Dissociation : Vol. 7, No. 4 (Dec. 1994)
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Item Open Access Dissociation : Vol. 7, No. 4, p. 246-260 : Various perspectives on parenting and their implications for the treatment of dissociative disorders(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Benjamin, Lynn R.; Benjamin, RobertThe parent-child dyad has been an underutilized resource for clinicians who treat individuals with dissociative disorders. This article examines the functions of the parent from the perspectives of various fields of knowledge: psychodynamic psychotherapy, attachment theory, infant development, affect theory, and family systems. It then elaborates on how dissociative symptoms may interfere with the normal processes of parenting and child development. Finally, it points out that there are a number of advantages to dealing with the parenting subsystem of the family of dissociative disorder individuals. Sensitizing clients to their own parenting can serve to benefit the therapeutic alliance as well as help the client/parent improve the parent-child relationship. This work has the potential both to aid in the recovery of the individual dissociative client and to begin to correct the transgenerational exploitation and mistrust which cause and perpetuate dissociative pathology.Item Open Access Dissociation : Vol. 7, No. 4, p. 261-271: Dissociation and schizophrenia: an historical review of conceptual development and relevant treatment approaches(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Gainer, KarenThis paper provides an historical perspective regarding the role of dissociation in the development of both etiologic theory and treatment paradigms for schizophrenia. References to the concept of dissociation are drawn from classic writings on dementia praecox, and from Bleuler's (1911) original conception of schizophrenia as a "splitting" of the personality. An accurate diagnostic distinction between schizophrenia and dissociative disorders, such as dissociative identity disorder (DID) and brief reactive psychosis (BRP), often has been difficult to ascertain due to the presence of Schneiderian First-Rank Symptoms (FRS) in both types of disorders. The traditional Schneiderian FRS, once thought to be indicative symptoms of schizophrenia, now are viewed as characteristic diagnostic indicators of DID. Research and theory pertaining to differential diagnosis between schizophrenia and trauma-related dissociative syndromes are reviewed. Early psychodynamic treatment paradigms for schizophrenia and contemporary treatment paradigms for dissociative disorders are compared. Relevant diagnostic and treatment implications for the field of dissociative disorders are emphasized.Item Open Access Dissociation : Vol. 7, No. 4, p. 239-245 : Utilizing parenting as a clinical focus in the treatment of dissociative disorders(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Benjamin, Lynn R.; Benjamin, RobertParenting is a potent resource in both the individual and family treatment of Dissociative Disorders. A focus on parenting helps to build the therapeutic alliance and establish a safe base. It subtly shifts the client's attention to childhood experiences and the parenting that he or she experienced. The therapist's empathy and crediting of the client is echoed in the relationship between the dissociative parent and his or her child. The therapist promotes bonding and attachment, sensitizes the parent to the child's needs, and increases the parent's sense of self-efficacy. Through involving the parenting partner, the therapist promotes cooperation and reduces conflict. Therapy is aimed toward teaching affect regulation, decreasing negative affect, and increasing positive affect among family members. Utilization of extrafamilial support is also encouraged. Attention to parenting serves both to stimulate progress in individual therapy and to interrupt and correct dysfunctional transgenerational patterns.Item Open Access Dissociation : Vol. 7, No. 4, p. 229-238 : Issues in the treatment of dissociative couples(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Benjamin, Lynn R.; Benjamin, RobertMarital work is an important adjunct to the individual treatment of the dissociative client. In this paper, we examine Kaslow's (1982) standard of the "healthy" couple and the specific problems inherent in marital work with dissociative clients and their partners. We believe that the course of marital treatment needs to be keyed to the stages of the individual treatment, although marital treatment can facilitate the progress of individual treatment as well. We describe our approach including contextual principles, marital dynamics, contributions from affect theory, and utilization of hidden resources. Finally, we review some controversies in the field and express our opinions based on our experiences. Marital work with dissociative clients is still