Narratives of dissociation: insights into the treatment of dissociation in individuals who were sexually abused as children.

This article provides an in-depth understanding of the treatment of dissociation from the perspective of 7 individuals who have a history of childhood sexual abuse and engage in moderate to high levels of dissociative behavior. Levels of dissociation were screened using the Dissociative Experiences Scale (E. Bernstein-Carlson & F. Putnam, 1993), and individual interviews were conducted to gain insight into how dissociation can best be treated in a therapeutic context. From a narrative research design with a holistic-content analysis (A. Lieblich, R. Tuval-Mashiach, & T. Zilber, 1998), 3 major themes and 16 subthemes were revealed. The major themes included (a) identifying specific tools and techniques that were recognized as critical in managing dissociative symptoms, (b) challenging the dominant medical paradigm by underscoring the importance of helping clients contextualize and normalize dissociative behavior, and (c) highlighting specific characteristics of the therapeutic relationship that create the necessary trust and safety to facilitate reparation. A detailed description of the 3 major themes and 16 subthemes is provided. Implications for both clinical theory and practice are identified.