Dissociation : Vol. 8, No. 2 (June 1995)
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Item Open Access Dissociation : Vol. 8, No. 2, p. 126 : Review: Multiple personlichkeiten: uberlebende extremer gewalt, ein handbuch(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Hofmann, Arne; Huber, MichaelaItem Open Access Dissociation : Vol. 8, No. 2, p. 124-125 : Beginnings--the start of an inpatient program for DID-patients in a German hospital(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Hofmann, ArneItem Open Access Dissociation : Vol. 8, No. 2, p. 120-123 : Dissociative identity disorder revealed through play therapy: a case study of a four-year-old(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Snow, Marilyn S.; White, JoAnna; Pilkington, Lloyd; Beckman, DarleneThis case study illustrates how DID symptomatology emerged and was identified during a traditional course of play therapy with a four-year-old child. Considering the history and presenting symptoms of children with dissociative identities, play therapy offers hopeful strategies for identification and intervention.Item Open Access Dissociation : Vol. 8, No. 2, p. 112-119 : Hypnotic susceptibility, dissociation, and marijuana use: a relationship between high hypnotic susceptibility, marijuana use, and dissociative ability(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Pekala, Ronald J.; Kumar, V. K.; Marcano, GeddesParticipants were 413 introductory psychology students from West Chester University. Participants completed the Anomalous Experiences Inventory (AEI) (Kumar, Pekala, & Gallagher, 1994) and the Dissociative Experiences Scale (DES) (Bernstein &Putnam, 1986). Participants then experienced the Harvard Group Scale of Hypnotic Susceptibility (Shor & Orne, 1962). Participants were divided into five groups of low to high susceptible participants (based on their responses to the Harvard) and ANOVA analyses were performed for the AEI drug items (use of alcohol, LSD, cocaine, heroin, and marijuana) as a function of hypnotizability and dissociative ability. A significant interaction between drug use and hypnotizability as a function of dissociative ability was found only for the use of marijuana. For participants who were highly hypnotizable (Harvard Scale scores of 10 to 12), endorsement of having used marijuana was associated with significantly higher DES scores of about 1 SD in comparison to those participants who did not use marijuana. The interrelationships among dissociation, marijuana use, and hypnotizability are reviewed with reference to the above research findings. Pending replication, implications concerning the use of marijuana as a means for experimentally assessing dissociative processes are discussed.Item Open Access Dissociation : Vol. 8, No. 2, p. 104-111 : Six completed suicides in dissociative identity disorder patients: clinical observations(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Kluft, Richard P., 1943-Recent studies demonstrate that the majority of dissociative disorder (DID) patients inflict self injury, and that 1-2.1 % of DID patients have succeeded in killing themselves. Six female DID patients ranging from 26 to 38 years in age suicided. All had received prior diagnoses of borderline personality disorder and affective disorder. In four cases the suicide attempts were planned to evade detection; in one case there was implicit planning by default; in the last matters defied ready classification. The major motivations for suicide appeared diverse, and included vindictiveness, the overwhelming impact of flashbacks that could not be distinguished from reality, inner warfare among the alters, anticipated object loss, guilt in connection with a parent's death, and pain and hopelessness associated with abandonment. However, these patients' traumata and burdens did not seem more overwhelming than those of comparable DID patients. Five of the completed suicides had in common the use of lying to attain their goals, ready rationalizations for dishonest and inappropriate behavior, disrupted or failed therapeutic alliances, a delusional intensity of the alters' convictions that they enjoyed complete separateness, and the alters' entertaining mutually incompatible subjective understandings of their personal realities. In these five an unresolvable clash between objective and subjective realities had occurred before the fatal events, and the patients, profoundly invested in their views, were unable or unwilling to accommodate to the demands and constraints of conventional reality. Suicide may have provided the illusion of the omnipotent reestablishment of their desired construction of reality, and precluded further painful confrontations, humiliations, and narcissistic deflations. The sixth suicide appears to have been due to inadequate treatment.Item Open Access Dissociation : Vol. 8, No. 2, p. 100-103 : A story for Marcie(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Kinsler, Philip J.Psychotherapists who work with abuse survivors are continually confronted with basic questions about human existence. Every day we must ponder what makes life worth living; how people can go on after the most horrifying experiences; when and whether the pain is ever so great that it is