated second edition of Psychosis, Trauma and Dissociation offers an important resource that takes a wide-ranging and in-depth look at the multifaceted relationship between trauma, dissociation and psychosis. The editors – leaders in their field – have drawn together more than fifty noted experts from around the world, to canvas the relevant literature from historical, conceptual, empirical and clinical perspectives. The result documents the impressive gains made over the past ten years in understanding multiple aspects of the interface between trauma, dissociation and psychosis. The historical/conceptual section clarifies the meaning of the terms dissociation, trauma and psychosis, proposes dissociation as central to the historical concepts of schizophrenia and borderline personality disorder, and considers unique development perspectives on delusions and the onset of schizophrenia. The empirical section of the text compares and contrasts psychotic and dissociative disorders from a wide range of perspectives, including phenomenology, childhood trauma, and memory and cognitive disturbances, whilst the clinical section focuses on the assessment, differential diagnosis and treatment of these disorders, along with proposals for new and novel hybrid disorders. This important resource: • Offers extensive updated coverage of the field, from all relevant perspectives • Brings together in one text contributions from scholars and clinicians working in diverse geographical and theoretical areas • Helps define and bring cohesion to this new and important field • Features nine new chapters on: conceptions of trauma, dissociation and psychosis, PTSD with psychotic features, delusions and memory, trauma treatment of psychotic symptoms, and differences between the diagnostic groups on hypnotizability, memory disturbances, brain imaging, auditory verbal hallucinations and psychological testing Written for clinicians, researchers and academics in the areas of trauma, child abuse, dissociation and psychosis, but relevant for psychiatrists, psychologists and psychotherapists working in any area, the revised second edition of Psychosis, Trauma and Dissociation makes an invaluable contribution to this important evolving field.
In this second edition of Joyanna Silberg’s classic The Child Survivor, practitioners who treat dissociative children will find practical tools that are backed up by recent advances in clinical research. Chapters are filled with examples of clinical dilemmas that can challenge even the most expert child trauma clinicians, and Silberg shows how to handle these dilemmas with creativity, attunement, and sensitivity to the adaptive nature of even the most complex dissociative symptoms. The new edition addresses the impact of the Covid-19 pandemic on children and provides tips for working with traumatized children in telehealth. A new chapter on organized abuse explains how children victimized by even the most sadistic crimes can respond well to therapy. Clinicians on the front lines of treatment will come away from the book with an arsenal of therapeutic techniques that they can put into practice right away, limiting the need for restrictive hospitalizations or out-of-home placements for their young clients.
There is now ample evidence from the preclinical and clinical fields that early life trauma has both dramatic and long-lasting effects on neurobiological systems and functions that are involved in different forms of psychopathology as well as on health in general. To date, a comprehensive review of the recent research on the effects of early and later life trauma is lacking. This book fills an obvious gap in academic and clinical literature by providing reviews which summarize and synthesize these findings. Topics considered and discussed include the possible biological and neuropsychological effects of trauma at different epochs and their effect on health. This book will be essential reading for psychiatrists, clinical psychologists, mental health professionals, social workers, pediatricians and specialists in child development.
Treating Complex Trauma and Dissociation is the ideal guide for the front-line clinician whose clients come in with histories of trauma, abuse, self-injury, flashbacks, suicidal behavior, and more. The second edition includes the latest research and developments in treatment for trauma and dissociative disorders. The book is written with the knowledge that survivors may read it, and the authors have consciously maintained the dignity of the survivors throughout. Clinicians will find that the chapters help them develop their own responses and practical solutions to common questions, including "How do I handle this?" "What do I say?" and "What can I do?" Treating Complex Trauma and Dissociation is the book clinicians will want to pick up when they're stuck and is a handy reference that provides the tools needed to deal with difficult issues in therapy. It is supportive and respectful of both therapist and client, and, most of all, useful in the office.