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An examination of structural dissociation of the personality and the implications for cognitive behavioural therapy

Published online by Cambridge University Press:  14 April 2011

Simon Harper*
Affiliation:
Maple House Business Centre, Cheltenham, Gloucestershire, UK
*
*Author for correspondence: Mr S. Harper, Maple House Business Centre, Bayshill Road, Cheltenham, Gloucestershire GL54 5JS, UK. (email: info@emdrpsychotherapy.co.uk)

Abstract

The aim of this review was to ascertain whether an examination of the theory of structural dissociation of the personality (TSDP) and its treatment may lead to recommendations in the treatment of dissociative identity disorder (DID) and other trauma-related disorders utilizing CBT. An analysis of the neurobiology of trauma will aid this process. The literature review considers a variety of literature on TSDP. Several themes were identified which suggested that dissociation refers to a structural dividedness of the personality and that there is a psychobiological pathway for all trauma-related disorders. Additionally the role of bottom-up vs. top-down processing was explored. Recommendations for the treatment of trauma-related disorders using CBT have been made.

Type
Review
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

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References

Recommended follow-up reading

Courtois, CA, Ford, JD (2009). Treating Complex Traumatic Stress Disorders. An Evidence-Based Guide. New York, Guilford Press.Google Scholar
Dell, PF, O'Neil, JA (2009) Dissociation and the Dissociative Disorders. DSM-V and Beyond. London, Routledge.Google Scholar
Herbert, C (2006). Healing from complex trauma; an integrative 3 systems approach. In: About a Body: Working with the Embodied Mind in Psychotherapy (ed. Corrigall, J., Payne, H and Wilkinson, H.), pp. 139161. London: Routledge.Google Scholar
LeDoux, J (1998). The Emotional Brain. London: Phoenix.Google Scholar
Van der Hart, O, Nijenhuis, ERS, Steele, K (2006). The Haunted Self. Structural Dissociation and the Treatment of Chronic Traumatization. New York/London: Norton and Company.Google Scholar
Van der Kolk, BA (1994). The body keeps the score: memory and the evolving psychobiology of post traumatic stress. Harvard Review of Psychiatry 1, 253265.CrossRefGoogle Scholar

