A fresh look at the importance of dissociation in understanding trauma. A new model of therapeutic action, one that heals trauma and dissociation, is overtaking the mental health field. It is not just trauma, but the dissociation of the self, that causes emotional pain and difficulties in functioning. This book discusses how people are universally subject to trauma, what trauma is, and how to understand and work with normative as well as extreme dissociation. In this new model, the client and the practitioner are both traumatized and flawed human beings who affect each other in the mutual process that promotes the healing of the client—psychotherapy. Elizabeth Howell explains the dissociative, relational, and attachment reasons that people blame and punish themselves. She covers the difference between repression and dissociation, and how Freud’s exclusive focus on repression and the one-person fantasy Oedipal model impeded recognition of the serious consequences of external trauma, including child abuse. The book synthesizes trauma/dissociation perspectives and addresses new structural models.

Drawing on the pioneering work of Janet, Freud, Sullivan, and Fairbairn and making extensive use of recent literature, Elizabeth Howell develops a comprehensive model of the dissociative mind. Dissociation, for her, suffuses everyday life; it is a relationally structured survival strategy that arises out of the mind’s need to allow interaction with frightening but still urgently needed others. For therapists dissociated self-states are among the everyday fare of clinical work and gain expression in dreams, projective identifications, and enactments. Pathological dissociation, on the other hand, results when the psyche is overwhelmed by trauma and signals the collapse of relationality and an addictive clinging to dissociative solutions. Howell examines the relationship of segregated models of attachment, disorganized attachment, mentalization, and defensive exclusion to dissociative processes in general and to particular kinds of dissociative solutions. Enactments are reframed as unconscious procedural ways of being with others that often result in segregated systems of attachment. Clinical phenomena associated with splitting are assigned to a model of “attachment-based dissociation” in which alternating dissociated self-states develop along an axis of relational trauma. Later chapters of the book examine dissociation in relation to pathological narcissism; the creation and reproduction of gender; and psychopathy. Elegant in conception, thoughtful in tone, broad and deep in clinical applications, Howell takes the reader from neurophysiology to attachment theory to the clinical remediation of trauma states to the reality of evil. It provides a masterful overview of a literature that extends forward to the writings of Bromberg, Stern, Ryle, and others. The capstone of contemporary understandings of dissociation in relation to development and psychopathology, The Dissociative Mind will be an adventure and an education for its many clinical readers.

Building on the comprehensive theoretical model of dissociation elegantly developed in The Dissociative Mind, Elizabeth Howell makes another invaluable contribution to the clinical understanding of dissociative states with Understanding and Treating Dissociative Identity Disorder. Howell, working within the realm of relational psychoanalysis, explicates a multifaceted approach to the treatment of this fascinating yet often misunderstood condition, which involves the partitioning of the personality into part-selves that remain unaware of one another, usually the result of severely traumatic experiences. Howell begins with an explication of dissociation theory and research that includes the dynamic unconscious, trauma theory, attachment, and neuroscience. She then discusses the identification and diagnosis of Dissociative Identity Disorder (DID) before moving on to outline a phase-oriented treatment plan, which includes facilitating a multileveled co-constructed therapeutic relationship, emphasizing the multiplicity of transferences, countertransferences, and kinds of potential enactments. She then expands the treatment possibilities to include dreamwork, before moving on to discuss the risks involved in the treatment of DID and how to mitigate them. All concepts and technical approaches are permeated with rich clinical examples.

The Dissociative Mind in Psychoanalysis: Understanding and Working With Trauma is an invaluable and cutting edge resource providing the current theory, practice, and research on trauma and dissociation within psychoanalysis. Elizabeth Howell and Sheldon Itzkowitz bring together experts in the field of dissociation and psychoanalysis, providing a comprehensive and forward-looking overview of the current thinking on trauma and dissociation. The volume contains articles on the history of concepts of trauma and dissociation, the linkage of complex trauma and dissociative problems in living, different modalities of treatment and theoretical approaches based on a new understanding of this linkage, as well as reviews of important new research. Overarching all of these is a clear explanation of how pathological dissociation is caused by trauma, and how this affects psychological organization -- concepts which have often been largely misunderstood. The Dissociative Mind in Psychoanalysis will be essential reading for psychoanalysts, psychoanalytically oriented psychotherapists, trauma therapists, and students.

Dissociation 101: The go-to guide for understanding your dissociative disorder, breaking the stigma, and healing from trauma-related dissociation. "Just as important as The Body Keeps the Score (but an easier read for me)." —5-star reader review Guided by clinical counselor Jamie Marich—a trauma-informed clinician living with a dissociative disorder herself—this book tells you everything you need to know about dissociation...but were too afraid to ask. Here, you’ll learn: What dissociation is—and why it’s a natural response to trauma How to understand and work with your “parts”—the unique emotional and behavioral profiles that can develop from personality fragmentation There’s nothing shameful about dissociating—that, in fact, we can all dissociate Skills and strategies for living your best, authentic, and most fulfilled life What to look for in a therapist: choosing a healer who sees you and gets it Foundational elements of healing from trauma, including PTSD and C-PTSD With practical guided exercises like “The Dissociative Profile” and “Parts Mapping,” this book is written for those diagnosed with dissociative disorders, clinicians and therapists who treat trauma and dissociation, and readers who are exploring whether they may have dissociative symptoms or a condition like dissociative identity disorder (DID). Dissociation Made Simple breaks it all down accessibly and comprehensively, with empowerment and support—and without stigma, judgment, or shame.

This book examines how drama therapists conceptualize and respond to relational and systemic trauma across systems of care including mental health clinics, schools, and communities burdened by historical and current wounds. This second edition of Trauma-Informed Drama Therapy: Transforming Clinics, Classrooms, and Communities offers a broad range of explorations in engaging with traumatic experience, across settings (clinical, educational, performance) and geographies (North America, Germany, Sri Lanka, South Africa, India, Belgium), and methodologies (Sesame, DvT, ethnography, performance, CANY, Self Rev). Each effort runs into obstacles, resistances, biases, and random events that highlight the authors’ passion and courage. No solutions are to be found. No grand schemes are proposed. Just hard work in the face of impenetrable truth: we are still at the beginning of understanding how to achieve an equitable, moral, accountable, healthy collective being-with. Confronting trauma, listening to victim testimonies, sitting with unsettling uncertainty, understanding the enormity of the problem, are difficult tasks, and over time wear people down. The chapters in this book belie this trend as they illustrate how the passion, creativity, faith, and perseverance of drama therapists the world over, each in their own limited way, can help. In each of these chapters you will read about people who have been pushed to the margins of existence, and then, how drama therapists have worked to remind them of their immutable, unique value that can transcend and transform those margins into spaces of care, power, and possibility. It will be useful for creative arts therapists, mental health professionals, educators, students and many others interested in the role of the drama and performance in the treatment of trauma.

This training manual for pateints who have suffered severe trauma includes a short educational piece, homework sheets, and exercises that promote essential emotional and life skills.