Synopses & Reviews
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. 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. 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.
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 Committee, ISSTD, Head of Research and Clinical Practice Adults Surviving Child Abuse (ASCA) Sydney Australia
Review
"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 Professor of Psychiatry, The Ichan School of Medicine at Mount Sinai
Review
"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 Shadow of the Tsunami: and the Growth of the Relational Mind
Review
"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.
Review
"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 Shelter from the Storm and Good Shrink/Bad Shrink
Review
"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 Dissociative Mind and Understanding and Treating Dissociative Identity Disorder
Review
"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!
Review
"Brilliant and amazing. I think of metaphors as part of the language of poetry. That makes Chefetz a marvelous poet. He has found countless ways of describing dissociation, and offers so many non-pathologizing descriptors." Farnsworth Lobenstine, LICSW, EMDRIA Approved Consultant, EMDR Institute and EMDR HAP Facilitator
Review
"Avoiding the density of a traditional textbook, takes an intimate look at the techniques that the author incorporates within his own practice. It couples this with a presentation style accessible for professional readership of diverse experience and methodology. . . . [A] highly illuminative book for how treatment for dissociative processes is unique . . . . For those therapists who are currently or expecting to encounter these processes in their work, the book is an expansive resource." Somatic Psychotherapy Today
Review
"Chefetz shows by example that we can reach beyond the limits of these disabling disorders. . . . It is clear from case illustrations that Chefetz has a special talent for working with complex conditions, as well guiding less experienced clinicians. Reading this book, I felt the comfort of talking with a mentor about my own difficult or confusing cases. . . . Few resources on this topic rival this well-written book. Without hesitation, I recommend it to all clinicians who work with complex disorders."
Synopsis
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.
Synopsis
What really happens in dissociation.
Synopsis
This book maps out a straightforward model of dissociative processes, relying heavily on clinical work and guided by studies on attachment, affect theory, vence, psychoanalysis, and psychotraumatology. It frames dissociative processes in a way that makes them more visible to therapists, and it teaches clinicians how to better understand their significance.
Synopsis
Extensive and detailed casework is the backbone of this meticulous in-the-trenches exploration of dissociative processes and their relation to affect theory, attachment, neurobiology, and an emergent self-state dominated structure of mind. Building upon the theoretical and practical clinical perspectives in the first six chapters, and decidedly psychodynamic in its orientation, illustrations of the adjunctive use of hypnosis, EMDR, and somatic experiencing are woven into the subsequent clinical material. Multi-chapter vignettes and verbatim transcripts show the reader how to work with challenging core issues in treatment of the dissociative disorders: clinical impasse, sexual addiction, negativity, negative therapeutic reaction, object-coercive doubting, and enactment.
Synopsis
Winner of the International Society for the Study of Trauma and Dissociation's (ISSTD) Pierre Janet Writing Award, 2015. What really happens in dissociation.
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