Issues in consultation for treatments with distressed activated abuser/protector self-states in dissociative identity disorder
Autor: | Richard A. Chefetz |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male Family therapy 050103 clinical psychology medicine.medical_specialty Psychotherapist medicine.drug_class media_common.quotation_subject Shame Dissociative Disorders 050108 psychoanalysis Affect (psychology) Dissociative behavioral disciplines and activities Delusion medicine Humans Transference Psychology 0501 psychology and cognitive sciences Psychiatry media_common Physician-Patient Relations 05 social sciences medicine.disease Identified patient Psychiatry and Mental health Clinical Psychology Dissociative identity disorder Female Family Relations medicine.symptom Psychology human activities Dyad |
Zdroj: | Journal of Trauma & Dissociation. 18:465-475 |
ISSN: | 1529-9740 1529-9732 |
Popis: | The identified "problem self-state" in a dissociative disorder consultation is like the identified patient in a family therapy; the one who is identified may have an assigned role to be blamed which serves the function of deflecting the activities of painful self-states in other family members. In consultation, the "family" includes the therapist in addition to the patient. When the state identified as a problem self-state is an abuser/protector self-state, complications often involve the profound nature of transference-countertransference enactments between patient and therapist, the delusion of separateness, chronic and acute threats of suicide, negative therapeutic reactions, and the evocation of intense negativity. They also involve affect phobia in both patient and therapist, and the emergence of intense shame in the clinical dyad amongst additional potential burdens in these complicated treatments. The task of the consultant is to protect both patient and therapist from an untoward outcome while relieving the painful burdens entailed by the treatment. The typical core dynamic of the abuser/protector state is as a repository for shame/humiliation welded to anger/rage. This dynamic, and others, must be understood in order to resolve these impasses and create useful movement toward growth in both patient and therapist. |
Databáze: | OpenAIRE |
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