Infusion or Confusion- Psychodynamic Currents in the Treatment of Severe Early Trauma

Contemporary approaches to trauma tend to minimize or even overlook a psychodynamic perspective to treatment. The challenge for the clinician is sensing when such interventions might help or hurt. This chapter illustrates this dilemma by drawing upon the author's experience, both personal and professional, in arriving at some basic principles. The synthesis of his experience on an inpatient dissociative disorders unit with his long-term analytic work in the outpatient setting is a treatment model, Psychoactive Psychotherapy. It is a six stage, transference-based approach, addressing the autohypnotic nature of dissociation as a defense. Integration of the compartmentalized self-states (alters) is facilitated through the delineation of the "mosaic transference" and the therapist's capacity for containment.