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Encompassing the contributions of expert clinicians and researchers in the area of traumatic stress and dissociation, this volume is the first to integrate current neuroscience research regarding traumatic dissociation with several cutting-edge approaches to treatment, providing a comprehensive, neurobiologically based treatment approach.
The text discusses current neuroscientific research regarding traumatic stress and dissociation that includes attachment, affective neuroscience, polyvagal theory, structural dissociation, and information processing theory, yielding a comprehensive model that guides treatment and clinical interventions for traumatic dissociation. It then integrates this model with stage-oriented treatment and current therapeutic interventions, including EMDR, somatic and body psychotherapy approaches, Ego State Therapy, and adjunctive pharmacological interventions. Readers are given hands-on practical guidance regarding clinical decision making, enabling them to make sound choices about interventions that will facilitate optimal treatment outcomes.
Key Features:
- Provides a broad-based treatment approach to traumatic stress syndromes and dissociation
- Offers accessible current research in the basic neurosciences relevant to our understanding of attachment, traumatic stress, and dissociation
- Includes practical suggestions for integrating EMDR, somatic, and body psychotherapy approaches with Ego State Therapy and adjunctive pharmacological interventions
- Integrates concepts from the affective and cognitive neurosciences and the study of consciousness
- Presents a comprehensive neurobiological model that accounts for the therapeutic effects of both somatic therapies and EMDR, as well as adjunctive pharmacological interventions
Contributors ix
Foreword by Jaak Panskepp, PhD xi
Preface xv
Introduction: The Ubiquity of Dissociation by Sandra L. Paulsen and Ulrich F. Lanius xix
PART I. NEUROBIOLOGY
Introduction: Dissociation and Neurobiology 1
Ulrich F. Lanius
1. Dissociation: Cortical Deafferentation and the Loss of Self 5
Ulrich F. Lanius, Sandra L. Paulsen, and Frank M. Corrigan
2. Threat and Safety: The Neurobiology of Active and Passive Defense Responses 29
Frank M. Corrigan
3. Peritraumatic Dissociation and Tonic Immobility: Clinical Findings 51
Michelle J. Bovin, Elise Ratchford, and Brian P. Marx
4. A Social–Cognitive–Neuroscience Approach to PTSD: Clinical and Research
Perspectives 69
Ruth Lanius, Paul Frewen, Anthony Nazarov, and Margaret C. McKinnon
5. Dissociation and Endogenous Opioids: A Foundational Role 81
Ulrich F. Lanius
6. Attachment, Neuropeptides, and Autonomic Regulation:
A Vagal Shift Hypothesis 105
Ulrich F. Lanius
7. Defense Responses: Frozen, Suppressed, Truncated, Obstructed, and
Malfunctioning 131
Frank M. Corrigan
8. The Clinical Sequelae of Dysfunctional Defense Responses: Dissociative Amnesia,
Pain and Somatization, Emotional Motor Memory, and Interoceptive Loops 153
Frank M. Corrigan
9. Shame and the Vestigial Midbrain Urge to Withdraw 173
Frank M. Corrigan
10. Attachment and Attachment Repair 193
Frank M. Corrigan, Alistair Wilson, and Deirdre Fay
11. Dissociation, EMDR, and Adaptive Information Processing: The Role of Sensory
Stimulation and Sensory Awareness 213
Ulrich F. Lanius and Uri Bergmann
PART II. TREATMENT
Introduction: Dissociation and Psychotherapy 243
Sandra L. Paulsen and Ulrich F. Lanius
12. Seeing That Which Is Hidden: Identifying and Working
With Dissociative Symptoms 247
Sandra L. Paulsen and Ulrich F. Lanius
13. The Compassionate Self 269
Frank M. Corrigan, Alistair Wilson, and Deirdre Fay
14. Stabilization Basics 289
Sandra L. Paulsen and Joan Golston
15. Stabilizing the Relationship Among Self-States 321
Sandra L. Paulsen and Joan Golston
16. Alexithymia, Affective Dysregulation, and the Imaginal: Resetting the Subcortical
Affective Circuits 341
Sandra L. Paulsen, Katie O’Shea, and Ulrich F. Lanius
17. Fractionating Trauma Processing: TOTEMSPOTS and Other
Attenuating Tactics 367
Sandra L. Paulsen and Ulrich F. Lanius
vi Contents
18. Accelerating and Decelerating Access to Self-States 383
Sandra L. Paulsen
19. Integrating Body and Mind: Sensorimotor Psychotherapy and Treatment of
Dissociation, Defense, and Dysregulation 399
Pat Ogden and Janina Fisher
20. Temporal Integration of Early Trauma and Neglect 423
Sandra L. Paulsen
21. Toward an Embodied Self: EMDR and Somatic Interventions 447
Ulrich F. Lanius and Sandra L. Paulsen
22. Opioid Antagonists and Dissociation: Adjunctive
Pharmacological Interventions 471
Ulrich F. Lanius and Frank M. Corrigan
Index 499