Braun B G
Dissociative Disorders Program, Sheridan Road Hospital, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
Psychiatr Clin North Am. 1989 Jun;12(2):307-24.
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.
对患有分离性障碍的乱伦幸存者的治疗可能比其他乱伦幸存者的治疗要困难一些,因为对其他乱伦幸存者来说,相关素材更容易获取。而且患有分离性障碍的患者可能遭受了更严重的虐待,否则就不需要分离性防御机制了。这也使得治疗变得困难,尤其是在最关键的一步:建立信任和融洽关系。尽管存在这些问题,但成功治疗的可能性很大,即通过“此时此地”恰当的视角,将解离的素材带回意识主流。这可以通过正确的诊断、扎实的理论基础以及包括设定适当界限的心理治疗和合理用药的治疗来实现。本文概述了BASK解离模型和另外两种模型,并就如何将这些模型应用于理解分离性障碍的病因及其治疗提出了一些想法。文中使用案例来阐释成功的治疗。虽然对患有分离性障碍的乱伦幸存者的治疗很困难,但可以预期会取得成功,这对患者的回报以及给治疗师带来的满足感都是巨大的。