Coping with Trauma-Related Dissociation: Skills Training for Patients and Therapists (Norton Series on Interpersonal Neurobiology)
Winner of the 2011 International Society for the Study of Trauma and Dissociation (ISSTD) Pierre Janet Writing Award.
A patient-oriented manual for complex trauma survivors.
This training manual for patients who have a trauma-related dissociative disorder includes short educational pieces, homework sheets, and exercises that address ways in which dissociation interferes with essential emotional and life skills, and support inner communication and collaboration with dissociative parts of the personality. Topics include understanding dissociation and PTSD, using inner reflection, emotion regulation, coping with dissociative problems related to triggers and traumatic memories, resolving sleep problems related to dissociation, coping with relational difficulties, and help with many other difficulties with daily life. The manual can be used in individual therapy or structured groups.
Reviews (172)
Amazing work
I can't say enough about this book. I had gotten very discouraged working with traumatized women and addicts. The first client I used this book with had been stuck for some time and was sinking deeper and deeper into despair, hopelessness, panic, anxiety and depression. She was also morbidly obese. After one session with this manual, she began to have hope, she engaged very actively in the treatment. One of the amazing things I see about working with these methods is that memories begin to surface spontaneously, as the client is ready, and within the context of the therapy, they feel safe to process and share the memories. In the case of this particular client, there was a facet of her abuse that haunted her immensely but she couldn't say why. By the third session, a memory had surfaced which explained it, and she was able to cope with it and process it in session. I found it very interesting that the memory surfaced as a movie on a screen with no sounds or smells, which is something the book indicates will happen. This client, as well as others, are enormously reassured and encouraged by the fact that suddenly everything makes sense, they are not the only ones who feel this way, and that there are therapists who have tons of experience working with these symptoms, to the point that they were able to write a book that both explains and offers hope. I also work with a lot of addicts and have become convinced that almost all addicts suffer from DDNOS, and I believe that this treatment should be a part of any successful substance abuse treatment. When I introduce some of these ideas in a group of addicts, I have the full attention of every person, male and female. They start to ask questions an things begin to fall into place for them. This work is so miraculous that I have purchased a pile of books all dealing with Polyvagal Theory, Sensorimotor Psychotherapy, Viseral Sensory Neuroscience, etc, to further my understanding of how the viscera reacts to trauma, and the role of neuroleptic not and interception in triggering people to have panic, anxiety, and to carry out behaviors such as self harming, eating disorders and substance abuse. Clients are awed to find out that there is an answer to the formerly mysterious monster that controls them and devours them. I am continuing to read and study, and in the meantime I am reaching my clients in a way that I have never been able to before.
Amazing resource for people with complex trauma
I had actual tears of recognition in my eyes after starting this book; six months later, upon completing it, I feel like I have reached a milestone in my recovery from abuse. I felt understood by this book in a way that I never have before with a psychology or therapy text, except for Judith Herman's Trauma and Recovery. This book is absolutely invaluable for someone with complex trauma in childhood, who used dissociation as their main defense mechanism. I am somewhere on the dissociative continuum (I had symptoms resembling DID in adolescence), though it wasn't identified as the source of my mental health problems until mid-adulthood, when I finally sought treatment for sexual abuse and trauma rather than depression alone, and then everything changed for the better. I started reading this as a follow-up to The Stranger in the Mirror (an excellent overview of dissociation), not expecting to get much out of this one, as therapy workbooks tend to be challenging for me. But I found myself highlighting every page. It's a gentler alternative to works that focus on sexual violence (many of which have helped, but those are hard to read when triggered). It's also made grounding and mindfulness exercises more accessible for me, since these are written expressly with a dissociative/traumatized reader in mind. The language, too, is so clear and validating. Some chapters might be more triggering, depending on your experience-- I was surprised that the relational stuff was harder for me-- so personally I recommend skipping a chapter or section if you feel like you're "fighting" with it, then returning to it later on. I had good luck with this approach. And don't be afraid to spend more time on a challenging chapter. You'll get out of the book what you put into it. I wish I had encountered this book years ago, but I'm just so glad to have it now. Best $17 I've ever spent. I want to tell the writers thank you.
Incredibly powerful
If you and your therapist have found your diagnosis to include dissociation, this is an incredibly useful book. I often pined for a practical guide to doing the stuff of daily life in light of my propensity to zone out. I thought I was just a procrastinator- but none of those self-help books came even close to helping. I even thought I had ADD/ADHD and bought some "how to stay organized" books for folks with those issues. When I finally understood that I was dissociating, it felt just like a fancy label and I didn't know what to do to get through the tough times of the day short of "curing" myself. Until one day it occurred to me that there must be ways to work around dissociations even before you can eliminate them from your life. So I googled "self care routine for dissociation" and I found this incredibly helpful manual. And it really is a manual. There are broader ideas as well but I find the minutiae of the instructions very helpful and comforting. It sometimes feels like re-learning how to be an adult, this time without the trauma. Huge thanks to the authors for writing this book.
