About the Book
Dissociative processes have long burdened trauma survivors with the dilemma of longing to feel "real" at the same time as they desperately want to avoid the pain that comes with that healing-a dilemma that often presents particularly acute difficulties for healing professionals. Recent clinical and neurobiological research sheds some light into the dark corners of a mind undergoing persistent dissociation, but its integration into the practice of talking therapy has never, until now, been fully realized.
Intensive Psychotherapy for Persistent Dissociative Processes brings readers into the consultation room, and into the minds of both patient and therapist, like no other work on the treatment of trauma and dissociation. Richard A. Chefetz marries neuroscientific sophistication with a wealth of extended case histories, following patients over several years and offering several verbatim session transcripts. His unpacking of the emotionally impactful experience of psychodynamic talking therapy is masterfully written, clearly accessible, and singularly thorough.
From neurobiological foundations he builds a working understanding of dissociation and its clinical manifestations. Drawing on theories of self-states and their involvement in dissociative experiences, he demonstrates how to identify persistent dissociation and its related psychodynamic processes, including repetition compulsion and enactment. He then guides readers through the beginning stages of a treatment, with particular attention to the psychodynamics of emotion in both patient and therapist.
The second half of the book immerses readers in emotionally challenging clinical processes, offering insight into the neurobiology of fear and depersonalization, as well as case examples detailing struggles with histories of incest, sexual addiction, severe negativity, negative therapeutic reactions, enactment, and object-coercive doubting. The narrative style of Chefetz's casework is nearly novelistic, bringing to life the clinical setting and the struggles in both patient and therapist. The only mystery in this clinical exposition, as it explores several cases over a number of years, is what will happen next.
In the depth of his examples and in continual, self-reflexive analysis of flaws in past treatments, Chefetz is both a generous guide and an expert storyteller. Intensive Psychotherapy for Persistent Dissociative Processes is unique in its ability to place readers in the consultation room of psychodynamic therapy. With an evidence-focused approach based in neurobiology and a bold clinical scope, it will be indispensible to new and experienced therapists alike as they grapple with the most intractable clinical obstacles.
About the Author :
Richard A. Chefetz, MD, is a psychiatrist in private practice in Washington, D.C. He was President of the International Society for the Study of Trauma and Dissociation (2002-3), and is a Distinguished Visiting Lecturer at the William Alanson White Institute of Psychiatry, Psychoanalysis, and Psychology. He is a faculty member at the Washington School of Psychiatry, the Institute of Contemporary Psychotherapy & Psychoanalysis, and the
Washington Center for Psychoanalysis.
Review :
"I am knocked out by [this book]... [B]oth confirming and revelatory. [Rich's] contribution to understanding and treatment of this disorder is enormous, should be widely known, and hopefully have many ripple effects both in research and to clinical practice. Wonderful stuff." -- Pam Stavropoulos, PhD, Member of the Scientific Co "Nothing short of a revelation. I've rarely encountered a psychiatric or psychoanalytic text that so well combines theoretical power with immediate clinical utility." -- Garrett Deckel, MD, PhD, Clinical Assistant Profes "Richard Chefetz, arguably the most astute and sophisticated mind in the field of trauma and dissociation, accompanies his readers on a personal journey into the mind and consulting room of a master clinician, scientist, and educator. This book demonstrates why dissociation is mostly not about dissociate disorders. It is about how a mind struggles to cope with the intolerable and unbearable. As both a traumatologist and a psychodynamic clinician, Chefetz has built a bridge that explores the joint dissociative processes that take place as part of the patient/therapist relationship." -- Philip M. Bromberg, PhD, author, The Shad "A master teacher on dissociative phenomena, Richard Chefetz integrates scientific sophistication with in-the-trenches clinical mastery. His eloquent writing-synthesizing theory and practice, mind and body, left- and right-brain processes, research and application, science and art-exemplifies the healing integration sought by every therapist familiar with dissociative disorders. I recommend it to anyone seriously interested in the treatment of fractured minds and defeated hearts. " -- Nancy McWilliams, PhD, Professor, Rutgers Universi "Dr. Chefetz has written an engaging and reader-friendly introduction to the relational understanding and treatment of dissociative processes. More impressively still, he accomplishes these objectives with the flair of a master storyteller... incredibly useful for any mental health professional beginning to make his or her way into the often complex, overwhelming, and disconcerting study of dissociative processes. I recommend it highly." -- Richard P. Kluft, MD, PhD, authors of She "An indispensable text for the clinician who works with trauma and dissociative disorders... Clinical vignettes provide the reader with an understanding that is 'from the inside out' of the patient's experience and of the interactions of the clinical dyad... a must-read for anyone who feels that they haven't 'gotten' dissociative phenomena." -- Elizabeth Howell, PhD, author of The Diss "With a wonderfully engaging style, Richard Chefetz instructs readers in the art of blending psychodynamic and affect theory with attachment, neurobiology, and trauma-related research in the treatment of severely dissociative patients. Clinicians, get ready to be inspired by the warmth, attunement, and clinical skill demonstrated in this book! " -- Bethany Brand, PhD, Principal Investigator, TOP DD
