Rebuilding Shattered Lives: The Responsible Treatment of Complex Post-Traumatic and Dissociative Disorders

Front Cover
John Wiley & Sons, Apr 30, 1998 - Family & Relationships - 271 pages
Every therapist who has worked with adult survivors of severe child abuse is aware of the perils associated with helping to rebuild an adult psyche shattered in childhood. All too often, in their efforts to identify and go beyond the defenses and compensatory tactics of young victims who elect to numb themselves to the pain of abuse, many bright, well-meaning therapists find themselves hopelessly entangled in therapeutic and interpersonal traps. How, in today's increasingly litigious climate, can therapists be sure that they are pursuing the most rational and effective course of treatment while, at the same time, safeguarding themselves against common professional snares? This book may provide the answer.

In Rebuilding Shattered Lives, James A. Chu, MD, describes a proven approach to the assessment and treatment of post-traumatic and dissociative disorders developed at the Dissociative Disorders and Trauma Program at McLean Hospital and Harvard Medical School. Drawing on his extensive empirical research and more than a decade's clinical experience specializing in treating survivors of severe abuse, Dr. Chu also offers valuable insights into all the major areas of trauma-related symptomatology and provides the most detailed explanation of dissociative theory currently in print. And, with the help of numerous vignettes and case examples, he clearly illustrates common clinical dilemmas encountered when dealing with survivors of severe abuse as well as the most effective techniques for resolving them.

The book opens with an integrated, up-to-date account of trauma theory and symptomatology. Chapters focus on complex dissociative and post-traumatic symptoms, difficulties in development and maturation, amnesia and other traumatic memory problems, and differential diagnosis. In the following section, Dr. Chu outlines his treatment strategies and offers valuable guidelines on managing self-destructive behavior, controlling dissociative and post-traumatic symptomatology, and navigating the maze of the therapeutic relationship. Concluding chapters are devoted to special topics and include a review of the latest treatment strategies for dissociative identity disorder, crisis intervention, and working with regressed and "impossible" patients.

Rebuilding Shattered Lives is an important working resource for mental health workers of all levels of experience. Throughout, the writing style is clear, and complex theories are explained with an emphasis on how they provide the conceptual basis for a rational, responsible, and safe approach to treatment.

"A major contribution to the clinical trauma literature by one of the field's most experienced clinicians." --Christine Courtois, PhD author of Healing the Incest Wound

"Dr. Chu brings calm lucidity to controversies around trauma, integrates recent advances in the field with traditional therapy strengths and provides clinicians with a balanced and sensible phase-oriented treatment approach. Best of all, in this volume he has deepened his area of greatest strength, working with relational challenges faced and posed in therapy by individuals with complex post-traumatic disorders." --Denise J. Gelinas, PhD Harvard Medical School.

"Dr. James Chu charts a deliberate and thoughtful approach to the treatment of severely traumatized patients. Written in a straightforward style and richly illustrated with clinical vignettes, Rebuilding Shattered Lives is filled with practical advice on therapeutic technique and clinical management. This is a reassuring book that moves beyond the confusion and controversies to address the critical underlying issues and integrate traditional psychotherapy with more recent understanding of the effects of trauma and pathological dissociation." --Frank W. Putnam, MD.
 

Contents

Chapter 2
18
Chapter 4
42
Chapter 7
92
Chapter 8
108
Chapter 10
127
Chapter 14
148
HOSPITALIZATION ACUTE CARE AND PSYCHOPHARMACOLOGY
162
Chapter 13
180
CONTROVERSIES IN THE TREATMENT OF DISSOCIATION
195
EPILOGUE
206
REFERENCES
219
AUTHOR INDEX
239
SUBJECT INDEX
245
Copyright

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About the author (1998)

National Institute of Mental Health, Bethesda, MD JAMES A. CHU, MD, is Director of the McLean Hospital Dissociative Disorders and Trauma Program and an Assistant Professor of Psychiatry at Harvard Medical School. He is recognized internationally for his work as a clinician, researcher, and educator specializing in the post-traumatic effects of childhood trauma, and for his pragmatic approach to understanding and treating victims of childhood abuse. His publications in the literature include both basic research on the effects of childhood abuse and discussions concerning the nature and techniques of treatment. Dr. Chu is a Fellow of the American Psychiatric Association, a Fellow and Past President of the International Society for the Study of Dissociation, and a recipient of the Cornelia B. Wilbur Award and distinguished achievement awards for outstanding contributions in the field of dissociative disorders.