Incredibly life changing read... but triggering... (at least for me)
Really life changing read so far... (not finished yet)... BUT be warned... while reading this is completely changing how I understand myself and some things - it is majorly triggering me. I've definitely sunk into a triggered depression... that is NOT to say anything negative about the book... in fact - shows how powerful the content is... only mention it as a warning for readers because I was completely unprepared for that element and have found myself struggling now without having prepared myself properly to cope.
Wow! Gems on every page -- for anyone who has experienced trauma, not just dissociation.
I love the simple language. I have her other book as well for psychotherapists. This book is for lay people. I l appreciate both books but I love this one. I love that it dives right in and doesn't "dumb it down" for lay people. I love that it provides exercises. I don't think I know anyone with full-blown dissociation, unless they hide it. However I find many things useful for myself and those I assist, because we all have "voices," like that voice that says we "should" do this or that, also an inner mom, an inner dad, an inner jesus or religious authority, an inner bad boy or "party girl," etc. For those of us who are not fully dissociative, I consider these not "parts" of self but perspectives. We harbor a dominant perspective and multiple other perspectives, including the spiritual or compassionate perspective which doesn't always get a voice. So everything we learn about dissociation, also helps the rest of us to find a harmonious balance!
Open ended textbook...it is written to expand more than treat both client and therapist
This is one very big textbook for therapists treating trauma related psychological disorders: from occasional flashbacks to true dissociative disorders. The difference being that both patient and therapist are addressed and given examples and teachings to help strong boundaries (re)develop. It’s taken me months to read this book. Each chapter challenges even the most intelligent person to learn and incorporate skills for both life skills and emotional tools to stay present and healthy. I like that it seems to accept that humans are flawed. It is how we recognize and respond to past a/o present stressors, dissociative thoughts and behaviors and healthier sleep that keep dissociative patients stuck, because these old patterns are safe. To be a fully functioning person in the best sense, a book like this can give you life skills and roadmaps and to not be scared to accept the help out there. As the authors say, this book, and this field are works-in-process. Overall, as slow as the read was, in this reviewers opinion it will help someone without “trapping” them into a set treatment. It would be a great book for Masters level counselors open to learning new things. 5/5
Not as helpful as I'd hoped
I am in recovery from DID and I had great hopes for this book but it didn't really help me much beyond a basic understanding of why I was suffering as I was. It's incredibly psychologically based, and seems to imply that we can change the reactions in the limbic system in our brain through a psychological approach. While this may work to a certain degree over a very long period of time, I feel that it's missing the main point: trauma is essentially in the limbic system in the brain, and also held in the body. Most of our mind reactions are too slow to compensate for the immediate triggering that takes place before we even realise it in our brain. I personally recommend two other books as being far more useful. Pat Ogden's
Really helpful book
This book is amazing. I would read chapter after chapter and say, "My life is in this book!" I didn't know that other people had the same problems that I did, and that people actually researched these types of problems! It made me feel good to know that I was not the only one experiencing these things. I picked up this book because it was mentioned in Pete Walker's "Complex PTSD" book as a work helpful for those who have "freeze" as one of their main responses to trauma. The book is written in a very nonjudgmental way, which is helpful for those of us who are easily triggered by criticism. The chapters are very short, which is good for people who are easily overwhelmed. I learned a lot about myself through this book and was able to develop some skills to help myself as I heal from complex PTSD.
It's really the Bible of work with dissociation and DID
As a therapist specializing in the field of complex PTSD, dissociation, and Dissociative Identity Disorder, I highly recommend this book. It's great as a stand alone book but works best when used with a therapist who understands and is trained in treating dissociation. It's important to understand what this book is. This book will not cure your trauma, no book can! It's a book designed to help you understand why you are the way you are, give you skills to help yourself, your ability to cope, improve your daily life and your relationships with others. This book is a huge gift, and is really the gold standard. Actually resolving the trauma itself and healing it--which is causing your symptoms in the first place--takes a therapist trained in something to do that such as EMDR, Somatic Experience, Sensorimotor Therapy, or Internal Family Systems.
Not helpful, a workbook for the therapist’s shelf
I have DID and thought the book was both useful and unhelpful. It is useful in that about 1/3 consists of a detailed, plain-language description of dissociation that is eye-opening and insightful. Another 1/3 is pedantic, comprised of basic, common sense advice that can be applied to dissociation (like “try to make your bedroom peaceful” or “use a calendar to keep a schedule”) as well as painstaking instructions for the use of relaxation techniques and guided imagery. The other 1/3 is overwhelming, consisting of about 100-200 questions and exercises, all of which use the trigger word “you,” and all of which are Only applicable if “parts” are aware of one other, share the same sense of time and space and actively are seeking integration. The book is essentially a workbook best kept as a reference on the therapist’s shelf.
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