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn.Washington, DC: American Psychiatric Association.Google Scholar
Ashworth, PD (1987). Qualitative Research in Psychology. London: Duquesne University Press.Google Scholar
Aveyard, H (2007). Doing a Literature Review in Health and Social Care. Berkshire: Open University Publications.Google Scholar
Beck, AT (1996). Beyond belief: A theory of modes, personality and psychopathology. In: Frontiers of Cognitive Therapy (ed. Salkvoskis, P. M.), pp. 125. London: Guilford Press.Google Scholar
Beere, D (2009). An EMDR protocol for dissociative identity disorder. In: Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols. Special Situations (ed. Luber, M.), pp. 387426. New York: Springer Publishing.Google Scholar
Biggam, J (2008). Succeeding with your Master's Dissertation. Berkshire: Open University Press.Google Scholar
Brewin, CR (2001). A cognitive neuroscience account of posttraumatic stress disorder and its treatment. Journal of Behaviour Research and Therapy 39, 373393.CrossRefGoogle ScholarPubMed
Brewin, CR, Dalgleish, T, Joseph, S (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review 103, 670686.CrossRefGoogle ScholarPubMed
Courtois, CA, Ford, JD (2009). Treating Complex Traumatic Stress Disorders. An Evidence-Based Guide. New York: Guilford Press.Google Scholar
Dorahy, MJ, Van der Hart, O (2007). Relationship between trauma and dissociation. In: Traumatic Dissociation Neurobiology and Treatment (ed. Vermetten, E., Dorahy, M. J. and Spiegel, D.), pp. 330. Washington DC, American Psychiatric Publishing.Google Scholar
Epstein, S (1993). Constructive Thinking. The Key to Emotional Intelligence. London: Praeger.Google Scholar
Fine, CG (1999). Tactical integration model for the treatment of dissociative identity disorder and allied dissociative disorders. American Journal of Psychotherapy 53, 361376.CrossRefGoogle ScholarPubMed
Fine, CG (2009). The wreathing protocol: the imbrication of hypnosis and EMDR in the treatment of dissociative identity disorder, dissociative disorder not otherwise specified, and post-traumatic stress disorder. In: Eye Movement Desensitization and Reprocessing> (EMDR) Scripted Protocols. Special Situations (ed. Luber, M.), pp. 329347. New York: Springer Publishing.Google Scholar
Foa, E, Rauch, S (2004). Changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 72, 879884.CrossRefGoogle ScholarPubMed
Follette, V, Palm, KM, Pearson, AN (2006). Mindfulness and trauma: implications for treatment. Journal of Rational-Emotive & Cognitive-Behaviour Therapy 24, 4561.CrossRefGoogle Scholar
Ford, JD, Courtois, CA (2009). Defining and understanding complex trauma and complex traumatic stress disorders. In: Treating Complex Traumatic Stress Disorders. An Evidence-Based Guide (ed. Courtois, C. A. and Ford, J. D.), pp. 1330. New York: Guilford Press.Google Scholar
Forgash, C, Copeley, M (2008). Healing the Heart of Trauma and Dissociation with EMDR Therapy and Ego State Therapy. New York: Springer Publishing.Google Scholar
Fuchs, T (2009). Embodied cognitive neuroscience and its consequences for psychiatry. Journal of Pollesis and Praxis 6, 219233.Google Scholar
Grant, A, Townend, M, Mills, J, Cockx, A (2008). Assessment and Case Formulation in Cognitive Behavioural Therapy. London: Sage Publications.Google Scholar
Hart, C (1998). Doing a Literature Review: Releasing the Social Science Research Imagination. London: Sage Publications.Google Scholar
Hart, K, Kritsonis, WA (2006). From multiple personality disorder to dissociative identity disorder: a clinical overview of diagnostic and treatment considerations. National Journal for Publishing and Mentoring Student Research 3, 17.Google Scholar
Herbert, C (2006). Healing from complex trauma; an integrative 3 systems approach. In: About a Body: Working with the Embodied Mind in Psychotherapy (ed. Corrigall, J., Payne, H. and Wilkinson, H.), pp. 139161. London: Routledge.Google Scholar
Herman, JL (1992). Trauma and Recovery. London: Pandora.Google Scholar
Holmes, EA, Brown, RJ, Mansell, W, Fearon, RP, Hunter, ECM, Frasquilho, F, Oakley, DA (2004). Are there two qualitatively distinct forms of dissociation? A review and some clinical applications. Journal of Clinical Psychology Review 25, 123.Google Scholar
Howell, EF (2005). The Dissociative Mind. London: Routledge.Google Scholar
Kennedy, F (2004). Towards a cognitive model of dissociation. Journal of Behavior Therapy and Experimental Psychiatry 35, 2548.CrossRefGoogle ScholarPubMed
Kennerley, H (1996). Cognitive therapy of dissociative symptoms associated with trauma. British Journal of Clinical Psychology 25, 325340.CrossRefGoogle Scholar
Kennerley, H (2009). Cognitive therapy for post traumatic dissociation. In: Casebook of Cognitive Therapy for Traumatic Stress Reactions (ed. Grey, N. A.), pp. 93110. London: Routledge.Google Scholar
Kluft, RP, Fine, CG (1993). Clinical Perspectives on Multiple Personality Disorder. Washington, DC: American Psychiatric Press.Google Scholar
LeDoux, J (1998). The Emotional Brain. London: Phoenix.Google Scholar
Levine, PA (2010). In An Unspoken Voice. How the Body Releases Trauma and Restores Goodness. California: North Atlantic Books.Google Scholar
Linehan, M (1993). Cognitive-Behavioural Treatment of Borderline Personality Disorder. New York: Guilford Press.Google Scholar
Liotti, G (2006). A model of dissociation based on attachment theory and research. Journal of Trauma and Dissociation 7, 5574.CrossRefGoogle Scholar
