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Written by a world-leading specialist in trauma-related
dissociation, this book comprehensively describes the diagnosis of
trauma-related disorders, taking up the many dilemmas around
criteria in DSM-5 and ICD-11, symptom recognition, the role of
traumatic experiences and of self-report questionnaires, as well as
other topics. The book elaborates on the assessment of these
disorders, using the diagnostic instrument Trauma and Dissociative
Symptoms Interview (TADS-I), developed by the author over decades
of work in the field. Several thematic chapters discuss key
differential diagnostic considerations and illustrate them with
case reports. Also discussed are the occurrence of false-negative
and false-positive diagnoses of trauma-related dissociative
disorders, the assessment of traumatic experiences and the
development of a treatment plan. This book is essential reading for
clinicians who diagnose dissociative disorders (or want to learn)
and useful for those who want to assist in better recognising
clients with dissociative symptoms and refer them for specialised
testing. The complete TADS-I is included as an appendix.
Therapists around the world ask similar questions and struggle with
similar challenges treating highly dissociative patients. This book
arose not only out of countless hours of treating patients with
dissociative disorders, but also out of the crucible of supervision
and consultation, where therapists bring their most urgent
questions, needs and vulnerabilities. The book offers an overview
of the neuropsychology of dissociation as a disorder of
non-realisation, as well as chapters on assessment, prognosis, case
formulation, treatment planning, and treatment phases and goals,
based on best practices. The authors describe what to focus on
first in a complex therapy and how to do it; how to help patients
establish both internal and external safety without rescuing; how
to work systematically with dissociative parts of a patient in ways
that facilitate integration rather than further dissociation; how
to set and maintain helpful boundaries; specific ways to stay
focused on process instead of content; how to deal compassionately
and effectively with disorganised attachment and dependency on the
therapist; how to help patients integrate traumatic memories; what
to do when the patient is enraged, chronically ashamed, avoidant or
unable to trust the therapist; and how to compassionately
understand and work with resistances as a co-creation of both
patient and therapist. Relational ways of being with the patient
are the backbone of treatment and are themselves essential
therapeutic interventions. As such, the book also focuses not only
on highly practical and theoretically sound interventions, not only
on what to do and say, but places strong emphasis on how to be with
patients, describing innovative, compassionately collaborative
approaches based on the latest research on attachment and
evolutionary psychology. Throughout the book, core
concepts-fundamental ideas that are highlighted in the text in bold
so they can be seen at a glance-are emphasised. These serve as
guiding principles in treatment as well as a summing-up of many of
the most important notions in each chapter. Each chapter concludes
with a section for further examination. These sections include
additional ideas and questions, exercises for practising skills and
suggestions for peer discussions based on topics in a particular
chapter, meant to inspire further curiosity, discovery and growth.
This training manual for patients who have a trauma-related
dissociative disorder includes short educational pieces, homework
sheets, and exercises that address ways in which dissociation
interferes with essential emotional and life skills, and support
inner communication and collaboration with dissociative parts of
the personality. Topics include understanding dissociation and
PTSD, using inner reflection, emotion regulation, coping with
dissociative problems related to triggers and traumatic memories,
resolving sleep problems related to dissociation, coping with
relational difficulties, and help with many other difficulties with
daily life. The manual can be used in individual therapy or
structured groups.
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