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SYMPTOMS, SIGNALS, AFFECTS: PSYCHOTHERAPEUTIC TECHNIQUES WITH DISSOCIATIVE PATIENTS PAUL M. GEDO, PH.D* - In this article, I will attempt to develop ideas that I began to consider in an earlier article (Gedo, 2000). I will draw upon my clinical experi ence with archaically organized persons at Chestnut Lodge Hospital, somewhat better organized analysands and therapy patients, and my own dissociative experiences. The earlier article explicated my notion that dissociation and disavowal* could fulfill multiple psychological func tions, in line with W aelder’s notion (1976) o f multiple function. For instance, these vertical splits in consciousness may allow the patient si multaneously to Not Know some painful memory or feeling, and yet also to Know it. Dissociation can ward o ff overwhelming affect while allow ing its repetition on a visceral level (e.g., in a flashback). While such repetitions can be painful or terrifying, they also create some order and predictability and are an attempt at mastery— that is, they are negen- tropic attempts at adaptation. Dissociation may also serve to keep other people at a distance and thus to avoid threatening feelings o f dependency and closeness. At the same time, they leave the person vulnerable and in need
Journal of the American Academy of Psychoanalysis – Guilford Press
Published: Dec 1, 2000
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