vol. 1, num. 1, 2003

Dissociative Phenomena. Questions and Answers.

Editors: Mario Di Fiorino and Maria Luisa Figueira

Basic steps to (re)-gain control in patients with a history of trauma, dissociation, and/or impulse dyscontrol problems

Summary. In this chapter we describe the basic steps in the treatment of patients with a history of trauma and the presence of dissociative symptoms. In the beginning phase, many patients have lost control over their lives and they often show many impulsive and self-destructive behaviours. When they are seeking help, many patients are convinced to be out of control, especially when they have been traumatised and/or show the tendency to dissociate. But a basic treatment goal will be to reach sufficient ”internal control” over what they do, think and feel. We continuously give the message that, from the moment the therapy starts, they must accept to take responsibility for their behaviour. We stress that, notwithstanding their bad experiences in the past, they can take their lives in their own hands and make their own positive choices. Of course, a basic condition for this learning process in any therapy will be the establishment of trustful and safe relationship. Especially in traumatised patients, safety and trust in the therapeutic relationship are the cornerstones of the treatment
In the following chapter we want to focus on those therapeutic actions which can help these patients to deal more effectively with the aftermath of trauma, the dissociative episodes and the maladaptive behaviours that disrupt their lives.

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