Dissociation : Vol. 3, No. 3 (Sept. 1990)
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Item Open Access Dissociation : Vol. 3, No. 3, p. 174 : Book Review(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Fraser, George A.; Ross, Colin A.Item Open Access Dissociation : Vol. 3, No. 3, p. 167-173 : Dissociation and subsequent vulnerability: a preliminary study(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Kluft, Richard P., 1943-Recent reports by D. Spiegel, F. Putnam, and others demonstrate that dissociation is a common response to severe trauma, serving to provide some degree of acute insulation against overwhelming stressors. This quite preliminary study explores certain of the consequences subsequent to the establishment of dissociative defenses, and illustrates that their successful employment is a two-edged sword, rendering those who develop an adaptation relying on dissociation vulnerable to rather than protected against subsequent victimization. Of eighteen carefully studied incest victims who had developed dissociative disorders and had been sexually exploited by psychotherapists, 14 (78 %) had been raped as adults. One hundred percent were found to suffer ongoing dissociative symptoms that disrupted their sense of mastery and control of themselves and their lives. One hundred percent demonstrated that the defensive ablation of memory of crucial information rendered them incapable of perceiving and reacting to actual danger situations appropriately. Ninety-two percent became frozen or withdrawn under stress, and met situations best avoided by decisive action with passive compliance and learned helplessness. The same percentage had suffered a shattering of basic life assumptions. In all cases, traumatically-induced dissociative deformation of the observing ego and debasement of cognitive functioning had occurred, leading to a decontextualization of traumatic experiences. The outcome of these sequelae, which offer acute protection, is a syndrome of chronic impairment which, in severe cases, predisposes those who suffer it to repetitive revictimization. These findings are duplicated in a larger series currently under study. Therapeutic implications and useful strategies are reviewedItem Open Access Dissociation : Vol. 3, No. 3, p. 165-166 : A brief note on "Jekyll and Hyde" and MPD(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Garcia, Emanuel E., 1954-Robert Louis Stevenson's macabre and riveting tale, "The Strange Case of Dr. Jekyll and Mr. Hyde, " perceptively displays critical psychological mechanisms at work in the development and maintenance of MPD, namely, 1) the naturally fragmented and chaotic state of the mind, 2) the yearning for unity, 3) the wish to disavow responsibility for certain impulses, 4) the delight taken in the gratification of forbidden desires by an alter, and 5) the inevitable failure of dissociative attempts to dispel psychic conflict. These observations find corroboration in clinical material presented.Item Open Access Dissociation : Vol. 3, No. 3, p. 160-164 : Non-rational guilt in victims of trauma(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Price, Gail M.The guilt many victims of physical and psychological trauma experience in response to their victimization often contains non-rational content which, when analyzed, is more appropriate to the perpetrator. This non-rational perpetrator guilt is imposed on the victim under two primary conditions: 1) attribution, in which the perpetrator disavows guilt and blames the victim for the victimization; and 2) terror, which results in the victim's rapid incorporation of essentially the entire world view of the perpetrator, including the perpetrator's guilt. Guilt results when some aspect of a moral system is transgressed. There are four aspects of a moral system reflecting different level of guilt and four basic components of guilt within each level. The perpetrator's violation of one aspect of a moral system may be processed by the victim at the level of another aspect, making resolution difficult. Resolution involves careful analysis of the content of the guilt to enable the victim to identify its source.Item Open Access Dissociation : Vol. 3, No. 3, p. 154-159 : Mental unity, altered states of consciousness and dissociation(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Tinnin, LouisThis model for understanding altered states of consciousness and dissociation is based on the hypothesis that normal consciousness depends on an illusion of mental unity generated by certain dynamic brain processes. When these processes are altered and the illusion of mental unity is lost, the individual experiences an altered state of consciousness in which normal consciousness is latent or "dissociated." Mental organizations formed during an altered state will, in turn, become dissociated when the altered state is terminated and mental unity returns. In some cases, recurrent altered states may lead to multiple dissociated mental systems or states. Therapeutic resolution of dissociation requires that the individual gain access to the memory, transcend the obligatory illusion of unity, and consciously avow the ego