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Dissociative disorders are one of the psychiatric consequences of childhood psychological trauma. While oppression is an aspect of traumatic conditions, dissociation undermines resistance to oppression throughout a person’s lifespan. Neither oppression nor dissociation are restricted to particular cultures, and both can affect the individual as well as societies. This collection engages with the universality of dissociative disorders and their close relationship to oppression. The chapters cover extreme examples such as ongoing incest in adulthood, children and adults forced to kill others, and abusive states in interrogation. Further subjects examined include the utilization of dissociation in postmodern societies to maintain oppression, the oppressive conditions of asylum seekers and the consequences of oppression as they are dealt with in psychotherapy. The final chapter considers how a paedophile pandering network employed multi-layered oppression to prevent the public becoming aware of the widespread and organised abuse of children. This book will engender interactions between trauma investigators – those whose approach is close clinical observation, those who use instruments to survey groups of individuals, those whose research takes the form of investigative journalism, and those who examine the truth embedded or hidden in documents created for multiple, and at times, disturbing political purposes. Portions of this book were originally published as a special issue of the Journal of Trauma & Dissociation. It also includes material from other sources.
Dissociative disorders are one of the psychiatric consequences of childhood psychological trauma. While oppression is an aspect of traumatic conditions, dissociation undermines resistance to oppression throughout a person’s lifespan. Neither oppression nor dissociation are restricted to particular cultures, and both can affect the individual as well as societies. This collection engages with the universality of dissociative disorders and their close relationship to oppression. The chapters cover extreme examples such as ongoing incest in adulthood, children and adults forced to kill others, and abusive states in interrogation. Further subjects examined include the utilization of dissociation in postmodern societies to maintain oppression, the oppressive conditions of asylum seekers and the consequences of oppression as they are dealt with in psychotherapy. The final chapter considers how a paedophile pandering network employed multi-layered oppression to prevent the public becoming aware of the widespread and organised abuse of children. This book will engender interactions between trauma investigators – those whose approach is close clinical observation, those who use instruments to survey groups of individuals, those whose research takes the form of investigative journalism, and those who examine the truth embedded or hidden in documents created for multiple, and at times, disturbing political purposes. Portions of this book were originally published as a special issue of the Journal of Trauma & Dissociation. It also includes material from other sources.
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.
Scientific and popular interest in dissociation and dissociative disorders has grown significantly in the past decade. Responding to the need for an authoritative reference on this topic, Steven Jay Lynn and Judith W. Rhue present an unusually comprehensive volume, covering the major aspects of dissociation--from the predominant models and diagnostic and treatment approaches, to significant research, clinical, and conceptual issues. Illuminating reading, Dissociation confronts many of the controversies and debates surrounding the topic. Founded on research and grounded in theory, it is an important addition to the scholarly literature. Laying the groundwork for the rest of the book, the first section discusses current theoretical and research perspectives on dissociation. Chapters set forth results of the latest research alongside actual clinical examples. In the second section, chapters present practical information designed to assist clinicians in diagnosing and treating clients suffering from dissociative disorders, post-traumatic stress disorders, and the consequences of sexual victimization and cult involvement. Fostering an appreciation for the ways in which social and cultural factors affect the expression of dissociative symptoms, this section also illustrates the ways in which transference and countertransference can affect dissociative symptoms and the treatment of multiple personality disorder, (MPD). The third section, on current issues and controversies, provides invaluable information for all clinicians who encounter clients with dissociative disorders. Chapters probe such questions as whether trauma causes dissociative pathology, whether and under what circumstances pseudomemories of child abuse can be created, the relationship between conversion and dissociative disorders and their respective placement in diagnostic classification schemes, and areas of possible rapprochement between those who believe in MPD and those who are skeptical of the disorder. Offering the most significant contribution to scholarly coverage of dissociation to date, this highly provocative volume offers valuable insights for the clinician, as well as many new theories, hypotheses, and syntheses of the research literature. As such, Dissociation will be welcomed by anyone who encounters dissociative disorders in clinical practice. It is also a useful primary text for researchers and students of psychotherapy in a broad range of helping professions.
