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.
Reviews and Endorsements:
“This comprehensive textbook by three master clinicians is a welcome addition to the growing literature on treatment of patients who have suffered the most extreme early life trauma. A calm and steady emphasis on basic principles, illustrated with numerous case vignettes, offers wise guidance to clinicians facing the challenges of this difficult but rewarding work.” — Judith Lewis Herman, MD, Professor of Psychiatry at Harvard Medical School
“Three expert, experienced clinicians and researchers who are leaders in the field have combined their vast experience and knowledge to write one of the most informative, comprehensive books on the treatment of complex trauma and trauma-generated dissociation I have ever read. This book is clearly written and presents a thorough framework for understanding trauma-generated dissociation and addresses such important issues as the collaborative therapeutic relationship, case conceptualization and treatment planning, phase-oriented treatment, and working with dissociative parts in a safe way that promotes integration. This is necessary reading for all clinicians not only for understanding and treating trauma-generated dissociation but also as a great text for therapy in general.” — Roger M. Solomon, PhD, Senior Faculty, EMDR Institute
About the Authors:
Kathy Steele, MN, CS, is in private practice with Metropolitan Psychotherapy Associates in Atlanta, Georgia. She is a former President of the International Society for the Study of Dissociation.
Suzette Boon, PhD, is a clinical psychologist and psychotherapist working in private practice in Maarssen, the Netherlands. She was the co-founder and first President of the European Society for the Study of Trauma and Dissociation.
Onno van der Hart, Ph.D., is Professor Emeritus of Psychopathology of Chronic Traumatization, Department of Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands, and a psychologist / psychotherapist in private practice in Amsterdam, the Netherlands. He is a Past President of the International Society for Traumatic Stress Studies (ISTSS).