Book review: Coping with trauma-related dissociation - Teaching ideas and skills for us all

By: Tom Cloyd - 6 min. read; reviewed: 2024-06-09:1725 Pacific Time (USA))

book cover

Boon, S., Steele, K., & van der Hart, O. (2011). Coping with trauma-related dissociation: Skills training for patients and their therapists. W. W. Norton 496 pages, $39.99 paperback - Amazon.

Unique in its usefulness, compassion, and authoritativeness, this book should be in the hands of anyone dealing with the symptoms of dissociation - their own or those of others they care about. This recommendation includes both mental health professionals and non-professionals.

The three authors are well-known and highly respected in the international dissociative disorders treatment community. Each has at least three decades of professional experience in the field, and have authored significant journal articles and books as well.

The purpose of this review is to introduce this book and invite the reader to take it with the utmost seriousness. Encompassing eight parts, 35 chapters, and close to 500 pages, with four appendices and a comprehensive index, it is in every way comprehensive. Of equal importance, its content is accessible and immediately useful.

The comprehensive skills explained and taught in the book are the product primarily of clinical experience, as research on effective interventions with dissociative disorders was at the time of the writing of this book 10 years ago modest at best. Since that time, quality research on the treatment of dissociation and dissociative disorders has been published, but to my best knowledge only supports what is laid out in this book.

In the book’s preface, we are cautioned to be aware of the difference between coping and treatment. This book is not a substitute for competent professional treatment. At the same time, there’s no question that learning better to manage dissociative symptoms can give one considerable hope for the benefits of such competent treatment.

On the first page of the first chapter, we are immediately invited into a well-described exercise in becoming present-oriented. Such a “grounding” exercise is basic, in the treatment of dissociation, and in my experience in using this sort of exercise in clinical practice it benefits virtually everyone, whether dissociative symptoms are a problem in their life or not. Following this engaging exercise are five well-written pages describing dissociation, dissociative experiences, and the normal development of a sense of self and how trauma-related dissociation dirupts this normal development.

Of great interest is the fact that the concept of personality parts is also introduced in this early section of the book. This is idea is essential to dealing with dissociative disorders, but the unfortunate fact is that this concept is largely excluded from the thinking of most professional therapists - a major reason why so many people with trauma-related dissociation report dismal experiences with psychotherapy. The idea that personality is modular is nevertheless remarkably useful to all of us, once understood.

Each chapter begins with a brief agenda outline, reflecting the fact that this manual grew out of an extended effort to train groups of people to better manage their symptoms. The last part of the manual, part 8, is devoted to advice for group skills trainers, but the skill-training content of the book is entirely usable by individuals, who can selectively pick what they need.

I want strongly to stress the value of this book for family members of dissociative Individuals, because its description of the inner life and experience of such individuals is quite remarkable. I have not elsewhere encountered anything equal to the detailed comprehensiveness and accuracy of what is described here.

While parts of the book reflect the deep technical knowledge and expertise of the authors, and may require some internet searching by readers to understand all that’s being said, for the most part the content is directly accessible to without having prior knowledge of dissociation.

Part two: After having initially contrasted groundedness with dissociation, the authors take up the problem of inner experience, the fears that people have of being aware of what’s going on inside them, and how to begin developing a sense of safety. These topics are an essential foundation for all that follows.

Part three: Continuing their focus on basic strength building, the author’s next take up sleep, daily structure, relaxation, physical self-care, and healthy eating habits. The thoroughness of their coverage is indicated by the fact that at this point we are 150 pages into the book.

Part four: Understanding and coping with trauma memories and triggers is the next big concern addressed. The problem of anticipating and dealing with challenging situations is also specifically addressed. As is true of all chapters in the book, each of the three chapters in this part has homework sheets that may be duplicated and filled out by readers or group participants. It has been observed that in many areas of life you get what you pay for, and this is most certainly correct relative to learning to deal with dissociative symptoms. This homework is not just useful - it’s essential.

Part five: At this point in the training process, an individual should have coping skills sufficient to allow a more detailed examination of their inner life than has ever before been possible. In part 5 is taken up the problem of challenging emotions, beliefs, and cognitive errors. This is a large array of topics, with a vocabulary that will need some attention, but the potential payoff is quite large.

Part six: Advanced and valuable skills in dealing with especially problematic feelings and needs are taken up in six chapters of this part. Anger, fear, and shame and guilt each get a chapter. As in all other parts of the book, I expect that most readers will find great value in this content, for themselves and everyone they know. Dealing specifically and constructively with destructive emotions is not a subject that is given much attention anywhere in society, in spite of the fact that such symptons are commonly encountered, if not commonly recognized.

The final three chapters of this part are devoted to topics of particular Importance to dissociative disorders: coping with the needs of inner child parts with self-harm, and promoting inner cooperation so that decision-making and general behavior is more constructive.

Part seven: We are social animals, and healthy people connect with others in constructive ways. Learning how to do this is the topic of this part’s five chapters. Every subject here is critically important - attachment, and loss, and relational conflict - who doesn’t need to work on these? And then are considered the problems of isolation and loneliness. Final chapters on assertion and personal boundaries conclude this part. Precisely because these are topics relating to healthy living, the content here has been benefits for anyone.

Focused, explicitly detailed skill-building instructions, accompanied by homework worksheets, all wrapped in a deep and compassionate understanding of the challenges of living with the dissociative symptoms of unresolved trauma memories - this is what this superb book offers. It all but shouts “We can do something about those problems!” to the many people who cannot find or afford an experienced, knowledgeable trauma therapist, to those who are workng with such a therapist and want to augment their therapy work, and to those who want to help others with dissociative symptoms.

For a fraction of the cost of a single therapy session, this book offers hours of productive activity, all of which will work to calm emotionally flooded, over-active, and fearful parts of personality. To the most mature, experienced, and well-grounded parts of anyone’s personality system, it offers a wealth of skills which have application well beyond a focus on dissociative symptoms.

 

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