Dissociation

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https://hdl.handle.net/1794/1129

The official journal of the International Society for the Study of Trauma and Dissociation (ISSTD), published between 1988 and 1997. The current official journal of ISSTD is the Journal of Trauma & Dissociation. Members of the University of Oregon community can access the Journal of Trauma & Dissociation online.

A print copy of this journal is available through the UO Libraries under the call number: KNIGHT RC553.D5 D57

We appreciate the support for this digitization project by Jennifer Freyd, PhD; Frank Putnam, MD; Richard Kluft, MD; Catherine Fine, PhD; Ruth Blizard, PhD; and ISSD.

If errors are found in any file or the description of any file, users are kindly requested to contact the Scholars' Bank Coordinator, at the University of Oregon Libraries.

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Open Access
Dissociation : Vol. 1, No. 1, p. 000 : Cover, table of contents
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03)
Open Access
Dissociation : Vol. 1, No. 1, p. 002-003 : Editorial
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Kluft, Richard P., 1943-
Open Access
Dissociation : Vol. 1, No. 1, p. 004-023 : The BASK Model of Dissociation
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Braun, Bennett G.
The BASK model conceptualizes the complex phenomenology of dissociation along with dimensions of Behavior, Affect, Sensation, and Knowledge. The process of dissociation itself, hypnosis, and the clinical mental disorders that constitute the dissociative disorders are described in terms of this model, and iIIustrated.
Open Access
Dissociation : Vol. 1, No. 1, p. 024-032 : The Switch Process in Multiple Personality Disorder and Other State-Change Disorders
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Putnam, Frank W., 1947-
This paper explores the properties of states of consciousness as they are revealed by the process of state-change or switching. Drawing on examples of state of consciousness transitions in infants, altered states of consciousness, and psychiatric disorders, a number of common principles are derived. These include the observation that states of consciousness are discrete self-organizing patterns of behavior differing along axes of affect, access to memory, attention and cognition, regulatory physiology, and sense of self. State transitions are marked by non-linear changes in these variables. A developmental model is outlined and the implications for treatment and further research are discussed.
Open Access
Dissociation : Vol. 1, No. 1, p. 033-038 : Psychodynamics and Dissociation : All that Switches Is Not Split
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Young, Walter C.
This paper contrasts the roles of splitting and dissociation in multiple personality disorder. It is proposed that dissociation is a unique defensive process that serves to protect the patient from the overwhelming effects of severe trauma and that multiple personality disorder need not call upon splitting as its central defensive process. Fantasies of restitution may be incorporated into the dissociative defense. Psychological, physiological, and behavioral models all are of use, making it likely that ultimately dissociation will be understood along multiple Iines of study.
Open Access
Dissociation : Vol. 1, No. 1, p. 039-046 : DSM-III-R Revisions in the Dissociative Disorders: An Exploration of their Derivation and Rationale
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Kluft, Richard P., 1943-; Steinberg, Marlene, 1953-; Spitzer, Robert L.
The authors describe and explore changes in the dissociative disorders included in the new DSM-III-R. The classification itself was redefined to minimize inadvertent areas of overlap with other classifications. Recent findings have necessitated substantial revisions of the criteria and text for multiple personality disorder. Ganser's Syndrome, listed as a factitious disorder in DSMIII, is reclassified on the basis of recent research as a dissociative disorder not otherwise specified. The examples for dissociative disorder not otherwise specified have been expanded to better accommodate recognized dissociative syndromes that do not fall within the four formally defined dissociative disorders. Several novel diagnostic entities and reclassifications were proposed that were rejected for DSM-III-R because there is insufficient supporting data at this point in time. These proposals identify issues that will require reconsideration for DSM-IV.
Open Access
Dissociation : Vol. 1, No. 1, p. 047-053 : Psychophysiologic Aspects of Multiple Personality Disorder, A Review
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Coons, Philip M.
Multiple personality disorder has been associated with marked psychophysiologic alterations ever since careful clinical observations have been made on this perplexing disorder. Physical symptoms known to be associated with multiple personality include headaches, conversion symptoms, changes in voice, seizure-like activity, unexplained pain or insensitivity to pain, alterations in handedness or handwriting style, palpitations, alterations in respiration, gastrointestinal disturbances including bulimia and anorexia, menstrual irregularities, sexual dysfunction, and dermatological conditions including unusual allergic response s and differential responses to medication. Early scientific studies on the galvanic skin response in multiple personality disorder were conducted by Prince in the early twentieth century. Since 1970 there has been a resurgence of interest in multiple personality disorder including sophisticated studies of physical symptoms, brain-wave activity, visual evoked potential, regional cerebral blood flow, visual refraction, muscle activity, cardiac and respiratory activity, galvanic skin response, and the switch process. In addition to describing these studies, the etiology of multiple personality disorder and future directions in research will be discussed.
