The Dissociative Mind
Routledge – 2008 – 328 pages
Drawing on the pioneering work of Janet, Freud, Sullivan, and Fairbairn and making extensive use of recent literature, 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 self-states 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, disorganized attachment, mentalization, 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 of the book examine dissociation in relation to pathological narcissism; the creation and reproduction of gender; and psychopathy.
Elegant in conception, thoughtful in tone, broad and deep in clinical applications, Howell takes the reader from neurophysiology to attachment theory to the clinical remediation of trauma states to the reality of evil. It provides a masterful overview of a literature that extends forward to the writings of Bromberg, Stern, Ryle, and others. The capstone of contemporary understandings of dissociation in relation to development and psychopathology, The Dissociative Mind will be an adventure and an education for its many clinical readers.
"In The Dissociative Mind, Elizabeth Howell seeks to provide a more substantial integration between psychoanalysis and traumatology and provides a superb inquiry into the question of trauma, dissociation, psychopathology, and the theoretical frameworks that guide our conceptual formulations and modes of clinical practice. Sensitive to concurrent work in trauma studies, neuroscience, attachment theory, defense, and personality structure, this book should be digested slowing for its rich and subtle flavors."
- Jon Mills, Ph.D., Psy.D., Psychologist-Psychoanalyst, Winter 2008
"This is a book that makes an important contribution to our understanding of dissociation. It should be read by clinicians and researchers who wish exposure to the complexities of the dissociative mind."
"Howell's excellent and clearly written book covers both aspects of dissociation. Howell makes excellent use of both her emotional sensitivity and her sharp intellect….read it and discover all it has to offer."
- International Journal of Psychoanalysis
"In sum, The Dissociative Mind provides a thorough context for evaluating current dissociation theories. The case descriptions that Howell uses to bring the complex and competing theories to life are true gems. Her book will be of particular interest and benefit to those interested in obtaining an overview of the history of dissociation theory, as well as a description of how dissociation relates to current psychodynamic constructs. As dialogue in the field focuses on the development of integrative models, we anticipate that this book will provide a valued voice that models, drawing on the best the field has to offer to advance dissociation theories."
- Anne P. DePrince, Ph.D., and Kristin M. Weinzierl, M.S., University of Denver, taken from Journal of Trauma and Dissociation, 8.1, 2007
"Elizabeth Howell's book, The Dissociative Mind, is a long overdue addition to both the traumatological and psychoanalytic literature….Dr. Howell's clear voice is taking its rightful place amongst the leading clinician/theoreticians of our time. I look forward to her future work, and I highly recommend this book to you as essential reading."
- Richard Chefetz, M.D., International Society for the Study of Dissociation
"This text weaves together an excellent theoretical synthesis of a full range of psychological and neurobiological theories to examine the complex nature of dissociation. The level of nuanced, scholarly analysis leads me to recommend a readership of practicing psychotherapists and psychoanalysts as well as Ph.D. students in mental health disciplines… it stands as an impressive example of an authoritative, masterful analysis of dissociation."
- Kathryn Basham, Clinical Social Work Journal, 36, 2008
Dissociation: A Model of the Psyche. The Self in Context: Unity and Multiplicity. Pioneers of Psychodynamic Thinking About Dissociation: Janet, Freud, Ferenczi, and Fairbairn. The Interpersonal and Relational Traditions: Sullivan, Bromberg, Davies and Frawley-O'Dea, and Stern. Hybrid Models: Ryle's Multiple Self State Model; Van Der Hart, Nijenhuis, and Steele's Theory of the Structural Dissociation of the Personality; Hilgard's Neodissociation Theory; and Somatoform Dissociation. Attachment Theory and Dissociation. Attachment-Based Dissociation: A Different View of Spliting. Projective Identification: Blind Foresight. Concepts of Psychic Processes, Defense, and Personality Organization. Narcissism: A Relational Aspect of Dissociation. "Good Girls," "Sexy Bad Girls," and Warriors: The Role of Trauma and Dissociation in the Creation and Reproduction of Gender. The Dissociative Underpinnings of Psychopathy: When the Terrible is True, Not Only Are We Not Safe, But, More Important, We Can No Longer Imagine
A psychoanalyst and traumatologist who specializes in the treatment of dissociative disorders, Elizabeth Howell, Ph.D., is Associate Editor of the Journal of Trauma and Dissociation and Co-Director of the Dissociative Disorders Psychotherapy Training Program of the International Society for the Study of Dissociation. Dr. Howell is a faculty member of the National Institute for the Psychotherapies Trauma Studies Program and an adjunct associate professor in the psychology department of New York University. She has written and lectured widely on various aspects of trauma and dissociation.