Article

The Application of Attachment Theory and Mentalization in Complex Tertiary Structural Dissociation: A Case Study

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Abstract

The concept of structural dissociation can provide useful information for increasingly complex applications of mentalizing in therapeutic settings; however, little integration of the two approaches has emerged. Grounded in the intricate case of a woman diagnosed with dissociative identity disorder, this case study integrates and applies the concepts of structural dissociation and mentalizing from an attachment perspective. Client history includes pervasive spiritual and sexual abuse, as well as extreme neglect throughout her development. The presenting problems, relevant history (including the profound impact of neglect), and the therapeutic models that guided treatment are described. Also presented are the specific therapeutic interventions that have facilitated and strengthened therapeutic alliances, levels of integration, and mentalizing capacity in this challenging but rewarding study of human resiliency.

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... Also, dissociation in intercountry adoptees has not been the focus of many research or publications. During a literature search, I could only find a few articles that were related to criminal, none relating specifically to children (Stewart, Dadson, & Fallding, 2011;Kirschner, 1992;Kirschner & Nagel, 1996). So what happens if we do look beyond the dysregulation and use a developmental trauma informed lens to take the problems that intercountry adoptees encounter into account? ...
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