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Product reviews for Understanding Dissociative Disorders
Kathryn Livingston (& Dr Anne) for "Rainbow's End" the newsletter of First Person Plural
Just reading the title of this book I was filled with hope " surely such a guide was long overdue. So many people I know (including myself) with dissociative experiences have been let down and badly re-traumatised because of the lack of knowledge about dissociative disorders among general practitioners and other general health care professionals working in primary & secondary care. I prayed that the book's contents wouldn't dash my hopes.
In fact, I was so reluctant to have my hopes betrayed that I kept putting off reading the book. And one fine way I found to delay writing this review was to loan the book to my own GP (who though not very knowledgeable about dissociation has been willing to listen, believe and learn). I asked her if she could find the time in her busy schedule to read the book and let me know what she thought. After all wasn't she one of those for whom the book had been written " a family physician. She returned the book to me less than a week later with a brief note:-
"I have read the whole book " very interesting " she seems to bring in most psychiatric problems. However, it does add to a GP's average level of knowledge about Dissociative Disorders and lots of other problems we see. Her positive attitude is helpful"
That "most psychiatric problems' and "lots of other problems' really piqued my interest. I have long held the view that an understanding of dissociation would go a long way towards understanding, not just those disorders classified as dissociative, but most psychiatric and many physical problems too. It was looking like Marlene Hunter agreed with me so I began to read.
I was not disappointed.
The book is less than 200 pages long and written in a readable style with short paragraphs, many references to real life situations and advice on how to respond. This all contributes to making it accessible and useful. This is very important, because, with the many conflicting demands in the busy life of the average health care professional, ignorance about dissociative disorders will continue to flourish if basic, immediately practical information to counter that ignorance isn't easily and quickly digestible.
And Dr Anne was right. The book does cover many problems which wouldn't traditionally be thought of as dissociative.
The author includes chronic pain syndromes such as fibromyalgia; other syndromes such as chronic fatigue syndrome, somatisation, irritable bowel, urinary problems. She advises understanding and treating all of these within a dissociative disorder framework. This is a welcome view as so often trauma survivors with inconsistent and confusing physical and neurological symptoms are dismissed as attention-seeking and manipulative.
Appropriately, a whole chapter is devoted to PTSD but also included are very readable sections on depression, borderline personality disorder, suicide & self-harm, alcohol abuse, body-image distortions, eating disorders, sleep disturbances " all of which are commonly found alongside (or misdiagnosed instead of) the traditional dissociative disorders.
Final chapters include information on sexual dysfunction and relationships. A chapter headed "For Children with Dissociative Parents" addresses the vulnerability of children in the care of people who are dissociative. While welcoming the responsible advice given for the protection of children I was disappointed that the author countered her own message that not all dissociative parents are bad parents with an ambiguous anecdote.
Traditional dissociative disorders are covered in early chapters which regrettably stereotype dissociative patients as "thick chart' patients. I can see that such stereotyping serves to get the target audience interested " GPs, particularly, want answers about patients who attend frequently but can't be firmly diagnosed" but its regrettable that the author panders to some professionals' prejudices with the use of such pejorative terms as "thick chart' and "difficult'. Other early chapters look at specific contexts of working with the dissociative patient " accident & emergency, obstetrics, surgery, even at the dentist. Brief though these sections are they show much needed recognition of how re-traumatising such experiences can be for the abuse survivor who dissociates.
There are useful chapters on how misleading the results of lab investigations can be when the patient is dissociative and about the special considerations needed when medicating people who dissociate.
But the basic definitions and explanations of the traditional dissociative disorders " particularly DID - are covered in an Introduction which is at risk of being skipped because of it's subtitles "How Did I Get Into This" or "What's a Nice Girl Like You Doing in Such a Psychotherapeutic Minefield". Don't skip it. The introduction is very informative and isn't as ego-centric as those subtitles suggest.
Throughout the book there is an oft repeated heading "What can you do?" which provides sensible and practical advice on how to respond to particular problems. And each chapter ends with a bullet point summary which is very useful.
