Dissociation : Vol. 2, No. 4 (Dec. 1989)
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Item Open Access Dissociation : Vol. 2, No. 4, p. 194-204 : Dissociative Disorders Presenting as Somnambuism Polysomnographic, Video and Clinical Documentation (8 Cases)(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Schenck, Carlos H.; Milner, Donna M.; Hurwitz, Thomas D.; Bundlie, Scott R.; Mahowald, Mark W.A polysomnographic (PSG) and clinical study of 150 consecutive patients presenting to a sleep disorders center during a 7.5 year period for evaluation of repeated sleep-related injury (ecchymoses, lacerations, fractures) identified 5.3percent (N=8) with Dissociative Disorders (DDs) as the cause of the injuries, and whose presenting diagnosis was somnambulism. 87.5 percent (7/8) were female, and the mean age at referral was 29.5 (+/-SD 6.1) years. Two patients fulfilled DSM-111-R criteria for Multiple Personality Disorder (MPD). The six other patients were diagnosed as Dissociative Disorders Not Otherwise Specified, but were strongly suspected to have MPD. One patient had an exclusively nocturnal, animalistic DD: a 19 year old male who had acted like a large jungle cat twice weekly for 4 years. PSG studies were diagnostic for nocturnal DD in 50 percent (4/8) of the cases (including that of the jungle cat), with distinctly altered, complex, repetitive and lengthy behaviors emerging suddenly from sustained electroencephalographic wakefulness. PSG studies supported the diagnosis of DD as the cause of nocturnal injury in the other 50 percent (4/8) of the cases: i) by not detecting seizure activity, NREM/REM sleep motor abnormality or sleep breathing disturbance, and ii) when correlated with the clinical history of chronic daytime DDs.Item Open Access Dissociation : Vol. 2, No. 4, p. 205-220 : Historical Versus Narrative Truth: Clarifying the Role of Exogenous Trauma in the Etiology of MPD and its Variants(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Ganaway, George K.The author notes a current trend toward viewing multiple personality disorder (MPD) and its variants as a form of chronic posttraumatic stress disorder based solely on exogenous childhood trauma, and cautions against prematurely reductionistic hypotheses. He focuses on Kluft's Third Etiological Factor, which includes various developmental, biological, interpersonal, sociocultural, psychodynamic shaping influences and substrates that determine the form taken by the dissociative defense. He hypothesizes a credibility continuum of childhood and contemporary memories arising primarily from exogenous trauma at one end, and endogenous trauma (stemming from intrapsychic adaptational needs) at the other. The author offers alternative multidetermined explanations for certain unverified trauma memories that currently are being accepted and validated as factual experiences by many therapists. He describes some potentially deleterious effects of validating unverified trauma memories during psychotherapy, and recommends that the MPD patients' need for unconditional credibility be responded to in the same manner as other transference-generated productions.Item Open Access Dissociation : Vol. 2, No. 4, p. 000 : Cover, table of contents(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12)Item Open Access Dissociation : Vol. 2, No. 4, p. 251-254 : Letters to the Editor(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Richard Noll; Michael Miller; Jean Goodwin; Sally HillItem Open Access Dissociation : Vol. 2, No. 4, p. 221-223 : A Validation Study of the DES in the Netherlands(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Ensink, Bernadine J.; Van Otterloo, DorienIn the Netherlands we did a small-scale validation study of the Dissociative Experiences Scale (DES) developed by Bernstein and Putnam (1986). The questionnaire was administered in two versions, with and without dummy questions, to 80 students (40 students in each condition) and in one version to 20 patients with a clinically diagnosed dissociative disorder (7 With multiple personality disorder and 13 with other dissociative disorders). The results show that the DES has a good internal consistency and a good criterion validity. If the DES is administered to normals it is advisable to insert dummies (less extreme dissociative items not counted in the statistics). This counteracts normal subjects’ reactions to the extremity of the DES item. The score of the Dutch normals is higher than for American normals. There may he cultural differences either in attitudes toward and/or in the level of actual dissociation between the populations of North America and the Netherlands.Item Open Access Dissociation : Vol. 2, No. 4, p. 191-193 : Editorial(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Kluft, Richard P., 1943-Item Open Access Dissociation : Vol. 2, No. 4, p. 239-242 : Dissociative Experiences in Adolescents and College Students(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Ross, Colin A.; Ryan, Lynne; Anderson, Geri; Ross, Dana; Hardy, LesleyThe authors administered the Dissociative Experiences Scale to 168 children aged 12-14, 345 college students with a median age 24 years, and 30 patients in a Geriatric Day Hospital. Scores were distributed in a highly left-skewed fashion, with no differences between males and females among the adolescents or college students. The median score for the adolescents was 17. 