Dissociation : Volume 10, No. 4 (Dec. 1997)

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Browsing Dissociation : Volume 10, No. 4 (Dec. 1997) by Author "Blizard, Ruth A."

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    Dissociation : Volume 10, No. 4, p. 223-229 : The origins of dissociative identity disorder from an object relations and attachment theory perspective
    (Ridgeview Institute and the International Society for the Study of Dissociation, 1997-12) Blizard, Ruth A.
    When 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.
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    Dissociation : Volume 10, No. 4, p. 246-254 : Therapeutic alliance with abuser alters in DID: the paradox of attachment to the abuser
    (Ridgeview Institute and the International Society for the Study of Dissociation, 1997-12) Blizard, Ruth A.
    Abuser alters present a dilemma in the treatment of adults with dissociative identity disorder, because they often undermine the therapy as well as re-abuse the patient. They are paradoxical because they were created to help the child survive abuse, but continue to do so by abusing the self. They were often modeled after an abusive primary caretaker to whom the child was attached. Object-relations and attachment theories clarify how creation of the abuser personality serves to preserve the attachment to the abusing caretaker. By understanding how abuser alters function to maintain attachment, contain overwhelming memories, and protect against abuse, therapists can better engage abuser alters in a therapeutic alliance. Empathy, cognitive reframing, and gentle paradoxical techniques can help host and abuser personalities become more empathic toward one another, develop common purpose, and begin integrating. By working through the transference, attachment to the internalized abusive caretaker is replaced by a healthy attachment to the therapist in the therapeutic alliance.