Dissociation : Vol. 5, No. 2, p. 098-103 : Empathic confrontation in the treatment of childhood abuse survivors, including a tribute to the legacy of Dr. David Caul
Chu, James A.
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Chu, James A.
Patients who are survivors of severe childhood abuse may present with complex post-traumatic and dissociative symptoms, as well as significant disturbance of characterologic development. These difficulties may lead patients to use a variety of dysfunctional and self-destructive patterns of behavior, many of which may be ingrained coping mechanisms which were developed in response to early abusive experiences. Dysfunctional behaviors which interfere with psychological growth and healing must be confronted to allow the therapeutic process to continue. However, patients are often quite resistant to letting go of their painful but familiar coping mechanisms. In addition, the often tenuous therapeutic alliance between abuse survivor patients and their therapists makes the necessary confrontations even more difficult. This discussion examines the nature of therapeutic confrontation and presents a model of empathic confrontation. Finally, this paper presents summary materials drawn from the late Dr. David Caul's use of empathic confrontation, and his unpublished writings on relating to patients with multiple personality disorder.