Overall, I can recommend this book " not just for GPs and other general health care workers. It's a valuable primer on the wide ranging effects of dissociation for front line staff in mental health too " for psychiatric nurses, social workers, support workers, housing workers etc. As it is so accessible the interested lay reader may also find it useful. " family, friends, survivors themselves.
In fact, I was so reluctant to have my hopes betrayed that I kept putting off reading the book. And one fine way I found to delay writing this review was to loan the book to my own GP (who though not very knowledgeable about dissociation has been willing to listen, believe and learn). I asked her if she could find the time in her busy schedule to read the book and let me know what she thought. After all wasn't she one of those for whom the book had been written " a family physician. She returned the book to me less than a week later with a brief note:-
"I have read the whole book " very interesting " she seems to bring in most psychiatric problems. However, it does add to a GP's average level of knowledge about Dissociative Disorders and lots of other problems we see. Her positive attitude is helpful"
That "most psychiatric problems' and "lots of other problems' really piqued my interest. I have long held the view that an understanding of dissociation would go a long way towards understanding, not just those disorders classified as dissociative, but most psychiatric and many physical problems too. It was looking like Marlene Hunter agreed with me so I began to read.
I was not disappointed.
The book is less than 200 pages long and written in a readable style with short paragraphs, many references to real life situations and advice on how to respond. This all contributes to making it accessible and useful. This is very important, because, with the many conflicting demands in the busy life of the average health care professional, ignorance about dissociative disorders will continue to flourish if basic, immediately practical information to counter that ignorance isn't easily and quickly digestible.
And Dr Anne was right. The book does cover many problems which wouldn't traditionally be thought of as dissociative.
The author includes chronic pain syndromes such as fibromyalgia; other syndromes such as chronic fatigue syndrome, somatisation, irritable bowel, urinary problems. She advises understanding and treating all of these within a dissociative disorder framework. This is a welcome view as so often trauma survivors with inconsistent and confusing physical and neurological symptoms are dismissed as attention-seeking and manipulative.
Appropriately, a whole chapter is devoted to PTSD but also included are very readable sections on depression, borderline personality disorder, suicide & self-harm, alcohol abuse, body-image distortions, eating disorders, sleep disturbances " all of which are commonly found alongside (or misdiagnosed instead of) the traditional dissociative disorders.
Final chapters include information on sexual dysfunction and relationships. A chapter headed "For Children with Dissociative Parents" addresses the vulnerability of children in the care of people who are dissociative. While welcoming the responsible advice given for the protection of children I was disappointed that the author countered her own message that not all dissociative parents are bad parents with an ambiguous anecdote.
Traditional dissociative disorders are covered in early chapters which regrettably stereotype dissociative patients as "thick chart' patients. I can see that such stereotyping serves to get the target audience interested " GPs, particularly, want answers about patients who attend frequently but can't be firmly diagnosed" but its regrettable that the author panders to some professionals' prejudices with the use of such pejorative terms as "thick chart' and "difficult'. Other early chapters look at specific contexts of working with the dissociative patient " accident & emergency, obstetrics, surgery, even at the dentist. Brief though these sections are they show much needed recognition of how re-traumatising such experiences can be for the abuse survivor who dissociates.
There are useful chapters on how misleading the results of lab investigations can be when the patient is dissociative and about the special considerations needed when medicating people who dissociate.
But the basic definitions and explanations of the traditional dissociative disorders " particularly DID - are covered in an Introduction which is at risk of being skipped because of it's subtitles "How Did I Get Into This" or "What's a Nice Girl Like You Doing in Such a Psychotherapeutic Minefield". Don't skip it. The introduction is very informative and isn't as ego-centric as those subtitles suggest.
Throughout the book there is an oft repeated heading "What can you do?" which provides sensible and practical advice on how to respond to particular problems. And each chapter ends with a bullet point summary which is very useful.
Overall, I can recommend this book " not just for GPs and other general health care workers. It's a valuable primer on the wide ranging effects of dissociation for front line staff in mental health too " for psychiatric nurses, social workers, support workers, housing workers etc. As it is so accessible the interested lay reader may also find it useful. " family, friends, survivors themselves.
Guest
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14/09/2004 01:00
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