Gazing into a mirror, what is it that you see? You see a reflection of the person others see when they look at you. If the mirror should shatter you would then see not just one, but many reflections of yourself in the fragments.
This is the first image that entered my mind as I began to read Coping with Trauma-Related Dissociation. Following that were images from the movies Sybil and The Three Faces of Eve. After not many pages into the book came the realization that dissociative identity disorder, the subject of this book, is what had been portrayed in those movies. “Dissociative parts of the personality are not actually separate identities in one body, but rather parts of a single individual that are not yet functioning together in a smooth, coordinated, and flexible way.”
In a collaborative effort by authors Suzette Boon, Ph.D.; Kathy Steele, M.N., C.S.; and Onno van der Hart, Ph.D., patients and their therapists are presented with a skills-training course as another avenue to travel in the treatment of dissociative identity disorder.
The book is aimed specifically at patients with the disorder and the authors note that it is not intended to be used by anyone who is not currently in therapy even though the content may be helpful on its own. While it can be utilized in a one-on-one session between a patient and therapist, the skills training was designed to be used in group sessions led by two trainers with a predetermined number of participants that have already been assessed, diagnosed, and are in current treatment for the disorder.
Coping with Trauma-Related Dissociation is divided into eight parts, logically progressing from understanding dissociation and trauma-related disorders, to initial coping skills (reflection), improving daily life (sleep; a healthy daily structure; free time and relaxation), coping with traumatic triggers and memories, understanding emotions and cognitions (core beliefs, cognitive errors), advanced coping skills (anger, fear, shame and guilt, needs of inner child parts, self-harm, inner cooperation), and finally to improving relationships (isolation, loneliness, learning to be assertive, and setting healthy personal boundaries). Each chapter begins with an agenda so that everyone knows upfront what to expect from the session. Homework assignments close out each chapter and “are a central part of the training course, because consistent practice is the tried and true way to learn new skills.” Awareness exercises and imagery exercises are presented throughout to help the patient effectively use what they are learning. Whereas the majority of the book speaks directly to the individual, the last part focuses on group trainers and contains the necessary information and guidance for assembling and conducting these skills-training groups.
Coping with Trauma-Related Dissociation is almost certainly not the kind of book a casual reader would pick up at the bookstore or library, but may do so out of curiosity nonetheless. Being neither a patient nor a therapist, it is with some hesitation that I attempt to conclude whether or not Coping with Trauma-Related Dissociation hits its intended mark. With that being said, it is from the perspective of an interested reader only that the following observations are offered, based on the knowledge gained about the disorder by reading this book.
For someone with dissociative identity disorder, having to essentially assume the role of referee with “all the different aspects of personality” on a daily basis would seem to be emotionally demanding. Add to that the tasks of reading this book and completing the in-depth homework assignments, the emotional demand could be stressful and overwhelming if it were not for the consistent manner in which the authors convey their message with thoughtfulness and understanding. More importantly, they are very careful to not be graphic about any references to trauma included and thereby demonstrate concern for the reader’s fragility by avoiding potential triggers. “Be patient with yourself and all parts of yourself” seems to be the underlying skill that is woven into the fabric of the training so that healing can progress. It is difficult to even begin to imagine how demanding it must be to get all the parts to practice patience and work in concert with each other in helping to heal the whole person.
For the therapist who elects to become one of the group leaders of a skills-training course, or chooses instead to use this book in treating a patient, they may be further educated in responding to these individuals in a different manner. It is a book worthy of their time, whether or not they use it in its entirety, as they may discover an opportunity to modify aspects of their current therapeutic approach by incorporating something from its pages they feel holds promise.
My conclusion is that if skills-training groups start sprouting up and the participants embarking on the journey together find its content important and mutually beneficial then, yes, the authors’ mission has been accomplished.
Coping with Trauma-Related Dissociation – Skills Training for Patients and Therapists
By Suzette Boon, Kathy Steele, Onno van der Hart
W. W. Norton & Company: March 28, 2011
Paperback, 496 pages