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Dissociative identity disorder – complex problems requiring complex approaches

Dissociative identity disorder – complex problems requiring complex approaches

Presentations of people with Dissociative Identity Disorder are complex and associated with considerable comorbidity. They are often misdiagnosed and therefore mistreated, sometimes for many years. Further complexity results from rejection of the validity of the diagnosis by non professional sources such as a sceptical press and organisations such as the False Memory Syndrome Foundation. Some mental health professionals, including some quite influential psychiatrists, also contemptuously reject the validity of the diagnosis. As a result trainee psychiatrists, as a rule, are taught little about dissociation and learn to react to those presenting with such symptoms with suspicion and scepticism.

This is particularly destructive to people with Dissociative Identity Disorder who, understandably, given their almost universally traumatic backgrounds, have profound difficulties forming trusting relationships. Mental health professionals are often on the defensive with their own colleagues when they treat people with Dissociative Identity Disorder. This adds to the problems inherent in treating such a difficult diagnostic group. In addition, therapists may experience secondary traumatisation as a result of problems their patients bring to them. A treatment approach addressing some of these complexities is discussed.

The need for commitment, validation and safety in psychotherapy is stressed. Biological treatments frequently need to be combined with psychotherapy to address comorbid conditions as well as ameliorating some symptoms directly arising from dissociation. Approaches to providing support for mental health professionals working with these patients are also discussed.

Areas of Interest / Categories: Psychotherapy, WCP 2011

WCP 2011

The individual and the couple in the context of the perinatal experience. A dream or a nightmare?

"There is no such thing as marriage - merely two scapegoats sent out by their families to perpetuate themselves". Whittaker & Keith 1981. This presentation will explore the experience of Anxiety and Depression for both men and women, in the perinatal period. The perinatal period offers a unique opportunity to provide comprehensive care for parents diagnosed with perinatal Anxiety and/or Depression. There is significant evidence that the partner's risk for developing a related Anxiety or Depression, is increased from 4.8% to 36% at 6 weeks postnatally. 

Complex trauma: voices of healing

Within the context of the recent natural disasters occurring around the world, attention has been focussed on trauma's psychological consequences. The trauma spotlighted here is on that of childhood maltreatment and the effects on subsequent adult life. Described in this paper are experiences of recovery from patient perspectives, and an examination of how these are different from, and interact with, representations of therapy derived from published expert theoristpractitioner experience. It is based on a phenomenological study of reports from seven women with histories of chronic childhood maltreatment. These women have since been through significant recovery from dissociative symptoms, and it is this part of their journey that was the focus of this research. From the data, two models are proposed.

The universality of infant-parent psychotherapy - a South African model

The birth of the democratic South Africa opened up the possibility of meeting with fellow citizens who had previously been kept apart.  Since 1995 a model of  infant-parent psychotherapy has been developed resulting in a mental health service which has come to be valued within the community.

The Light In Darkness - Art-therapy, a powerful tool in Palliative Care!

Over the years, we as health care providers have proven that a good perinatal preparation, a good birthing process and a good postnatal care ensures the physical and mental well being of the newborn and his mother. A similar opportunity for quality outcome should be afforded at life`s final phase - preparation and a good 'gateway' for the dying person, as well as a good follow - up period of those left behind. A good death needs guidance to settle outstanding issues, to articulate values, beliefs and doubts and to live the remaining period of life in the fullest and most meaningful way. Early contact is pivotal to learn about our client and his life history. This time is needed to build our client`s trust, to endorse our commitment, and to collect the tools needed to guide him through the gateway and when taking his last breath. It is equally important to meet the immediate needs of his family and to develop the crucial trusting partnership that will ensure a good dying process for their loved one in setting of his choice, and a better acceptance of their loss. It is realistic to assume that people in the future will invest in their final time. 

Lateral violence and Indigenous peoples.

Lateral violence occurs when the violence associated with oppression is internalised by those who are oppressed, and redirected between the members of the oppressed group. Among Aboriginal and Torres

Clinical dream incubation and body

For 1000 years during the beginning of Western medicine (500 B.C. - 500 A.D.,) of the hundreds of medical treatments offered at the time, only dream-based medicine was ubiquitously practiced throughout

Psychotherapy with deaf and speechless clients.

Traditional psychotherapy as presented in most psychotherapy training programmes in South Africa do not equip psychotherapists with sufficient skills to deal with people who have special needs.