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Shame and complex traumatisation: attitudes to therapeutic interventions for shame in those with dissociative identity disorder

Dr. Martin Dorahy

Within the clinical setting, shame can manifest as a central self-conscious emotion in the aetiology and maintencance of psychological problems. In chronic manifestations, typically present in dissociative and traumatised clients, shame motivates a range of behaviours designed to protect the sense of self from further psycholgical damage. These include avoidance and withdrawal behaviours. Little is known about immediate clinician responses to shame and their therapeutic utility. This study used an experimental design and investigated 5 potentially therapeutic responses to shame disclosures in mock clients. Given the centrality of shame in the treatment of complex trauma, the aim was to determine how dissociative clients would respond to therapist interventions that ranged from staying with the shame feelings to completely avoiding them. Twenty two participants with dissociative identity disorder and a clinical comparion sample with non-dissociative disorders were asked to rate the effectiveness of each therapeutic response. Participants heard segments of mock therapy sessions where clients either disclosed shame (experimental condition) or shock (control condition). Dissociative participants were hypothesized to rate the avoidance responses as more helpful following the shame disclosures. Results are discussed in terms of managing and treating shame feelings in the therapy of those with chronic and complex traumatisation

WORLD DREAMING: WORLD CONGRESS FOR PSYCHOTHERAPY
24-28 August 2011 Sydney Convention and Exhibition Centre
Darling Harbour, Australia.
Visit The World Council for Psychotherapy at http://www.worldpsyche.org

Martin Dorahy
Martin Dorahy
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Dr. Martin Dorahy

Martin Dorahy, PhD, DClinPsych, is a clinical psychologist and senior lecturer in the Department of Psychology, University of Canterbury. He has a clinical, theoretical and research interest in complex trauma and dissociative disorders, their phenomenology, and cognitive and affective underpinnings. He has published over 60 peer-reviewed journal articles and Co-edited two books in the area of psychotraumatology (Traumatic Dissociation: Neurobiology and Treatment, 2007, American Psychiatric Publishing, Inc; Psychosis, Trauma and Dissociation: Emerging Perspectives on Severe Psychopathology, 2008, Wiley Press). He is Chair of the International Society for the Study of Trauma and Dissociation’s David Caul Graduate Research Award and Co-editor (with Onno van der Hart, PhD) of the European Society for Trauma and Dissociation’s Newsletter. Along with his academic and research work, he maintains a clinical practice focused primarily on the adult sequelae of childhood relational trauma.

Co-authors: Julia Gorgas, Lenaire Seager, Warwick Middleton
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