In the year 2000, approximately one million people died from suicide: a "global" mortality rate of 16 per 100,000, or one death every 40 seconds. In the last 45 years suicide rates have increased by 60% worldwide. Suicide is now among the three leading causes of death among those aged 15-44 years (both sexes); these figures do not include suicide attempts up to 20 times more frequent than completed suicide. Suicide worldwide is estimated to represent 1.8% of the total global burden of disease in1998, and 2.4% in countries with market and former socialist economies in 2020. Although traditionally suicide rates have been highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of countries, in both developed and developing countries. Mental disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide; however, suicide results from many complex sociocultural factors and is more likely to occur particularly during periods of socioeconomic, family and individual crisis situations (e.g., loss of a loved one, employment, honour). The economic costs associated with completed and attempted suicide are estimated to be in the billions of dollars. One million lives lost each year are more than those lost from wars and murder annually in the world. It is three times the catastrophic loss of life in the tsunami disaster in Asia in 2005. Every day of the year, the number of suicides is equivalent to the number of lives lost in the attack on the World Trade Center Twin Towers on 9/11 in 2001. Everyone should be aware of the warning signs for suicide: Someone threatening to hurt or kill him/herself, or taking of wanting to hurt or kill him/herself; someone looking for ways to kill him/herself by seeking access to firearms, available pills, or other means; someone talking or writing about death, dying or suicide, when these actions are out of the ordinary for the person. Also, high risk of suicide is generally associated with hopelessness; rage, uncontrolled anger, seeking revenge; acting reckless or engaging in risky activities, seemingly without thinking; feeling trapped – like there’s no way out; increased alcohol or drug use; withdrawing from friends, family and society, anxiety, agitation, unable to sleep or sleeping all the time; dramatic mood changes; no reason for living; no sense of purpose in life. Table 1: Understanding and helping the suicidal individual should be a task for all. Suicide Myths How to Help the Suicidal Person Warning Sights of Suicide Myth: Suicidal people just want to die. Fact: Most of the time, suicidal people are torn between wanting to die and wanting to live. Most suicidal individuals don’t want death; they just want to stoop the great psychological or emotional pain they are experiencing -Listen; -Accept the person’s feelings as they are; -Do not be afraid to talk about suicide directly -Ask them if they developed a plan of suicide; -Expressing suicidal feelings or bringing up the topic of suicide; -Giving away prized possessions settling affairs, making out a will; -Signs of depression: loss of pleasure, sad mood, alterations in sleeping/eating patterns, feelings of hopelessness; Myth: People who commit suicide do not warn others. Fact: Eight out of every 10 people who kill themselves give definite clues to their intentions. They leave numerous clues and warnings to others, although clues may be non-verbal of difficult to detect. -Remove lethal means for suicide from person’s home -Remind the person that depressed feelings do change with time; -Point out when death is chosen, it is irreversible; -Change of behavior (poor work or school performance) -Risk-taking behaviors -Increased use of alcohol or drugs -Social isolation -Developing a specific plan for suicide Myth: People who talk about suicide are only trying to get attention. They won’t really do it. Fact: Few commit suicide without first letting someone know how they feel. Those who are considering suicide give clues and warnings as a cry for help. Over 70% who do threaten to commit suicide either make an attempt or complete the act. -Express your concern for the person; -Develop a plan for help with the person; -Seek outside emergency intervention at a hospital, mental health clinic or call a suicide prevention center Myth: Don’t mention suicide to someone who’s showing signs of depression. It will plant the idea in their minds and they will act on it. Fact: Many depressed people have already considered suicide as an option. Discussing it openly helps the suicidal person sort through the problems and generally provides a sense of relief and understanding. Suicide is preventable. Most suicidal individuals desperately want to live; they are just unable to see alternatives to their problems. Most suicidal individuals give definite warnings of their suicidal intentions, but others are either unaware of the significance of these warnings or do not know how to respond to them. Talking about suicide does not cause someone to be suicidal; on the contrary the individual feel relief and has the opportunity to experience an empathic contact. Suicide profoundly affects individuals, families, workplaces, neighbourhoods and societies. The economic costs associated with suicide and self-inflicted injuries are estimated to be in the billions of dollars. Surviving family members not only suffer the trauma of losing a loved one to suicide, and may themselves be at higher risk for suicide and emotional problems. Mental pain is the basic ingredient of suicide. Edwin Shneidman calls such pain “psychache” [1], meaning an ache in the psyche. Shneidman suggested that the key questions to ask a suicidal person are ‘Where do you hurt?’ and ‘How may I help you?’