Facing Emotional Pain—a Model for Working with People with Intellectual Disabilities and Trauma
This paper summarises over twenty years of work to develop a model and tool for addressing emotional development within the context of attachment relationships. The story charts the process and results, arriving at a useful approach for helping people with intellectual disability and additional emotional disability. The latter follows from trauma and results in the individuals being described as having “complex needs”. This approach works and can allow the individuals helped to live in open environments with supportive, well-trained staff.
“Masochism”, behaviourally defined as the tendency to be abused, hurt, or humiliated by others or oneself, is a highly controversial term. On the one hand the term usefully describes a recognisable problem in living. A term that accurately refers to a recognisable behaviour and provides a useful, experience-near dynamic formulation is a benefit. On the other hand, the term may connote victim-blaming or be used in a victim-blaming way. Unfortunately, the term masochism, has traditionally come with a dynamic formulation that is experience-distant, humiliating to the person to whom it is ascribed, and in my view, simply wrong. In much of the previous literature, a problematic logic has prevailed, according to which what might be called masochistic strategies for living have been viewed solely in motivational terms, involving the imputation of a desire to be abused, hurt, humiliated, or dominated—presumably because these are found pleasurable. This motivational definition of pleasure in pain has led to a diagnostic dismissal of the abuse and suffering of many people who have been harmed in relationships, or who inordinately hurt or punish themselves. When the pattern that has been called masochism is reframed as an outcome of trauma and dissociation rather than of volition, the person's experience is more understandable. This article presents a view of this pattern
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as post-traumatic and dissociation-based, emerging from attachment need, specifically attachment to the abuser, and dissociation. This interaction is at the heart of the syndrome. Finally, the article describes how masochism contains the seeds of its own transcendence.
This tendency to be abused, hurt, or humiliated by others or oneself can range across different levels and kinds of psychopathology as well as across a dissociative continuum, from “moral”, or superego-driven masochism, in an otherwise relatively well functioning person, to Dissociative Identity Disorder (DID), or Dissociative Disorder Not Otherwise Specified (DDNOS). The pattern can also characterise certain presentations of borderline personality disorder. It is the author's thesis that despite these differences in severity or type of organisation, all of these presentations are dissociation-based. The overriding formulation of this article is meant to apply to these different levels of dissociative processes and structure and is not limited to DID or DDNOS.
Healing Childhood Trauma: Connecting with Present Experience and Body-Based Insights
Survivors of child sexual abuse are often overwhelmed by various residual effects which have the potential to limit their functioning and interfere with their interpersonal relationships. This article is a case presentation describing clinical and theoretical aspects of an integrative relational approach to a therapeutic journey with a survivor of childhood sexual abuse. The clients' needs were prioritised as a need for trust, safety, empowerment, and establishment of a therapeutic window while working within the client's resilience capacity. Our psychotherapy focused on making her unconsciousaffect and physiological experience conscious and attending to her developmental needs for a dependable, consistent and involved relationship.
This is a follow-up article about my work with Vanisha who was diagnosed with schizophrenia when she was in her twenties. She had been put onto heavy medication but had never been offered any other kind of help. She began therapy
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with me when she was in her mid-forties and I wrote this after trying to come to terms with her unexpected death earlier this year.
This article is a speculative reflection on psychotherapy's ubiquitous interest in the representation of foundational experience in image and narrative. In particular, it presents an inquiry into the connections between Gaston Bachelard's phenomenology of the imagination, the narrative framing of Bowlby's attachment theory and the encounter with death experienced in the context of palliative care. Four real life narratives demonstrate the power of strong imagery in holding together the intense experiences of grief, anticipatory grief, and attachment. These narratives lead the reader through each of these connecting ideas, allowing a distinction to be made between the constructed meaning suggested by narrative (often including imagery), and the impact of that image itself (often contextualised within a narrative) before it is reflected on and created as an object of meaning. The author explores both the different and complementary nature of these distinctions using the seminal work of D. W. Winnicott on transitional phenomena and play. One speculative conclusion reached is that the kind of imagery and narrative generated by people encountering death can be understood as a form of brutal play, which allows individuals to negotiate the transitional, liminal experience of grief and anticipatory grief along with the attendant attachment experience evoked therein.
Key words: Image, attachment, death, transition, play
Mind Control in the German Democratic Republic
Irina Vogt (Translated by Winja Lutz)
During my longstanding work as a psychotherapist, time and again I met clients who spoke about mind control experiments in the GDR. I am convinced, also due to my own experiences, that the Stasi conducted a variety of secret experiments on children and adolescents. Children as small as kindergarten experienced severe violence and were ideologically conditioned by means of electric shocks, drugs, abuse, and hypnotic suggestions.
Keywords: State Security of the GDR, mind control, secret experiments with children, medicinal drug testing without consent.
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(2013). Summaries and Keywords. Att: New Dir. in Psychother. Relat. Psychoanal., 7(3):317-319