Understanding and Treating Dissociative Identity Disorder ─ A Relational Approach

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.

A psychoanalyst and traumatologist who specializes in the treatment of dissociative disorders, Elizabeth Howell, Ph.D., is Associate Editor of the Journal of Trauma and Dissociation and Co-Director of the Dissociative Disorders Psychotherapy Training Program of the International Society for the Study of Dissociation. Dr. Howell is a faculty member of the National Institute for the Psychotherapies Trauma Studies Program and an adjunct associate professor in the psychology department of New York University. She has written and lectured widely on various aspects of trauma and dissociation. The author of The Dissociative Mind (Analytic Press, 2005), she has been awarded the Print Media Award for her work.

Introduction. Part I: Understanding Dissociative Identity Disorder. The Lives and Psychotherapy of Three People with DID. The Dynamic Unconscious and the Dissociative Structure of the Mind. "The 'We' of Me:" Personality Organization in DID. DID is a Trauma Disorder. Dissociated Self-states, Trauma, and Disorganized Attachment. Some Neurobiological Correlates of the Structure and Psychodynamics of Dissociated Self-states. Dissociated Self-states: Creation and Contexualization. Part II: Treating Dissociative Identity Disorder. Assessment and Diagnosis of DID. Phase-oriented Treatment. Facilitating Co-consciousness and Co-participation in the Treatment. Working with Persecutory Alters and Identification with the Aggressor. The Therapeutic Relationship: Multiple Dimensions of Co-construction. Dreams in DID. Suicidality. Comorbidity and Seeming Comorbidity: Problematic Outcomes of Severe and Rigid Dissociative Structuring of the Mind.