Attachment, Trauma and Multiplicity by Sinason, Valerie -- Read -- Imperial Library of Trantor

Index

Contents Notes on contributors Part I Mapping the territory: childhood aetiology, attachment research, attachment patterns, abuse, dissociation, Dissociative Identity Disorder and culture

Introduction

Dissociation and fragmentation as a childhood defence Dissociative identity disorder Hiding selves What is dissociative identity disorder and how does it happen? John Bowlby and DID DID as a paradigm shift Fragmentation in the team Theoretical formulations DID and ritual abuse

Towards a Definition o f Ritual Abuse

Sinason and Asha-kin Aduale, Safeguarding London Children (2006)

Towards a Definition o f Spiritual Abuse

Sinason and Asha-Kin Aduale, Safeguarding London Children, June 2006

Acknowledgements References FROM A DID MOTHER FOR HER DAUGHTER

Amy’s Mama has DID

FROM A MOTHER FOR HER DID DAUGHTER DID AND MARRIAGE: A PERSONAL PERSPECTIVE

Chapter 1 Multiple voices versus meta-cognition

The nature of the attachment system The continuity of patterns of attachment Adult attachment measures

Attachment and mentalising Metacognitive monitoring and the development of the self Some speculations about pathological development based on the dialectic model A transgenerational model of dissociation in personality disorder

Psychotherapy and mentalising Note References

Chapter 2 Multiplicity revealed in the Adult Attachment Interview

Some technical considerations when administering the AAI to an individual with dissociative identity disorder

Illustrations from the interviews On the possibility of resolving catastrophic trauma evident in ritual abuse

References

Chapter 3 Undoing the effects of complex trauma

Introduction Clinical example Steps in creating a trauma narrative Clinical example

Understanding a child’s experience: the professional narrative with the young person’s experiences Using genograms at different points in the young person’s life Ecograms Drawing family members ‘In My Shoes’—to map children’s experiences Trauma Inventory Remembering events Cycle of thoughts, feelings and action Pete’s lifeline Creating a trans formative narrative Clinical re-assessment

Acknowledgements References

Chapter 4 Dissociation and spirit possession in non-western countries

Note References

Part II Attachment focus: mainly theory

MY NAME IS DRIVEN Chapter 5 As thick as thieves, or the ritual abuse family

Introduction The RA family and DID

Bella

Infanticidal attachment

Attachment types in decreasing order of aiding survival

As thick as thieves Implications for therapy

‘Wait with Me’

References

Chapter 6 A theoretical framework for understanding multiplicity and dissociation

A conversation with John Bowlby circa 1988 On the multiple nature of the self On the need for a group dynamics theory when working with dissociation Bion’s group dynamic theory in individual and group settings Structural working models

Archetype 1: the associating multiple person Archetype 2: the repressed multiple person Archetype 3: the dissociating multiple person who blames Self; no psychotic selves Archetype 4: the dissociating multiple person who blames the Other and has psychotic selves Real persons are not archetypes

Moments in movement—the microscopic aspects of the therapy process The mourning cycle and the creative orgasmic cycle Moments in movement, time and reconstruction The real, the imaginary and the symbolic registers Working with pre-verbal selves Finally a contribution to our understanding from neuroscience Technical note References

Chapter 7 Post-traumatic stress disorder and dissociation

Introduction to PTSD and its underlying neuropsychology PTSD as an attachment disorder and the origins of the ‘traumatic attachment’ Treatment approach

Assessment Ensuring safety Psychoeducation Empowerment

Assessment of dissociative disorders Modulation of affect and grief work: the construction of a narrative One foot in the past and one foot in the present Working as a team Therapeutic difficulties and how we deal with them

Problems around dissociative phenomena Problems around avoidance Problems associated with ending Problems relating to false memory syndrome

Taking care of the therapist Conclusions References

Chapter 8 Dark dimensions of multiple personality

The content and process of DID Memory and DID Characteristics of the dissociative mind—the distributed consciousness Some principles of treatment Hazards to the psychotherapist Use of energy psychology modalities in work with DID References

Part III Attachment focus: mainly practice

HALLOWEEN GROWING OUT OF IT Chapter 9 The shoemaker and the elves

Technical and ethical issues Acknowledgements References

Chapter 10 Snow White and the seven diagnoses

Snow White and the seven diagnoses Precursors to the seven child alters: death fears, cruel parenting and the mixed-up attachment mirror Snow White and the seven therapists Conclusion References

Chapter 11 Will you sit by her side?