7 for the college students 7. 9 and for the elderly 4.8. These findings suggest that dissociative experiences are more common in early adolescence than in young adulthood, and that they continue to decline with increasing age after the third decade.Item Open Access Dissociation : Vol. 2, No. 4, p. 224-230 : Precursors of Integration in the Treatment of Multiple Personality Disorder: Clinical Reflections(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Greaves, George B.At the present time it is, as a practical matter, quite impossible to describe a treatment paradigm by which multiple personality (MPD) is cured. Fathoming the languages of the discourse among the various schools of psychotherapy is itself much like trying to communicate with the myriad workmen who sought to build the Tower of Babel. Despite this problem, patients themselves regularly present "marker events" which indicate they are getting better or worse. This paper is an analysis of such events.Item Open Access Dissociation : Vol. 2, No. 4, p. 231-238 : Understanding and Responding to Religious Material in the Therapy of Multiple Personality Disorder(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Bowman, Elizabeth S.A review of the literature on religion and (MPD) shows numerous associations between (MPD) and a fundamentalist religious upbringing and demonstrates that primary and secondary personalities differ greatly in God images and religious practices. The suffering and abuse experiences of MPD patients raise religious and existential questions in psychotherapy. Religious questions fall into three areas: God and the existence of evil, anger at God or institutional religion, and spiritual growth questions that accompany psychological growth. The dynamic significance of religious ideation and of five components of God images are explained. Suggestions are offered for eliciting and interpreting religious background and ideation. Pitfalls originating in positive and negative countertransference are identified and a neutral approach to religion is suggested. Examples are given for dealing with religious material that functions as resistance and suggestions are offered for collaborating with clergy in the treatment of religious MPD patients.Item Open Access Dissociation : Vol. 2, No. 4, p. 243-249 : The Rehabilitation of Therapists Overwhelmed by Their Work with MPD Patients(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Kluft, Richard P., 1943-It is generally recognized that the treatment of multiple personality disorder (MPD) may prove an arduous undertaking for patient and therapist alike. The literature is replete with descriptions of the impact of treatment upon MPD patients, but has been understandably circumspect about the effects of this process upon therapists. This discrete silence belies the intense concentration upon this aspect of work with MPD patients in workshop and consultation settings. Although the number of new therapists in the field continues to expand, it is well known that there is a much smaller, but not inconsiderable stream of clinicians who exit the field, and discontinue working with MPD patients. Furthermore, a larger group continues to work with MPD patients, but at a diminished level of effectiveness. This presentation will review some of the stressors inherent in work with MPD patients, and describe characteristic sequences in the reactions of those who work with MPD (e.g., front fascination with MPD and MPD patients to various expressions of withdrawal, the breakdown of empathy and rapport, the loss of an optimal therapeutic stance, and acting out in the countertransference). Several patterns of therapist distress will be noted. A model for diagnosing the problem areas of overwhelmed therapists will be described, and types of interventions targeted at the alleviation of the problem areas will be noted. Corrective measures will be outlined, in the framework of educational domains. Observations on the effect of rehabilitating the therapist upon the therapist's patients will be offered.Item Open Access Dissociation : Vol. 2, No. 4, p. 250 : Book Review(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1989-12) Schecker, Neil; James, Beverly