Luber, M (2009). EMDR Scripted Protocols. Special Populations. New York: Springer Publishing.Google Scholar
McLeod, J (2001). Qualitative Research in Counselling and Psychotherapy. London: Sage Publications.CrossRefGoogle Scholar
Merskey, H (1992). The manufacture of personalities: the production of multiple personality disorders. Journal of British Psychiatry 160, 327340.CrossRefGoogle Scholar
Mueser, KT, Rosenberg, SD, Rosenberg, HJ (2009). Treatment of Postraumatic Stress Disorder in Special Populations: A Cognitive Restructuring Program. New York: American Psychological Association.CrossRefGoogle Scholar
Myers, CM (1940). Shell Shock in France. Cambridge: Cambridge University Press.Google Scholar
Nijenhuis, ERS, De Boer, JAD (2009). Neurobiology of dissociation: a view from the trauma field. In: Dissociation and the Dissociative Disorders: DSM-V and Beyond (ed. Dell, P. F. and O'Neil, J. A.), pp. 337366. London: Routledge.Google Scholar
Nijenhuis, ERSVan der Hart, O (in press). Dissociation in trauma: a new definition and comparison with previous formulations. Journal of Trauma and Dissociation.Google Scholar
Ogden, P, Minton, K, Pain, C (2006). Trauma and the Body. A Sensorimotor Approach to Psychotherapy. New York: W. W. Norton and Company.Google Scholar
Paulsen, S (2009). ACT-AS-IF and ARCHITECTS approaches to EMDR treatment of dissociative identity disorder. In: Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols. Special Situations (ed. Luber, M.), pp. 357386. New York, Springer Publishing.Google Scholar
Piper, A, Merskey, H (2004). The persistence of folly: critical examination of dissociative identity disorder. Part 11. The defence and decline of multiple personality or dissociative identity disorder. Canadian Journal of Psychiatry 49, 678683.CrossRefGoogle ScholarPubMed
Power, MJ, Dalgleish, T (1999). Handbook of Cognition and Emotion. Chichester: Wiley.Google Scholar
Reinders, AATS, Nijenhuis, ERS, Paans, AMJ, Korf, J, Willemsen, ATM, De Boer, JAD (2003). One brain, two selves. Journal of NeuroImage 20, 21192125.CrossRefGoogle ScholarPubMed
Reinders, AATS, Nijenhuis, ERS, Quak, J, Korf, J, Haaksma, J, Paans, AMJ, Willemsen, ATM, De Boer, JAD (2006). Psychobiological characteristics of dissociative identity disorder: a symptom provocation study. Journal of Biological Psychiatry 60, 730740.CrossRefGoogle ScholarPubMed
Ruden, RA (2010). When the Past is always Present. Emotional Traumatization, Causes and Cures. London: Routledge.Google Scholar
Siegel, D (1999). The Developing Mind. New York: Guilford Press.Google Scholar
Steele, K, Van der Hart, O (2009). Treating dissociation. In: Treating Complex Traumatic Stress Disorders (ed. Courtois, C. A. and Ford, J. D.), pp. 145165. New York: Guilford Press.Google Scholar
Steele, K, Van der Hart, O, Nijenhuis, ERS (2005). Phase-oriented treatment of structural dissociation in complex traumatization: overcoming trauma-related phobias. Journal of Trauma and Dissociation 6, 1153.CrossRefGoogle ScholarPubMed
Stokes, TB (2009). What Freud Didn't Know. A Three Step Practice For Emotional Wellbeing Through Neuroscience and Psychology. New Jersey: Rutgers University Press.Google Scholar
Teasdale, J, Barnard, P (1993). Affect Cognition and Change. Re-modelling Depressive Thought. Hove: Lawrence Erlbaum Associates.Google Scholar
Van der Hart, O, Dorahy, MJ (2009). History of the concept of dissociation. In: Dissociation and the Dissociative Disorders: DSM-V and Beyond (ed. Dell, P. F. and O'Neil, J. A.), pp. 326. London: Routledge.Google Scholar
Van der Hart, O, Nijenhuis, ERS (1999). Bearing witness to uncorroborated trauma: the clinician's development of reflective belief. Journal of Professional Psychology Research and Practice 30, 3744.CrossRefGoogle Scholar
Van der Hart, O, Nijenhuis, ERS, Solomon, R (2010). Dissociation of the personality in complex trauma-related disorders and EMDR: theoretical considerations. Journal of EMDR Practice and Research 4, 7692.CrossRefGoogle Scholar
Van der Hart, O, Nijenhuis, ERS, Steele, K (2006). The Haunted Self. Structural Dissociation and the Treatment of Chronic Traumatization. New York: Norton and Company.Google Scholar
Van der Hart, O, Nijenhuis, ERS, Steele, K, Brown, D (2004). Trauma related dissociation: conceptual clarity, lost and found. Journal of Australian and New Zealand Psychiatry 38, 678686.CrossRefGoogle ScholarPubMed
Van der Hart, O, Van, Dijke, Van Son, , Steele, K (2000). Somatoform dissociation in traumatised World War 1 combat soldiers: A neglected clinical heritage. Journal of Trauma and Dissociation 1, 3366.CrossRefGoogle Scholar
Van der Hart, O, Van Echten, J, Van Son, MJM, Steele, K, Lensvelt-Mulders, G (2008). Relations among peritraumatic dissociation and posttraumatic stress: a critical review. Journal of Trauma and Dissociation 9, 481505.CrossRefGoogle ScholarPubMed
Van der Kolk, BA (1994). The body keeps the score: memory and the evolving psychobiology of post traumatic stress. Harvard Review of Psychiatry 1, 253265.CrossRefGoogle Scholar
Van der Kolk, BA (2002). EMDR and the lessons from neuroscience research (http//www.traumacenter.org/products/publications.php). Accessed 13 October 2010.Google Scholar
Van der Kolk, BA, McFarlane, AC, Weisaeth, L (1999). Traumatic Stress: Effects of Overwhelming Experience on Mind, Body and Society. New York: Guilford Press.Google Scholar
Young, J, Klosko, JS, Weishaar, ME (2003). Schema Therapy. A Practitioners Guide. New York: Guilford Press.Google Scholar
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