Dr. Lowenstein provided a comprehensive review of psychogenic amnesia and fugue, noting the frequent association of these disorders with sudden trauma. Dr. Steinberg observed that depersonalization disorder is an unusual dissociative symptom in that it co-occurs with a wide variety of other disorders, including anxiety and somatoform disorders. Dr. Kluft provided a concise and clea4r overview of the diagnosis and treatment of multiple personality disorder, emphasizing the structure necessary for effective psychotherapy, including recognition of transference problems elicited by early life trauma and the use of hypnosis. Dr. Nemiah provided a cogent argument for a reconciliation between the estranged conversion and dissociative disorders. In my chapter I reviewed the evidence linking trauma and dissociation.
Dissociation is an intrinsically interesting phenomenon.
It seems to occur during experiences of physical trauma and to persist afterward, allowing individuals to ward off memories of abuse or trauma and the associated painful affects, but at the price of a sense of fragmentation, an inability to integrate and control memories, and a sense of demoralization. It is a disorder in which the part becomes the whole. The extremity of self as viewed during trauma comes to seem to be the real truth about a person, making for sudden and dizzying shifts in self-appraisal and mood. There are a variety of techniques, ranging from hypnosis to other kinds of psychotherapy that are clearly effective in helping patients manage dissociative disorders. Indeed, this is one of the hopeful areas in the domain of psychotherapy.