The Dissociative Mind In Psychoanalysis

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.

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.

Evil - along with its incarnation in human form, the psychopath - remains underexamined in the psychological and psychoanalytic literature. Given current societal issues ranging from increasingly violent cultural divides to climate change, it is imperative that the topics of psychopathy and human evil be thoughtfully explored. The book brings together social scientists, psychologists, and psychoanalysts to discuss the psychology of psychopaths, and the personal, societal and cultural destruction they leave as their legacy. Chapters address such questions as: Who are psychopaths? How do they think and operate? What causes someone to commit psychopathic acts? And are psychopaths born or created? Psychopaths leave us shocked and bewildered by behavior that violates the notions of common human trust and bonding, but not all psychopaths commit crimes. Because of their unique proclivities to deceive, seduce, and dissemble, they can hide in plain sight; especially when intelligent and highly educated. This latter group comprise the "successful or corporate" psychopaths, frequently found in boardrooms of corporations and among leaders of national movements or heads of state. Addressing a wide range of topics including slavery, genocide, the Holocaust, the individual as psychopath, the mind of the terrorist, sexual abuse, the role of attachment and the neurobiology of psychopathy, this book will appeal to researchers of human evil and psychopathy from a range of different disciplines and represents essential reading for psychotherapists and clinical psychologists.

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.

'At last we have a book that provides a comprehensive overview and assessment of the intersubjective turn in psychoanalysis, showing its logical and clinical limitations and exploring its social and cultural determinants. Bohleber emphasizes the clinical importance of real traumatic experience along with the analysis of the transference as he reviews and broadens psychoanalytic theories of memory in relation to advances in cognitive psychology and neuroscience. Psychoanalytic ideas on personality, adolescence and identity are re-thought and updated. Bohleber brilliantly presents a unique understanding of malignant narcissism and prejudice in relation to European anti-Semitism and to contemporary religiously inspired terrorist violence.'- Cyril Levitt, Dr Phil, Professor and former Chair Department of Sociology, McMaster University Hamilton, Ontario. Psychoanalyst in private practice, Toronto, Ontario

Winner of ISSTD's 2009 Pierre Janet Writing Award for the best publication on dissociation in 2009! Dissociation and the Dissociative Disorders is a book that has no real predecessor in the dissociative disorders field. It reports the most recent scientific findings and conceptualizations about dissociation; defines and establishes the boundaries of current knowledge in the dissociative disorders field; identifies and carefully articulates the field’s current points of confusion, gaps in knowledge, and conjectures; clarifies the different aspects and implications of dissociation; and sets forth a research agenda for the next decade. In many respects, Dissociation and the Dissociative Disorders both defines and redefines the field.

Early in these essays, Bromberg contemplates how one might engage schizoid detachment within an interpersonal perspective. To his surprise, he finds that the road to the patient's disavowed experiences most frequently passes through the analyst's internal conversation, as multiple configurations of self-other interaction, previously dissociated, are set loose first in the analyst and then played out in the interpersonal field. This insight leads to other discoveries. Beneath the dissociative structures seen in schizoid patients, and also in other personality disorders, Bromberg regularly finds traumatic experience -- even in patients not otherwise viewed as traumatized. This discovery allows interpersonal notions of psychic structure to emerge in a new light, as Bromberg arrives at the view that all severe character pathology masks dissociative defenses erected to ward off the internal experience of trauma and to keep the external world at bay to avoid retraumatization. These insights, in turn, open to a new understanding of dissociative processes as intrinsic to the therapeutic process per se. For Bromberg, it is the unanticipated eruption of the patient's relational world, with its push-pull impact on the analyst's effort to maintain a therapeutic stance, that makes possible the deepest and most therapeutically fruitful type of analytic experience. Bromberg's essays are delightfully unpredictable, as they strive to keep the reader continually abreast of how words can and cannot capture the subtle shifts in relatedness that characterize the clinical process. Indeed, at times Bromberg's writing seems vividly to recreate the alternating states of mind of the relational analyst at work. Stirringly evocative in character and radiating clinical wisdom infused with compassion and wit, Standing in the Spaces is a classic destined to be read and reread by analysts and therapists for decades to come.

The conflict and dissociation between the Body and the Mind have determinant implications in the context of our current clinical practice, and are an important source of internal and relational disturbances. Body-Mind Dissociation in Psychoanalysis proposes the concept as a new hypothesis, different from traumatic dissociation or states of splitting. This approach opens the door to a clinical confrontation with extreme forms of mental disturbance, such as psychosis or borderline disorders, and strengthens the relational power of the analytic encounter, through a focus on the internal sensory/emotional axis in both analyst and analysand. The book details this importance of the analyst’s intrasubjective relationship with the analysand in constructing new developmental horizons, starting from the body-mind exchange of the two participants. Body-Mind Dissociation in Psychoanalysis will be of use to students, beginners in psychotherapy, mental health practitioners and seasoned psychoanalysts.