with Onno van der Hart
Phase-oriented treatment, the standard of care for therapy with patients suffering from complex dissociative disorders, consists of the following phases:
PHASE 1: stabilization, symptom reduction, and skills training;
PHASE 2: treatment of traumatic memories;
PHASE 3: (re)integration and rehabilitation of the personality.
Phase-oriented treatment aims to overcome the many phobias that maintain dissociation and, consequently, non-optimal functioning. It takes the form of a spiral, in which these different phases of treatment may alternate according to the patient’s needs.
Guided by Janetian theory and the concept of structural dissociation of the personality, the overall treatment involves increasing the patient’s integrative capacity and promoting integration—that is, the improvement of mental health.
This workshop highlights the specific goals and methods for achieving them in Phase 2 and Phase 3. Careful preparation for Phase 2 is essential, with as much work as possible devoted to overcoming the phobia of traumatic memories.
As will be explained during the workshop, the emphasis is on two levels of integration of traumatic memories:
• guided synthesis (and related approaches such as EMDR), which involves sharing a traumatic memory among the dissociated parts of the personality, with some of them oriented to the present;
• guided realization, which involves making traumatic memories part of one’s “autobiography,” so that the patient becomes the owner of these memories and recognizes that they refer to past events.
This workshop aims to enable participants to acquire the skills required to address the dominant dimensions at this stage: working with grief; integration of the personality; overcoming phobias of intimacy, change and ordinary life; and developing the necessary skills in these areas.
In general, patients who have achieved stable integration of their personality are better able to cope with the stressors of everyday life. Since Phase 3 work builds extensively on the achievements of the earlier phases of treatment, the workshop will also provide opportunities to focus on selected aspects of the first two phases.
The therapeutic approaches and underlying conceptual frameworks will be discussed in depth, demonstrated, practised through role-plays, and illustrated with video presentations.