state formed during the traumatic altered state of consciousness.Item Open Access Dissociation : Vol. 3, No. 3, p. 144-150 : Unusual medication regimens in the treatment of dissociative disorder patients: part I: noradrenergic agents(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Braun, Bennett G.The noradrenergic agents propranolol and to a lesser extent, clonidine, are used in an experimental setting to reduce switching and anxiety in dissociative disorder patients, making them better candidates for psychotherapy. The rationale for this non-FDA-approved use of the drugs is founded in the James-Lange and Cannon-Bard theories of emotion. It is hypothesized further that the mechanisms proposed by the two theories are reinforcing of one another via classical conditioning in the production and reinforcement of chronic, severe anxiety responses. The effect of propranolol and clonidine can complement the effect of benzodiazepines in these patients. In the experimental protocol described, propranolol or clonidine is sometimes used at ultrahigh doses, with patients always under close medical supervision.Item Open Access Dissociation : Vol. 3, No. 3, p. 151-153 : The dissociative experiences scale: further replication and validation(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Frischholz, Edward J.; Braun, Bennett G.; Sachs, Roberta G.; Hopkins, Laura; Shaeffer, Denise; Lewis, Jennifer; Leavitt, Frank; Pasquotto, James N.; Schwartz, David R.The purpose of the present study was to provide further evidence in support of the validity of the Dissociative Experiences Scale (DES) as a reliable measure of dissociative psychopathology. The DES was administered to 259 college students, 33 patients with multiple personality disorder (MPD), and 29 patients with a dissociative disorder not otherwise specified (DDNOS). The inter-rater reliability for the DES scoring procedure was excellent (coefficient of absolute agreement=.96; coefficient of relative agreement =.99). The test retest reliability of DES scores (within approximately one month) was also excellent (coefficient of absolute agreement =.93; coefficient of relative agreement=.96) and suggests that DES total scores are temporally stable and similar in absolute value across testings. Finally, the internal consistency of DES scores was also very high (alpha for students=.93; alpha for MPD patients =.94; alpha for DDNOS patients=.94; alpha for the combined total sample=.95). Both MPD (mean DES score =55.0) and DDNOS patients (mean DES score =40.8) earned significantly higher DES scores than students (mean DES score=23.8). In addition, MPD patients earned significantly higher DES scores than DDNOS patients. The results of the present study also suggest that a DES cutoff score of 45 to 55 maximizes the probability of correctly classifying students from dissociative disorder patients (87%) while minimizing the rates of false positive (2 to 6 %) and false negative errors (7 to 11%). Suggestions for further validation research are also made.Item Open Access Dissociation : Vol. 3, No. 3, p. 135-143 : The clinical phenomenology of males with MPD: a report of 21 cases(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Loewenstein, Richard J.; Putnam, Frank W., 1947-We describe 21 male patients meeting DSM-111-R and NIMH criteria for multiple personality disorder (MPD). They were compared with female patients in the NIMH data base on MPD and dissociative disorders. Striking similarities between males and females were found on most variables. Both groups had extensive childhood histories of sexual and physical abuse far exceeding the prevalences reported for other clinical and non-clinical populations. There were trends for males to have more alcoholism and antisocial behavior. Generally, males had more subtle clinical presentations than females and reported fewer alter personalities. Implications of these findings and the limitations of the present study are discussed.Item Open Access Dissociation : Vol. 3, No. 3, p. 127-134 : MPD, borderline personality disorder and shizophrenia: a comparative study of clinical features(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Fink, David L.Multiple personality disorder (MPD) has at times been confused with both schizophrenia (SCHIZ) and borderline personality disorder (BPD). In this study, 38 patients with DSM-III-R diagnosis of MPD (N=16), SCHIZ (N = 11) were evaluated with a battery of structured interviews (SCID, DDIS) and psychometric tests (MMPI, MCMI, DES) in order to define distinguishing features among the three diagnostic groups. MPD was differentiated from SCHIZ on the great majority of test measures. MPD was not differentiated from BPD on MMPI or MCMI, but these groups differed in many clinical features, particularly measures of severity of abuse and dissociative symptoms.Item Open Access Dissociation : Vol. 3, No. 3, p. 125-126 : Editorial(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09) Kluft, Richard P., 1943-Item Open Access Dissociation : Vol. 3, No. 3, p. 0 : Cover, table of contents(Ridgeview Institute and the International Society for the Study of Multiple Personality and Dissociation, 1990-09)