Rhonda Sabo, PsyD
Excerpted from the May, 2006 NESTTD Newsletter
Dear Friends and Colleagues,
As I finally sat down to type this last letter to you following days of ingenious procrastination, I of course had to check my E-mail first. After perusing the two ISSD list serves, DISSOC and ISSDWORLD, and surfing the web for a few more days, I am at last ready to write this. And I came across some interesting news.
While going through my list serve messages, I happened to learn that the story of Sybil is being remade this year for television—30 years after the original came out. “Well what is so interesting about that”? you might ask, assuming that like yourself and your colleagues in NESTTD, few working Americans have time to watch television. Maybe, but the publicity surrounding the release of the new film could generate a resurgence in media interest in the diagnosis of DID. I wonder if the controversy around dissociative disorders will begin again, with a clamor of media voices pronouncing dissociation to be a North American fad.
Searching online I decided to check out the False Memory Syndrome Foundation Web site. I did note
that a letter has been written to CBS (you can read it at www.fmsfonline.org/currentnewsletter.html), stating that DID does exist, but that it is a “consequence of the interaction between patient and a source of suggestion, usually a therapist.” The author also suggests that “in the absence of outside influence, it can be caused by autosuggestion, a very rare phenomenon.” The author of the FMSF letter urges CBS to get involved in expanding the story, perhaps with an epilogue. The letter states, “The notion that Sybil suffered from multiple personality disorder was a hoax that caused incalculable suffering for psychiatric patients and their families. CBS is in a position to ameliorate some of that harm and to prevent yet another epidemic of irrational malpractice” and “To remake Sybil without including this full story will make CBS look foolish, or even worse, put CBS in the position of perpetuating this bizarre and harmful hoax”.1 Perhaps this is a time for experienced researchers and clinicians in the fields of dissociation and traumatology to resume sending scientifically informed letters to media outlets such as CBS.
Whether or not a television movie returns us to the days when accusation and hype followed this field, it is always reassuring to know that dissociation theorists actively continue their healthy scientific discussion. I am looking forward to reading John Briere and Catherine Scott’s Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment, (Sage). Another book coming out in the fall by Onno van der Hart, Ellert Nijenhuis and Kathy Steele is called The Haunted Self: Chronic Traumatization and Structured Dissociation of the Personality (Norton). When John Briere was here presenting at our spring meeting, I noted with great interest the divergent views expressed by him and Nijenhuis and Steele (two former NESTTD presenters) related to somatoform dissociation, structural dissociation and a number of other topics. Listening to Briere discuss his research and clinical experience and his understanding of the scientific literature, I find myself encouraged by the diversity of viewpoints that exist within the trauma and dissociation fields today. And I am pleased that NESTTD supports the expression of different points of view within our field.
Speaking of theory, another plug: I have been enjoying Elizabeth Howell’s just published book The Dissociative Mind very much indeed! (Although if you don’t abide psychoanalytic language you may want to leaf through it first.) The book seriously addresses the subject that will be the theme of next November’s ISSD Conference: The Relationship Between Dissociative Processes and Other Mental Disorders.
At such a time it is also helpful to remember that careful epidemiological research on dissociation continues. For example, in the coming months a study by Vedat Sar and colleagues will come out in Psychiatry Research. His group looked at the general population of women in Istanbul, Turkey and found a 1.1% prevalence rate of DID (a number consistent with other research) and a high 8.3% DDNOS.2 And for those of us interested in Hispanic populations in the U.S., there is an article in the April 2006 issue of the American Journal of Psychiatry.3 The authors looked at the prevalence of DD’s in low-income, inner-city, largely Hispanic outpatients. This article is particularly timely, given the fact that interest in Latin American immigration is currently at the forefront of political discourse in the US.
And while the myth of dissociation as a “North American fad” continues despite the continuing epidemiological studies examining a range of countries and cultures, I would like to share a very positive experience with you. As you may know, Israel’s professional community has been studying and treating PTSD for some time now. However, interest in dissociation has been much slower to arrive in that country. But, this past January when I visited Israel, I was invited to meet with Eli Somer, Ph.D., the president of ISSD, who lives in Haifa and a group of Israeli professionals from around the country who are treating dissociation there. That group is working to create an active component society of ISSD in Israel and was interested in hearing about some of our experiences starting and developing NESTTD. It was a delight to establish connections with the Israeli group, and I am confident that they will last into the future.
I don’t want to neglect to mention that the study of dissociation continues in other areas of the Middle East besides Turkey (cited above) and Israel. For example, this past November, I was surprised to see a research team from the Shiraz University of Medical Sciences in Iran!4 And I understand that some training on dissociation is taking place in Iran this month.
Just a reminder: As we continue to work with dissociative clients in a contentious environment, it is always important to think about guidelines for sound and ethical practice. A wonderful Internet resource on these topics is the Web site of Kenneth Pope, Ph.D. at www.kspope.com. Ken is a former presenter at NESTTD who took us all through some group discussions of ethical dilemmas at one of our meetings. His Web site contains a wealth of articles that cover a very wide range of questions about clinical practice that therapists are sometimes reluctant to ask. The populations that we treat can be so complex and difficult. I think we may too often ignore risk management questions out of fear that the answers might increase our anxiety along with our knowledge. But Ken’s Web site is so rich, and the articles so helpful, that you will not regret spending time there.
Finally a few last Thank You notes: In our earlier newsletter this year we forgot to mention that at the November 2005 International Society for the Study of Dissociation Conference our own Jim Chu received the President’s Award of Distinction for outstanding service to the Society. Jim, thanks for your years of continued contribution to the field.
Norah and I also want to express our appreciation to those individuals who are leaving the NESTTD Board this summer: Members-at-Large Joan Atkinson and Rina Dubin and Treasurer Suzanne Hoffman. We are much indebted to each of them for their years of devoted service to this organization. I also want to express my appreciation for those who are leaving the Program Committee, similarly after many years of service: Laurie Brown, Debbie Korn and Nancy Reimer. The creativity and skill that you have brought to your work on this committee have been awesome. And I would like to especially thank Girvani Leerer, our outgoing program chairperson who, with unrivaled organizational skill, has given us five years of excellence in programming.
Happy spring to all, best wishes and thanks,
Yours truly,
NESTTD Co-President
1. Quotes from: Freyd, P. Letter from FMSF to CBS, 1/30/05. In FMS Foundation Newsletter, March/April 2006, Vol. 15, No. 2
2. Sar, V., Gamze, A., & Dogan, O. Prevalence of dissociative disorders among women in the general population. (In press). (Available online at www.sciencedirect.com)
3. Foote, B., Smolin, Y., Kaplan, M., Legatt, M.E., & Lipschitz, D. (2006). Prevalence of dissociative disorders in psychiatric outpatients. American Journal of Psychiatry, 163:623-629.
4. Kianpoor, M., Firoozabadi, A., Ommizadeh, S., Bahredar, M. Comparing the level of dissociative experience in prisoners with substance use disorder and other prisoners in Shiraz. Paper presented at the 22nd ISSD International Fall Conference, Toronto, Ontario, Nov. 2005.