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.
Elizabeth F. Howell
Most Helpful Customer Reviews
This book is the best I have read on the subject of dissociative identity disorder and other dissociative states. It is a brilliant summary of the history of understanding of the subject plus contains the author's original ideas on diagnostic categories and treatment as well as fruitful examples from her work. She clearly has a lot of respect for her clients' traumatic experiences and courage as well as a keen intellectual mind.
This books is not an easy light read but it is clear and very readable for someone at all versed in the subject or ready to become so.
It is a great addition to the work Howell previosly did in the history of the concept of dissociation and trauma as a way of understanding both conditions of injury and a general concept of how the mind works. As an earlier reviewer here noted we are not born unitary and then break apart, everyone faces the task of creating a workable semblance of wholeness. Some have it easier than others based on life...
As a therapist and a person with integrated DID, there isn't a false step in the book. She really "gets it." Her discussions of treatment are up-to-date and clearly written. She has built on the historical work of Putnum and Kluft, both of whom are experts on internal structure but are limited to treatment circa 1989. Ms. Howell has brought treatment up-to-date.
I tried to read this book and was stumped lol. It really is for clinicians and not the normal reader. Make sure you have a dictionary for clinicians if you choose to tackle this book. Although the history of D.I.D. was very interesting and the experiences of patients within was enlightening.
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