Blizard, Ruth A.2005-10-302005-10-301997-120896-2863https://hdl.handle.net/1794/1803p. 223-229When a child is utterly dependent for survival on a parent or caregiver who is abusive, the child faces an extraordinary dilemma in finding a way to preserve the attachment to the caregiver while trying to survive terrifying abuse. Concepts from object relations and attachment theories will be integrated with current thinking about trauma and dissociation to develop a theory of why multiple identity states are created by the child to survive this paradox. According to this view, alter personalities may be understood as over-elaborations and personifications of internalized, split, self and object representations. Because of the severity of trauma, these were kept separate and dissociated in order to preserve both the self and the attachment to the "good" aspects of the caregivers while allowing the child to survive by maintaining functioning relationships with the "bad" aspects of the caregivers. Understanding the origins of these personality states in childhood object relations can help to elucidate the dynamics of the relationships within the system of personalities in adulthood. They can also clarify the purpose of reenactment of abuse, whether between two self states, or in external relationships. These principles are illustrated with a case example.727805 bytesapplication/pdfen-USArticle