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The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization (Norton Series on Interpersonal Neurobiology), by On
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Life is an ongoing struggle for patients who have been chronically traumatized.
They typically have a wide array of symptoms, often classified under different combinations of comorbidity, which can make assessment and treatment complicated and confusing for the therapist.Many patients have substantial problems with daily living and relationships, including serious intrapsychic conflicts and maladaptive coping strategies. Their suffering essentially relates to a terrifying and painful past that haunts them. Even when survivors attempt to hide their distress beneath a facade of normality―a common strategy―therapists often feel besieged by their many symptoms and serious pain. Small wonder that many survivors of chronic traumatization have seen several therapists with little if any gains, and that quite a few have been labeled as untreatable or resistant.
In this book, three leading researchers and clinicians share what they have learned from treating and studying chronically traumatized individuals across more than 65 years of collective experience. Based on the theory of structural dissociation of the personality in combination with a Janetian psychology of action, the authors have developed a model of phase-oriented treatment that focuses on the identification and treatment of structural dissociation and related maladaptive mental and behavioral actions. The foundation of this approach is to support patients in learning more effective mental and behavioral actions that will enable them to become more adaptive in life and to resolve their structural dissociation. This principle implies an overall therapeutic goal of raising the integrative capacity, in order to cope with the demands of daily life and deal with the haunting remnants of the past, with the “unfinished business” of traumatic memories.
Of interest to clinicians, students of clinical psychology and psychiatry, as well as to researchers, all those interested in adult survivors of chronic child abuse and neglect will find helpful insights and tools that may make the treatment more effective and efficient, and more tolerable for the suffering patient.
- Sales Rank: #212163 in Books
- Published on: 2006-11-17
- Original language: English
- Number of items: 1
- Dimensions: 9.60" h x 1.50" w x 6.50" l, 1.81 pounds
- Binding: Hardcover
- 440 pages
Review
A powerful set of insights for clinicians, students of clinical psychology and psychiatry, and any involved in mental health issues. (The Bookwatch)
About the Author
Onno van der Hart, Ph.D.,�is Professor Emeritus of Psychopathology of Chronic Traumatization, Department of Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands, and a psychologist / psychotherapist in private practice in Amsterdam, the Netherlands. He is a Past President of the International Society for Traumatic Stress Studies (ISTSS).
Ellert R. S. Nijenhuis, Ph.D., is a clinical psychologist, psychotherapist, and researcher. He is affiliated with Mental Health Care Drenthe, The Netherlands and collaborates with various Universities. He is a former director of the Executive Council of the International Society for the Study of Dissociation (ISSD).
Kathy Steele, MN, CS, is in private practice with Metropolitan Psychotherapy Associates in Atlanta, Georgia. She is a former President of the International Society for the Study of Dissociation.
Most helpful customer reviews
336 of 351 people found the following review helpful.
A Great Exposition of Understanding for Human Suffering
By Walt
I must express extreme praise and admiration for the work and eventual understanding the authors of The Haunted Self have so relatively displayed in researching trauma related disorders and maladaptive behaviors. But the amazing thing is they were able to explain it in terms a sufferer can understand. This is not something that happens in research very often. I have been involved in research of some sort all my adult life and know that research produces facts and figures from which decisions and theories can be constructed with a reasonable amount of certainty. The one thing research cannot do is produce empathy and compassion. Being a post-modern theologian as well as an engineer, I know these two expressions can only come from a calling to help humanity. I am a fifty-one year old male who has suffered the agonizing pain of the effects of trauma in many different ways and forms all my life. After reading well over one-hundred and twenty thousand pages of research on my symptoms and problems and theorizing and journaling thoughts, I finally found not only an explanation but compassion and empathy within the pages of this book. I believe this is vital in any therapeutic relationship. Without a shadow of a doubt, the reader can make a therapeutic relationship with this book that can be externalized and extended into their patient therapist relationship. This book is to trauma and mental health as Einstein's theory of relativity is to physics or what the personal computer is to how we view information or, more importantly, what parole is to a prisoner.
I have been treated for many anxiety related symptoms but another symptom would just take its place after treatment. Then the original symptom would reoccur. This cycle has lasted all my life with devastating personal effects. But like most people with psychological disorders or underdeveloped functionality, it was hard to talk about what was really going on inside of me. I could neither express nor have the courage to face my inward demons. I was stuck in a living example of structural disassociation. My emotional self (EP) was stuck in the state of both somatic (empty) and exaggerated memories of accumulative trauma (or of personal perceptions of life events) while my normal every day self (ANP) was in a defensive war keeping me from dealing with the pain, relived trauma and torture of those memories. This actually caused a somatic type of discomfort. Of course this psychosomatic physical suffering just kept the cycle of mental distress going in a spiral of disassociation. Actually I was fighting for the gift of life as found in wholeness.
I have been inducted into the lifer's panic attack hall of fame. If that were not enough I have fought phobias, struggled with intrusive misplaced thoughts bordering OCD, mimicked heart attacks getting intimate with the EKG machine. I endured the embarrassment of publicly displaying tics and jerks and leg movements during stressful situations that I was ill equipped to handle. I would have to find some excuse for losing my current thought process during emotional and trying times. The list could go on but at this point I think you have the idea. I felt like a loser with no hope. Make no mistake. All of those labeled disorders were real. That is; they were symptomatically real due to trauma related structural disorder which affected and distorted my understanding of the gift of life. Treatment was nothing more than an aspirin for the pain. Healing started, however, through understanding the complex make up of my person.