developing as an approach, and there is much yet to be learned.Item Open Access Dissociation : Vol. 7, No. 4, p. 221-228 : Educational problems in patients with dissociative identity disorder(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Hobbs, Donna L.; Coons, Philip M.Previous studies on patients with Dissociative Identity Disorder (DID) have provided only cursory descriptions of their educational performance. Ten adult outpatients with DID were interviewed to discover educational problems experienced from grade school through postgraduate school. A structured interview explored demographic data, academic achievement, conduct and behavioral problems, interactions with teachers and peers, dissociative symptoms, and physical health. The majority of the subjects reported the experience of severe dissociative symptoms, usually on a daily basis, beginning by grade school, and dissociation was remembered as increasing in severity over time. Most reported behavioral or conduct problems. Nearly all reported significant problems with school performance. Although none were diagnosed with DID until after the 12th grade, the unrecognized DID may have been responsible for the recalled difficulties with their educational and social performance. The wide-ranging effects of DID strongly suggest the need for early recognition and appropriate treatment of those who suffer with this disorder.Item Open Access Dissociation : Vol. 7, No. 4, p. 212-220 : Preliminary results of the field trial of proposed criteria for dissociative disorder of childhood(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Peterson, Gary; Putnam, Frank W., 1947-Despite recent increased awareness of child and adolescent dissociative disorders, the lack of an official "sanction" by the inclusion of specific diagnostic entities in the DSM-III-R/ W has seriously impeded the acceptance of these conditions in youthful population. There are also widespread concerns that the adult-oriented DSM criteria are often inappropriate for child and adolescent cases. To correct these deficiencies, the diagnosis of Dissociative Disorder of Childhood (DDoC) has been proposed. A preliminary, questionnaire-based, field trial was initiated to test the proposed DDoC criteria. Results indicate that the DDoC criteria identify a group of children who do not meet DSM-III-R/ IV criteria for multiple personality disorder, but who nonetheless have significant levels of dissociative symptoms. These criteria also serve to discriminate children with DDoC from another group of children, frequently labeled with Dissociative Disorder NOS, who have a different clinical picture. Based on these data, DDoC criteria will be further refined.Item Open Access Dissociation : Vol. 7, No. 4, p. 204-211 : Further validation of the child dissociative checklist(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Putnam, Frank W., 1947-; Peterson, GaryThe Child Dissociative Checklist (CDC) is a 20-item parent/adult observer report measure of dissociative behaviors. The processes of establishing the reliability, validity and limitations of such an instrument includes its use by different investigators and under different conditions. This study compared CDCs completed by parents and guardians of children with analogous dissociation scales completed by the children's primary therapists. In this sample the CDC had a Cronbach's alpha of .86 and was significantly correlated with the two clinician-completed measures of dissociation. The CDC was able to statistically discriminate between children diagnosed as having multiple personality disorder and dissociative disorder not otherwise specified. The results provide further evidence that the CDC is a useful, reliable and valid screening tool for the detection of pathological dissociation in children.Item Open Access Dissociation : Vol. 7, No. 4, p. 201-203: Editorial: Two jobs well done(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Kluft, Richard P., 1943-Item Open Access Dissociation : Vol. 7, No. 4, p. 000 : Cover, table of contents(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12)Item Open Access Dissociation : Vol. 7, No. 4, p. 272-283 : Clinical observations on the use of the CSDS Dimensions of Therapeutic Movement Instrument (DTMI)(Ridgeview Institute and the International Society for the Study of Dissociation, 1994-12) Kluft, Richard P., 1943-The CSDS Dimensions of Therapeutic Movement Instrument (DMTI) is a 12-item instrument designed to allow therapists to follow the progress of the treatments of patients with Dissociative ldentity Disorder (formerly Multiple Personality Disorder) and allied forms of Dissociative Disorder Not Otherwise Specified (DDNOS.) The current communication will illustrate its clinical applications and offer guidelines with regard to the frequency of its use, the meaning of its scores, and the implications of the treatment trajectories that it demonstrates.