Psychotherapy of the Survivor of Incest With a Dissociative Disorder

Abstract

The treatment of the survivor of incest who suffers from a dissociative disorder is probably somewhat more difficult than that of other survivors of incest because for these others the material is more readily available. Also the patient with DD was probably more severely abused or the dissociative defense would not have been needed. This too makes therapy difficult, especially in that most necessary step: the development of trust and rapport. Despite these problems, there is a very good chance for a successful therapy that will bring the dissociated material back into the main stream of consciousness with a "here and now" appropriate perspective. This can be accomplished through proper diagnosis, good theoretics grounding, and therapy including psychotherapy with appropriate limit setting and the judicious use of medication. This article presents a summary of the BASK model of dissociation and two other models and gives ideas on how these models may be applied to the understanding of the etiology of dissociative disorders and their treatment. Case examples are used to illustrate successful treatment. Although treatment of incest survivors with dissociative disorders is difficult, success can be anticipated, and the rewards to the patient and the satisfaction for the therapist are great.