Rebuilding Shattered Lives: Treating Complex PTSD and Dissociative Disorders

Rebuilding Shattered Lives: Treating Complex PTSD and Dissociative Disorders

James A. Chu

Language: English

Pages: 384

ISBN: 0470768746

Format: PDF / Kindle (mobi) / ePub

Praise for Rebuilding Shattered Lives, Second Edition

"In this new edition of Rebuilding Shattered Lives, Dr. Chu distills the wisdom he has gained from many years spent building and directing an extraordinary therapeutic community in a major teaching hospital. Both beginners and experienced clinicians will benefit from this book's unfailing clarity, balance, and pragmatism. An invaluable resource."—Judith L. Herman, MD, Director of Training for the Victims of Violence Program, Cambridge Health Alliance, Cambridge, MA

"The need for this work is immense, as is the reward. Thank you, Dr. Chu, for continuing to share your sustaining insight and wisdom in this updated edition."— Christine A. Courtois, founder and principal, Christine A. Courtois PhD & Associates, PLC, Washington, DC; author of Healing the Incest Wound: Adult Survivors in Therapy and Recollections of Sexual Abuse

Praise for the first edition:

"Dr. James Chu charts a deliberate and thoughtful approach to the treatment of severely traumatized patients. Written in a straightforward style and richly illustrated with clinical vignettes, Rebuilding Shattered Lives is filled with practical advice on therapeutic technique and clinical management. This is a reassuring book that moves beyond the confusion and controversies to address the critical underlying issues and integrate traditional psychotherapy with more recent understanding of the effects of trauma and pathological dissociation." —Frank W. Putnam, MD

A fully revised, proven approach to the assessment andtreatment of post-traumatic and dissociative disorders—reflecting treatment advances since 1998

Rebuilding Shattered Lives presents valuable insights into the rebuilding of adult psyches shattered in childhood, drawing on the author's extensive research and clinical experience specializing in treating survivors of severe abuse.

The new edition includes:

  • Developments in the treatment of complex PTSD

  • More on neurobiology, crisis management, and psychopharmacology for trauma-related disorders

  • Examination of early attachment relationships and their impact on overall development

  • The impact of disorganized attachment on a child's vulnerability to various forms of victimization

  • An update on the management of special issues

This is an essential guide for every therapist working with clients who have suffered severe trauma.

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intense form of “staff splitting” (Braun, 1993; Putnam, 1989; Steinmeyer, 1991). Some staff will be viewed as hostile and abusive, whereas others will be seen as nurturing and understanding. This problem is sometimes aggravated by the tendency of staff to have markedly differing views of patients with DID (Kluft, 1991a). Some staff may view the diagnosis skeptically, whereas others may be overly accepting of patients’ difficulties in controlling switching and maintaining control. The initial

through contact with many other members of the hospital staff, especially nursing staff. Ongoing contact with outside treaters should be encouraged as practical and appropriate, and the community therapist should be involved as much as possible as part of the inpatient treatment team. Often, covert problems in the ongoing therapy become apparent during an inpatient hospitalization. For example, if a patient consistently appears destabilized following sessions with the outside therapist, it can

(e.g., film and television portrayals of DID), and broader sociocultural expectations regarding the presumed clinical features of DID. For example, some proponents of the sociocognitive model believe that the release of the book and film Sybil in the 1970s played a substantial role in shaping conceptions of DID in the minds of the general public and psychotherapists. (Lilienfeld & Lynn, 2003, p. 117) From my perspective, I find most of these assertions absurd. I have made the definitive

self-destructive thoughts and behaviors (related to PTSD and borderline personality). If the symptomatology is truly trauma-related, patients will not optimally respond to treatments for major depression such as antidepressant medication. In our study comparing patients with childhood trauma to nontraumatized patients with major depression (Chu, Dill, & Murphy, 2000), both groups met DSM-III criteria for major depressive disorder and had many classic neurovegetative signs and symptoms of

best efforts to feel otherwise, these conscientious young residents resented being regarded as insensitive and uncaring, and they responded with automatic distance and dislike, thus completing the relational reenactment of emotional abuse and neglect. It was only after I asked the residents to consider what may have made the patients relate in this dysfunctional way that they realized that the patients’ fundamental assumptions differed from their own. As high achievers, most residents grow up

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