Open Access
Dissociation : Vol. 1, No. 1, p. 054-060 : Munchausen's Syndrome as a Dissociative Disorder
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Goodwin, Jean, 1946-
A patient is described who was diagnosed as having Munchausen's Syndrome and Munchausen's by Proxy as well as Multiple Personality Disorder. Commonalities between Munchausen's and Multiple Personality Disorder include: multigenerational patterns, self-mutilating behaviors, multiple somatic symptoms, having been accused of lying, use of many different names, and fuguelike disappearances . Commonalities between Munchausen's and child abuse related behaviors include hospital peregrination and the production of inadequate explanations for inflicted injuries. The present case is one of a series of Munchausen' s Syndrome case reports in which extreme abuse has been documented in the patient's childhood.
Open Access
Dissociation : Vol. 1, No. 1, p. 061-066 : Common Errors in the Treatment of Multiple Personality Disorder
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Greaves, George B.
Psychotherapists report widely different experiences in their attempts at treating multiple personality disorder (MPD) patients. Some have deepened their interests and developed full-time specialized practices with this clinical population. Others have declined to have any further contact with them at all, referring possible MPD patients to colleagues when they first suspect that this disorder may be present. Still others have decided against treating more than one or two MPD patients. These diverse decisions are examined with a focus upon the effects of therapists' uneven attention to the formal properties of the dyadic psychotherapeutic experiences as a possible influence upon their future work with MPD. Problems concerning the framework of psychotherapy and the countertransference conflicts which often move the therapist unconsciously and irrationally to alter the canons of psychotherapy in mutually detrimental ways appear to be crucial determinants.
Open Access
Dissociation : Vol. 1, No. 1, p. 067-072 : The Management of Malevolent Ego States in Multiple Personality Disorder
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Watkins, John G. (John Goodrich), 1913-; Watkins, Helen Huth
"Malevolent" personalities create tremendous problems to both the patient and the therapist. The dangers of possible suicide, homocide and other acting-out by such angry states multiply the difficulties in achieving personality integration. Such entities originally developed to protect the individual. They represent a defense for the abused child who was confronted with a situation with which he could not cope. Suggestions by the therapist that the treatment goal is "fusion" constitute a threat to the existence of alter personalities, and mobilize their resistance. Ego-state theory holds that "dividing" lies on a continuum, ranging from normal, adaptive differentiation (as represented by different moods) to pathological dissociation (as represented by true multiple personality disorder). Between lie covert "ego-states" which are organizations of behavior and experience separated by semi-permeable boundaries. In this theory, treatment of Multiple Personality Disorder involves reducing the rigidity of the boundaries and moving them down the continuum until they become ego-states-such as are found in normal subjects under hypnosis. From this point of view malevolent alters need not be threatened with non-existence, but are promised continued selfness and identity within a larger organizational framework. Such an approach lowers their resistance to treatment, and "integration" (which is not the same as "fusion") is more easily attained. The therapist becomes their "friend" rather than their "enemy."
Open Access
Dissociation : Vol. 1, No. 1, p. 073-076 : Multiple Personality Disorder and Transference
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Wilbur, Cornelia B.
The appreciation, interpretation, and management of transference constitute a crucial dimension in the treatment of multiple personality disorder. The author offers remarks and observations based on a considerable body of direct clinical experience and consultations to colleagues. The most commonly encountered problematic transferences in work with MPD, the hostile, erotic, and dependent, are illustrated and discussed.
Open Access
Dissociation : Vol. 1, No. 1, p. 077-083 : Multiple Personality Disorder Misdiagnosed as Mental Retardation: A Case Report
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-03) Atlas, Gail; Fine, Catherine G., 1950-; Kluft, Richard P., 1943-
A woman was diagnosed as mentally retarded when she was five years of age and spent the next 35 years so classified. She also was considered schizophrenic. Incongruities in her clinical presentation ultimately led to the suspicion that she suffered multiple personality disorder. It was found that she had retreated into an adaptation consistent with the superficial manifest appearance of mental retardation, and that the intrusion of her dissociative psychopathology was mistaken for schizophrenia. Correctly diagnosed and treated, she has made noteworthy gains. Selected issues relevant to the misdiagnosis of MPD are discussed.
Open Access
Dissociation : Vol. 1, No. 2, p. 000 : Cover, table of contents
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-06)
Open Access
Dissociation : Vol. 1, No. 2, p. 001 : Editorial
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-06) Kluft, Richard P., 1943-
Open Access
Dissociation : Vol. 1, No. 2, p. 002-015 : Toward A Psychobiological Theory Of Borderline Personality Disorder: Is Irritability the Red Thread that Runs Through Borderline Conditions?
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-06) Stone, Michael H.
