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This chapter describes the application of transference-focused psychotherapy (TFP) to the treatment of former child soldiers suffering from dissociative identity disorder. It focuses on problems with aggression faced in psychotherapy. TFP is an evidence-based treatment designed for patients with a borderline personality organization. It provides a psychodynamic object relations model to understand the aggression arising in psychotherapy, focusing on transference and countertransference in the here-and-now of the therapeutic relationship. Aggression is considered an essential and vital inner dynamic aimed at autonomy, distancing, and the prevention of injury and dependency. In extremely traumatized patients there may be aggressive and oppressive inner parts that want total control—identifying with childhood aggressors—thus avoiding vulnerability. According to TFP, it is vital that this aggression is addressed as belonging to the patients themselves in order to reach some form of integration, balance, and health. This is illustrated in a case description. |