OK for a human being to take his own life; and the question of good and evil. It is the author's experience that therapists do not often write about their struggle with these questions. They are shared in private quiet moments with closely valued colleagues and family. What follows is one therapist's struggle to cope with these questions, set off by a particularly difficult set of clinical and personal experiences.Item Open Access Dissociation : Vol. 8, No. 2, p. 091-099 : Persecutory alters and ego states: protectors, friends, and allies(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Goodman, Lisa A.; Peters, JayPersecutor alters in dissociative identity disorder are uniformly described in behavioral terms as belligerent, abusive, and violent. While most authors agree that persecutors begin as helpers there is no consensus about their later development or function within the system. This paper presents a theoretical model of the etiology and development of persecutor alters. It elucidates the underlying and continuously protective nature of the alter which becomes masked by the apparently "persecutory" behavior. Using clinical examples which build on their appreciation of the positive function of persecutor alters the authors present their treatment techniques, which include: engagement, building rapport with the underlying protective function, psychoeducation of the alter, and finally, family therapy style negotiations of roles, expectations, and boundaries. The paper concludes with an examination of the countertransference issues which commonly arise in working with persecutor alters and their impact on the clinician and the therapeutic task.Item Open Access Dissociation : Vol. 8, No. 2, p. 084-090 : Dissociation and the processing of threat-related information(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Waller, Glenn; Quinton, Stephanie; Watson, DerrickIt is well established that dissociation is a clinically important phenomenon. However, relatively little is known about the cognitive processes that underpin that phenomenon. It is suggested that dissociation reflects a characteristic pattern of processing information about present or past threat. Using a novel computer-driven task, this study examines the association between dissociation and the processing of threat-related information in a group of 105 non-clinical women. The results show that women with higher levels of dissociation (particularly absorption) take longer to respond to threatening information, even though the task might be expected to produce faster processing. A model of cognitive processing is suggested, in which dissociation is characterized by secondary schemata that are specifically unrelated to the threatening information. Further research is needed to test and extend this model especially with clinical subjects.Item Open Access Dissociation : Vol. 8, No. 2, p. 073-083 : Treatment of DID and DDNOS patients in a regional institute for ambulatory mental health care in the Netherlands: a survey(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Groenendijk, Ingrid; Hart, Onno van der, 1941-To survey the number and characteristics of DID and DDNOS patients treated at a Regional Institute for Ambulatory Mental Health Care in the Netherlands, their treatment goals and treatment course, and the organizational investment, semi-structured interviews were held with therapists about all patients diagnosed with DID or DDNOS during a three-month period (May 31, 1993 - August 31, 1993), and a study of these patients' files took place. One hundred one patients received a dissociative disorder diagnosis, i.e., forty-one the diagnosis of DID and sixty the diagnosis of DDNOS. On average, these patients received the dissociative disorder diagnosis after a treatment period of over two years. Most therapists followed a basic stage-oriented treatment model. In the majority of cases, hypnosis was an important adjunctive technique. For more than half of the patients (DID:53.7%; DDNOS:60.0%), therapists reported stabilization and symptom reduction as the treatment goal. For one-third (DID: 39.0%; DDNOS: 31.6%), the focus included treatment of traumatic memories as well as reintegration and rehabilitation. This objective was chosen within one to three years of stabilization and symptom reduction. Average treatment length was six years, most often with a frequency of one session a week. In 10% of all cases, a second therapist joined the treatment. Therapists reported concern with regard to: boundary issues, co-therapy, diagnostic issues, (contra) indications for treatment of traumatic memories, attachment problems, cooperation with other agencies, underdevelopment with regard to dissociative disorders in child and adolescent mental health care. The emphasis on supportive therapy only and the use of secondary therapists may perhaps be different from clinical approaches elsewhere.Item Open Access Dissociation : Vol. 8, No. 2, p. 071-072 : Editorial: Triumphs and tragedies(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06) Kluft, Richard P., 1943-Item Open Access Dissociation : Vol. 8, No. 2, p. 000 : Cover, table of contents(Ridgeview Institute and the International Society for the Study of Dissociation, 1995-06)