The origins of the little creature: the process of dissociation from an attachment perspective The nature of the little creature as a dissociated part of the self An attachment-based view of the key features of the little creature as a dissociated self

He or she belongs to a goal-directed system The little creature has an ineffective inner supportive environment The little creature is part of system that has suffered a loss of narrative context It is a creature whose capacities for metacognitive processing have been disrupted The little creature lives in a state of vigilant quiescence The little creature is part of a system that suffers a continuing massive chemical onslaught on the brain

The therapeutic task Stages of therapeutic work

Stage 1: assessing the system

Key therapeutic task: recognition of the existence of the little creature Therapeutic issues

THE ESTABLISHMENT OF A SECURE BASE SUPPORTIVE COMPANIONABLE RELATING

Stage 2: accessing the system

Key therapeutic task: creating a context for the development of internal relating

BREACHING THE DEFENSIVE EXCLUSION OF ATTACHMENT NEEDS ATTUNEMENT TYPES OF ATTUNEMENT ATTUNING TO MULTIPLE SELVES, MULTIPLE FEELING STATES AND MULTIPLE ATTACHMENT STYLES

Stage 3: chaos and disorganisation

Key therapeutic issue: the beginnings of co-existence and the creation of a shareable inter- and intra-personal world

KEEPING IN SUPPORTIVE COMPANIONABLE MODE AND MAINTAINING AN EXPLORATORY ALLIANCE

Stage 4: ambivalent relating

Key therapeutic task: the development of an incipient careseeking and caregiving system

DEALING WITH FEARS OF AGENCY/DEVELOPING AUTONOMY RECONNECTING WITH THE BODY WORKING IN THE ZONE OF PROXIMAL DEVELOPMENT

Stage 5: the beginnings of secure internal relating

Key therapeutic task: the development of internal attachment bonds and an inner supportive environment

CONTINUING ROLE OF THERAPY AS A SECURE BASE FACILITATING GRIEF AND MOURNING THE DEVELOPMENT OF NEW COPING MECHANISMS

Stage 6: secure internal relating

Key therapeutic task: the transfer of external attachment bonds to a secure internal base

INTERNAL RESTRUCTURING CHANGE IN GOAL-DIRECTED BEHAVIOUR CHANGE IN METACOGNITION RECONSTRUCTION OF THE NARRATIVE RE-NEGOTIATING THE THERAPEUTIC RELATIONSHIP

Conclusion: the survival of the attachment dynamic References

Chapter 12 Profound desolation

Clinical material Conclusions References

Addendum

Update on patients referred to Claremont House, the regional department of psychotherapy in Newcastle, with a diagnosis of dissociative identity disorder

Part IV Other frames of reference: linguistic, diagnostic, forensic and historic issues

LABELS TRYING TO LEAVE Chapter 13 Dissociation sounds more scientific

The spread of understanding Professional fears Naming the symptom but not the cause Looking scientific Language in the media Reaching for alternative terms References

Chapter 14 Dissociative disorders

References

Chapter 15 Interview with Detective Chief Inspector Clive Driscoll

My first encounter Use of drugs and the description of a ceremony

Abuse allegations about ceremonies Liaison work with the Clinic for Dissociative Studies

A Catholic priest Lost documents and a decommissioned church Honour killing and abuse within religious groups Reference

Chapter 16 Multiple personality disorder and schizophrenia

The life of Flora Rheta Schreiber Some extracts from an interview with Professor Flora Rheta Schreiber Interview with Flora Rheta Schreiber References

Information for people with DID and professionals working with them

Recommended books Key journals Clinical and support links

Index

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