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Almost 35 years ago the first functional brain imaging study in an individual with Dissociative Identity Disorder (DID) was performed using positron emission tomography (PET). This study of the resting brain found hyperperfusion in the right temporal lobe (Mathew et al., 1985) a region that was also identified as a possible neurostructural biomarker for DID in the latest brain imaging study of the presenter (Reinders et al. 2019).
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This forum is based on a comprehensive literature review of secondary trauma (STS/VT/CF) and a plea for renewed research for the next decade. Offering an overview and critique of the research literature, we focus on the personal and organizational risk factors for trauma therapists.
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For decades, the diagnosis of borderline personality has been used to disparage abuse survivors as “difficult to treat,” often minimizing their experience of trauma, as noted in Herman’s classic Trauma and Recovery. In contrast, from 1989 to the present, studies have repeatedly shown the high co-occurrence of BPD and severe dissociative symptoms.
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This presentation has been updated to include recent literature relevant to assessment of structural dissociation, the newly updated MID Analysis v5.0, and the Interpretive Manual, 3rd Edition. Since the development of EMDR therapy in the early 1990s, a large body of research has shown that it is efficacious for PTSD.
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Chronic shame, an experience of being without value, is often at the center of the aftermath of traumatic experience accompanied by active dissociative processes. Infant attachment strategies are generated in the face of fear and seek proximity to a caretaker. Such seeking is compromised when the attachment relationship is itself a source of terror, horror, or other physical or psychic pain.
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Therapy with people who have been severely traumatized presents challenges to both the client and the therapist. The intensity of emotional and physical needs of trauma survivors with complex PTSD and Dissociative Disorders confront therapists with challenges of how best to manage those issues – for both the client and for the therapist.
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Abstract
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