Am J Psychiatry 1996; 153:103-110
Copyright © 1996 by American Psychiatric Association
Treating the traumatic memories of patients with dissociative identity disorder
RP Kluft
Dissociative Disorders Program, Institute of Pennsylvania Hospital, Philadelphia, USA.
OBJECTIVE: The author uses clinical experience informed by research
findings to suggest approaches to the treatment of the traumatic memories
of patients with dissociative identity disorder. METHOD: Recent findings in
the treatment of patients with this disorder and current considerations
with regard to memories of childhood trauma are used to develop recommended
approaches. RESULTS: Treatment of traumatic memories appears crucial in the
recovery of patients with dissociative identity disorder, even though the
reported memories may not be historically accurate. Criteria are available
for determining whether a patient with the disorder is able to undertake
such efforts, and methods such as fractionated abreaction have been
developed to make the process less unsettling. CONCLUSIONS: Despite the
difficulties posed by the vulnerability of patients with dissociative
identity disorder to decompensation when working with traumatic material
and the vicissitudes of autobiographical memory, modern therapeutic
approaches allow the processing of such patients' traumatic material in a
manner that reduces the likelihood of disruptive events and the misuse of
recovered material.
