Abstract:In the third day of his life Oedipus suffered a violent murderous assault in which his ankles were pierced so that he could be left to die. In fact, he was not only saved, but brought up as their son by the childless King and Queen of Corinth. My hypothesis is that a severe trauma left a significant physical and psychological scar, which was hidden beneath an illusion of a normal childhood. His background, including the cause of the infirmity of his ankles, remained obscure until it was revealed in the course … Show more
“…However, when there has been significant trauma, there may be a need for adaptations or for greater acknowledgement or emphasis on the reality of the external event, perhaps especially at the start of the therapeutic journey. John Steiner (2018) says:…”
mentioning
confidence: 99%
“…However, when there has been significant trauma, there may be a need for adaptations or for greater acknowledgement or emphasis on the reality of the external event, perhaps especially at the start of the therapeutic journey. John Steiner (2018) says:…we must also recognise that some traumas inflict damage over and beyond the sense of disillusionment and loss of idealisation. The horrendous traumas of physical and sexual abuse leave specific scars behind that create additional damage that we often fail to understand.…”
Using a composite clinical case, this paper describes working with complex trauma, non‐recent child sexual abuse and dissociative identity disorder within an NHS setting. The clinical work of an NHS trauma service is described in both historical and current terms. The case history elucidates the use of specialist group work for non‐recent child sexual abuse and then individual work within a trauma team setting as the diagnosis of dissociative identity disorder comes to light. The recognition of the role of shame in both non‐recent sexual abuse and dissociative identity disorder presentations serves to highlight the countertransference experiences of disbelief or inauthenticity. This is linked to the history in psychoanalysis of the shift away from external realities of abuse and to its exploration of the concept of dissociation. The question of acknowledging and attending to the reality of abuse continues to be an issue within many aspects of British psychotherapy and psychoanalysis and has perhaps added to the disbelief that the diagnosis of dissociative identity disorder often seems to engender. The consideration of setting in relation to the NHS and limitations on lengths of treatment is also addressed for these complex patients.
“…However, when there has been significant trauma, there may be a need for adaptations or for greater acknowledgement or emphasis on the reality of the external event, perhaps especially at the start of the therapeutic journey. John Steiner (2018) says:…”
mentioning
confidence: 99%
“…However, when there has been significant trauma, there may be a need for adaptations or for greater acknowledgement or emphasis on the reality of the external event, perhaps especially at the start of the therapeutic journey. John Steiner (2018) says:…we must also recognise that some traumas inflict damage over and beyond the sense of disillusionment and loss of idealisation. The horrendous traumas of physical and sexual abuse leave specific scars behind that create additional damage that we often fail to understand.…”
Using a composite clinical case, this paper describes working with complex trauma, non‐recent child sexual abuse and dissociative identity disorder within an NHS setting. The clinical work of an NHS trauma service is described in both historical and current terms. The case history elucidates the use of specialist group work for non‐recent child sexual abuse and then individual work within a trauma team setting as the diagnosis of dissociative identity disorder comes to light. The recognition of the role of shame in both non‐recent sexual abuse and dissociative identity disorder presentations serves to highlight the countertransference experiences of disbelief or inauthenticity. This is linked to the history in psychoanalysis of the shift away from external realities of abuse and to its exploration of the concept of dissociation. The question of acknowledging and attending to the reality of abuse continues to be an issue within many aspects of British psychotherapy and psychoanalysis and has perhaps added to the disbelief that the diagnosis of dissociative identity disorder often seems to engender. The consideration of setting in relation to the NHS and limitations on lengths of treatment is also addressed for these complex patients.
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