The Haunted Self provided that understanding. I introduced the book to my therapist, whom is very good and someone I trust very much. She embraced the detailed theory as it applied to me much to my surprise. By the way, did I say she was good? Something amazing happened with this embrace. I know that what I am about to say will sound patronizing but healing is something one must share. Within five weeks of therapy using a facilitated understanding of this book by my therapist, symptoms began to weaken (of course I had already completed my homework and I desperately wanted change). Wholeness began happening in my life. Doors began to open to things I never understood. Changes began to happen to my thought process bleeding over into my actions (synaptic psychotherapy). I was actually creating opportunities for myself. I was able to accept past trauma perceptions and started believing and knowing that the defense used by my everyday self (ANP) only made things worse. I feel a life time of treatment, attempted understanding and suffering came to a head with nothing more than simple insight made clear to a somewhat neurotic person. Actually this understanding was presented as a detailed expression of the conflicting forces that wreck havoc on the lives of so many people that make up our world (makes one question the concept of spontaneous panic attacks).
This review is way too long so I will end here with a challenge. I challenge anyone who has been beleaguered with anxiety related disorders to look at themselves and their disorders from a different point of reference like the changing colors of light through a prism as presented in The Haunted Self. I also challenge all mental health professionals to at least look over this book and allow it to provoke your thoughts (it should be required reading for all doctoral students in psychology if only because of the post-modern interpretation of prior research). I believe this book is a holistic expression for a broad range of disorders that are now being treated separately and in this sufferer's opinion sometimes ineffectively. I do not pretend to be an expert in psychology as some of you who are will notice, while chuckling at my review, but I am a seasoned professional at suffering due to trauma or perceptions of trauma and the extreme bizarre anxiety and actions it produces.
103 of 106 people found the following review helpful.
A Major Advancement in Understanding Trauma and Dissociation
By A. Hardy
In THE HAUNTED SELF the authors, Onno van der Hart, Ellert Nijenhuis and Kathy Steele present a theory of structural dissociation that builds upon the work of Pierre Janet and ties together the recent developments in the areas of trauma and dissociation. They build their theory methodically and concisely, tackling the difficult subject of dissociation and its effects on survivors of trauma. Their writing is compassionate and understanding, illuminating their therapeutic skills while at the same time delving into one of the most misunderstood and confounding areas of psychology with clarity and thoughtfulness.
The book is a challenging read, not because of the language, but because of the thoroughness and detail devoted to the construction of the authors' somewhat complex theory. Divided into two sections, the first constructs the theory of structural dissociation itself, with the second section presenting the phase oriented treatment, including examples illustrating the therapeutic processes involved.
The theory the authors present is consistent with recent advances in neuroscience and has the potential to impact the treatment of those suffering from a range of psychological disorders. The authors fully acknowledge and solicit feedback for those parts of their theory that are in need of further research. They also use the work of many others who have extended our knowledge of trauma and dissociation and its treatment over the past century.
Rather than approaching dissociative disorders by only examining the modern theories and developments, they begin with the work of Janet and thus are able to define the sequential breakdown of the personality in the face of traumatic incidences. Their theory respects the varied nature of individual responses making their approach most accessible for those who work directly with any dissociative system, from the simplest ranging to the most complex or polyfragmented.
This book is great advanced reading for those DID'ers who have already read everything else out there and are looking for more. Although it is dense, if you can make your way through it, you will find yourselves, as I did, commenting on how `on the mark' it feels.
THE HAUNTED SELF should be required reading for all psychology and neurobiology students as well as for all private practitioners and those currently working with the mentally ill in institutions, programs and educational settings. It is also excellent material for those seeking to understand more about the functions of the brain.
138 of 145 people found the following review helpful.
Putting the pieces of the puzzle together
By B. Sugarman
Prior to reading this book, not only did I feel fragmented myself, but the different theories about what had happened to me that were put forward also seemed fragmented and disconnected, like slices at different angles to the truth. As well as advocating an method of integration in the patient, the theory of structural dissociation presented in this book also seems integrative in itself, in showing how different, seemingly unrelated diagnoses can be seen to be derived from the same underlying trauma related processes. As a patient this is not just theoretically interesting but it can help take away alot of the anxiety, confusion, and scepticism that comes from being sliced and diced in different ways by different mental health professionals. I think that the more patients and professionals that are exposed to these ideas, the better.
I thought this was a brilliant, original and beautifully written book, that expresses some very sophisticated ideas in a clear and systematic way. As well as the theoretical insights conveyed, this book also provides a integrative treatment plan, which brings together tools and ideas from across a broad spectrum of psychological paradigms. After only a few pages into the book, I got an "aha" moment and this deepened into a sense that finally someone seemed to be speaking a language that made sense to me. The book is written in a structured, iterative way. The first few chapters give you a broad understanding of what structural dissociation involves, and how it plays a core role in creating the symptoms experienced by both "classic" dissociative individuals, and those who may appear to have another mental illness (anxiety, depression etc), but whose symptoms are in fact a manifestation of underlying structural dissociation. The rest of the book goes into further theoretical detail, and then explains the phased treatment programme, with a comprehensive array of information and guidance for mental health professionals on how to effectively treat patients. Depending on their current level of mental stamina and capability, patients may find that they only need to read the first few chapters to understand the basics of the ideas, but those with more energy and interest will get great value out of the rest of the book also.
While not all mental illness is caused by structural dissociation, those who have experienced problems with getting a diagnosis or effective therapy may gain value from the insights contained in this book. I strongly feel that this is the best book by far that i have found on trauma related dissociative disorders, and i recommend it highly to anyone suffering from DID, BPD, PTSD, conversion/somatisation disorders etc.
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