Psychological dissociation, psychotherapy, and pathways to recovery: Survivor narratives and theoretical perspectives

Deborah Spermon (2011). Psychological dissociation, psychotherapy, and pathways to recovery: Survivor narratives and theoretical perspectives PhD Thesis, School of Social Work and Human Services, The University of Queensland.

       
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Author Deborah Spermon
Thesis Title Psychological dissociation, psychotherapy, and pathways to recovery: Survivor narratives and theoretical perspectives
School, Centre or Institute School of Social Work and Human Services
Institution The University of Queensland
Publication date 2011-11
Thesis type PhD Thesis
Supervisor Dr Paul Gibney
Dr Yvonne Darlington
Total pages 219
Total colour pages 9
Total black and white pages 210
Language eng
Subjects 16 Studies in Human Society
Abstract/Summary Objective: This study is an exploration of the experience of recovery for those with histories of severe developmental trauma with resulting chronic dissociative symptoms in adulthood. Its aim is to build a greater knowledge base of patient-centred data in an area where little is published. The importance of this phenomenon resides both in the degree of suffering for those who have not recovered, and in the sheer numbers of people affected. Research into what constitutes recovery, given in first-hand reports, will aid the efforts of those who attempt to provide treatment, as well as those who fund and regulate these efforts. This study investigates the nature and significance of recovery for patients and compares descriptions to those that experts report in the literature. Employing an epistemology that privileges a patient phenomenological perspective, the focus of this research was on the meanings and experiences of recovery at three levels of description. These were: first, themes derived from patient interviews and theorist-practitioner publications; second, constructs of two recovery models based on those themes; and finally the construction of a meta-model based on the interaction of the two recovery models. Method: Two sources of information were used in this study. The first comprised of interviews with seven participants with backgrounds of severe childhood abuse, chronic dissociative symptomatology, and with experiences of significant recovery. Based on these direct reports of recovery experience and knowledge, an ongoing circular process was included with both inductive and deductive methods of phenomenological enquiry. This data set was contrasted with a less-developed analysis of selected publications from four eminent professional theorist-practitioners in the area. The purpose of this contrast was to return the recovery concept to the dialectic within therapeutic interactions. The data for participants and for theorist-practitioners was separately, but similarly, developed until the final stage of analysis. Two broad levels of analysis were applied to each data set. The first level of analysis consisted of data transcription, and then coding within and across individual’s accounts. Sub-themes and themes, increasingly characterized by less specificity and greater conceptual power, were grouped under the four Aristotelian enquiry classifications. These enquiries consisted of: precipitants of entry into the recovery process (causa efficiens); mechanisms or activities included in recovery experience (causa materialis); forms and patterns of recovery experience (causa formalis); and its intended outcomes (causa finalis). Descriptions based on these four enquiry areas are understood to provide a comprehensive depiction of the phenomena being investigated. The second broad level of analysis consolidated themes into larger constructs within two models of recovery, one relating to participant data and the other to theorist-practitioner information. These models allowed a more concise understanding of the elements of recovery, and also incorporated relationships between them. Finally, a “meta-model” was proposed that described dimensions of dynamic interactions between the two models. Results: Diversity and commonality existed within and between sources. Unity in participants’ narratives included constructs of: self-discovery/formation; separation-connection boundaries; dilemmas of choice; managing issues of affect overwhelm; and the incorporation of the therapist into an internal operation. Theorist-practitioner constructs included: theorized aetiologies; workplace processes; engaging in a shared experience and moving between the unique and the universal. Professional perspectives had similarities with participant narratives in terms of the shared space of the therapeutic relationship. However, there were substantial differences between participant and theorist-practitioner perceptions and descriptions varied. The former is characterized by ontological experiences of the reality of “being”, and the ability to inhabit experiences more fully was valued. Theorist-practitioners took a more epistemological stance where reflection, knowledge and an organized system of response were highlighted. The dynamics of the work space processes (for example, interactional boundaries and progress patterns) were a greater focus for therapists than for participants who concentrated more on content areas (for example, particular events and specific emotions). Conclusions: Experiences of recovery have different qualities for participants and theorist-practitioners. Both psychological theory and practice benefit from an exploration of “recovery” which encompasses fields larger than their treatment strategies or therapeutic goals. As well, the incorporation of a variety of perspectives from both patient accounts and schools of theory give richness to an understanding of the complex field of dissociation. Parallels of integration (synthesis and differentiation) were noted across the epistemological approach, the methodology, and reports of recovery as given by participants and theorist-practitioners. As such, phenomenology has particular advantages in its application to this population as it provides a template for describing and integrating diversity, and provides data that may then be useful for other, more empirical, styles of enquiry.
Keyword Dissociation
Childhood Trauma
Psychotherapy
Phenomenology
Recovery
Survivor
Additional Notes Colour: p.136-141; 159; 202-203 Landscape: p.57; 196-200

 
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Created: Fri, 18 Nov 2011, 13:33:09 EST by Ms Deborah Spermon on behalf of Library - Information Access Service