This paper proposes a psychobiological model of the borderline conditions that explores the role of a hyperirritability that may either antedate parent-child interactions or stand apart from traditional developmental stages. It suggests that one pathway toward this hyperirritability is the traumatic effect of abuse, which may alter the neuroregulatory response system in ways that cannot be accounted for in purely developmental models. The therapeutic implications of this model are reviewed.
Open Access
Dissociation : Vol. 1, No. 2, p. 016-023 : The Bask Model Of Dissociation: Part II- Treatment
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-06) Braun, Bennett G.
This article is a continuation of the BASK Model of Dissociation: Part I, which discussed the phenomena and theory of dissociation. It uses the previously described BASK Model (Behavior, Affect, Sensation, Knowledge levels within a time continuum) and applies it to treatment. Since treatment is a dynamic concept and knowledge is a static term, BASK is changed to BATS, wherein the active term "thought" is substituted for "knowledge." The interrelationship of the various dimensions of the BATS model is demonstrated and described. The BASK format is used to describe how a behavior, affect, thought and/or sensation clue is used to track down and synthesize the BASK/BATS components in psychotherapy through work with different personalities and/or fragments. A main thesis is that congruence of the BASK/BATS levels across the space/time continuum is required for healthy functioning. It is hoped from this discussion that the reader will get a sufficient understanding of the practical use of the BASK model and that he/she might apply it to her/his school and practice of psychotherapy.
Open Access
Dissociation : Vol. 1, No. 2, p. 024-026 : Determining Prognosis In The Treatment Of Multiple Personality Disorder
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-06) Caul, David
Determining the prognosis of a multiple personality disorder (MPD) patient has received little systematic attention in the literature. Drawing on clinical experience, the author offers sixteen questions that he finds useful in gauging whether or not an MPD patient is likely to have a good or poor prognosis for a relatively straightforward, psychotherapy and constructive outcome. In the author's experience, patients who have less favorable prognoses in terms of these questions generally will have difficult and prolonged therapies, and are more likely to interrupt treatment, reach a stalemate in treatment, or fare poorly.
Open Access
Dissociation : Vol. 1, No. 2, p. 027-033 : Diagnosis Of Covert And Subtle Forms Of Multiple Personality Disorder Through Dissociative Signs
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-06) Franklin, Jean
There are different forms of multiple personality disorder (MPD) that vary on a dissociative continuum from subtle forms in which the alters are not very distinct or elaborated and often influence each other without assuming full control, to patients with fully developed AIPD, whose alters are distinct, elaborated, assume full control, and emerge covertly. Most MPD patients present covertly, and some patients with covert presentations will later show overt classic symptoms, while those with subtle forms will often remain mild and subdued. Most MPD patients hide or disguise their condition, while their alters express their thoughts and feelings through subtle dissociative signs that occur when the alters influence each other, partly emerge, or subtly shift. These signs consist of frequent, sometimes sudden, fluctuations in affects, thoughts and behaviors, transferences, developmental levels, and psychiatric symptoms, and marked discrepancies in memories, viewpoint, and attitudes, which may indicate the possible presence of alters and of MPD or Dissociative Disorder Not Otherwise Specified : variants of MPD. The case of a subtle form of MPD is presented which illustrates some of the subtle signs of dissociation and other dissociative symptoms often seen in these patients.
Open Access
Dissociation : Vol. 1, No. 2, p. 034-038 : Some Aspects Of Resistence In The Treatment Of Multiple Personality Disorder
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-06) Chu, James A.
Therapists who treat patients with Multiple Personality Disorder (MPD) commonly experience discomfort and frustration. This paper contends that the most significant cause of therapist discomfort is the particular resistances encountered in the treatment of MPD. In- MPD, etiologic childhood traumatic experiences are defensively repressed and dissociated. In addition, the normal ability to engage in trusting interpersonal relationships is disrupted. Thus, a psychotherapy which requires the retrieval of past traumas in the context of an interpersonal therapeutic relationship is tremendously threatening to the patient with MPD. In the normal course of the psychotherapy of MPD, intense resistances are encountered at every stage. This paper outlines the nature of resistance in the treatment of patients with MID, presents a number of clinical examples, and discusses the importance of understanding and working with resistance as an intrinsic part of the treatment.
Open Access
Dissociation : Vol. 1, No. 2, p. 039-042 : Multiple Personality Disorder Patients With A Prior Diagnosis Of Schizophrenia
(Ridgeview Institute and the International Society for the Study of Multiple Personality & Dissociation, 1988-06) Ross, Colin A.; Norton, G. Ron, 1941-
The authors collected a series of 236 cases of multiple personality disorder patients reported to them by 203 clinicians throughout North America. The series included 81 patients who had received a past diagnosis of schizophrenia and 96 who had not. The patients with a past diagnosis of schizophrenia were more self-destructive and spent more time in the mental health system prior to diagnosis. During this period they received more other psychiatric diagnoses and treatments. They had more Schneiderian first-rank symptoms but did not have more auditory hallucinations.