. If the function of suicide is to put a stop to an unbearable flow of painful consciousness, then it follows that the clinician’s main task is to mollify that pain. Shneidman (1) also pointed out that the main sources of psychological pain, such as shame, guilt, rage, loneliness, hopelessness and so forth, stem from frustrated or thwarted psychological needs. These psychological needs include the need for achievement, for affiliation, for autonomy, for counteraction, for exhibition, for nurturance, for order and for understanding. Shneidman [2], who is considered the father of suicidology, has proposed the following definition of suicide: ‘Currently in the Western world, suicide is a conscious act of self-induced annihilation, best understood as a multidimensional malaise in a needful individual who defines an issue for which the suicide is perceived as the best solution’. Shneidman has also suggested that ‘that suicide is best understood not so much as a movement toward death as it is a movement away from something and that something is always the same: intolerable emotion, unendurable pain, or unacceptable anguish. Strategies involving restriction of access to common methods of suicide have proved to be effective in reducing suicide rates; however, there is a need to adopt multi-sectoral approaches involving other levels of intervention and activities, such as crisis centers. There is compelling evidence indicating that adequate prevention and treatment of depression, alcohol and substance abuse can reduce suicide rates. School-based interventions involving crisis management, self-esteem enhancement and the development of coping skills and healthy decision making have been demonstrated to reduce the risk of suicide among the youth. Worldwide, the prevention of suicide has not been adequately addressed due to basically a lack of awareness of suicide as a major problem and the taboo in many societies to discuss openly about it. In fact, only a few countries have included prevention of suicide among their priorities. Reliability of suicide certification and reporting is an issue in great need of improvement. It is clear that suicide prevention requires intervention also from outside the health sector and calls for an innovative, comprehensive multi-sectoral approach, including both health and non-health sectors, e.g., education, labour, police, justice, religion, law, politics, the media.
The diagnosis of multiple personality disorder (MPD) entered the clinical mainstream with a rapidity and in a manner atypical for new descriptions of psychiatric illness. This book contains the most up-to-date information on MPD available written by experts in this field. The first section is a memorial to Cornelia B. Wilbur, M.D., a pioneer in MPD treatment. It is full of personal accounts from people who knew her well. The second section deals with general issues in the treatment of MPD. It discusses basic principles in conducting the psychotherapy of MPD, posttraumatic and dissociative phenomena in transference and countertransference, and treatment of MPD as a posttraumatic condition. The third section goes on to give case studies that illustrate the application of techniques, approaches, and insights that are considered important in the treatment of MPD patients but are difficult to learn because they have not been documented in detail in the literature. Methods discussed include the use of Amytal interviews, play therapy, egoûstate therapy, and the use of sand trays. The last section of the book discusses some of the contemporary concerns in the field (including consultation in the public psychiatric sector and the incidence of eating disorders in MPD patients), and on the recent history of the study of MPD.
Global Perspectives in Health is a component of Encyclopedia of Biological, Physiological and Health Sciences in the global Encyclopedia of Life Support Systems (EOLSS), which is an integrated compendium of twenty one Encyclopedias. The Theme on Global Perspectives in Health provides the essential aspects and with a myriad of issues of great relevance to our world such as: Global Perspectives in Health; Determinants of Health and Their Interactions; Epidemiology: Health and Disease in Populations; Health Care Systems; Ethical Issues in Health; New Problems in Global Health. These two volumes are aimed at the following five major target audiences: University and College students Educators, Professional practitioners, Research personnel and Policy analysts, managers, and decision makers and NGOs.
The Dissociative Mind in Psychoanalysis: Understanding and Working With Trauma is an invaluable and cutting edge resource providing the current theory, practice, and research on trauma and dissociation within psychoanalysis. Elizabeth Howell and Sheldon Itzkowitz bring together experts in the field of dissociation and psychoanalysis, providing a comprehensive and forward-looking overview of the current thinking on trauma and dissociation. The volume contains articles on the history of concepts of trauma and dissociation, the linkage of complex trauma and dissociative problems in living, different modalities of treatment and theoretical approaches based on a new understanding of this linkage, as well as reviews of important new research. Overarching all of these is a clear explanation of how pathological dissociation is caused by trauma, and how this affects psychological organization -- concepts which have often been largely misunderstood. The Dissociative Mind in Psychoanalysis will be essential reading for psychoanalysts, psychoanalytically oriented psychotherapists, trauma therapists, and students.
Illustrates the critical association between pathological dissociation and trauma, and provides a clear synthesis of what is known about the psychobiology of dissociative disorders and the effects of pathological dissociation on cognition and memory. Amply illustrated with clinical vignettes, it also offers an array of diagnostic and treatment techniques.