Publication date: 22 May 2008
Drawing on the pioneering work of Janet, Freud, Sullivan, and Fairbairn, Elizabeth Howell develops a comprehensive model of the dissociative mind. Dissociation, for her, suffuses everyday life; it is a relationally structured survival strategy that arises out of the mind’s need to allow interaction with frightening but still urgently needed others. For therapists dissociated selfstates are among the everyday fare of clinical work and gain expression in dreams, projective identifications, and enactments. Pathological dissociation, on the other hand, results when the psyche is overwhelmed by trauma and signals the collapse of relationality and an addictive clinging to dissociative solutions.
Howell examines the relationship of segregated models of attachment, disorganised attachment, mentalisation, and defensive exclusion to dissociative processes in general and to particular kinds of dissociative solutions. Enactments are reframed as unconscious procedural ways of being with others that often result in segregated systems of attachment. Clinical phenomena associated with splitting are assigned to a model of ‘attachment-based dissociation’ in which alternating dissociated self-states develop along an axis of relational trauma.
Later chapters examine dissociation in relation to pathological narcissism; the creation and reproduction of gender; and psychopathy.