Trauma Theory Glossary
The purpose of this
glossary is to provide definitions for the frequently
used terms in the field of traumatic stress disorders.
The anticipated audience is diverse, ranging from mental
health professionals to consumers of mental health
services and their families. Because of this diversity,
we have included general mental health terms for those
unfamiliar with psychological literature. The goal is to
provide a common vocabulary and meanings in common for both general psychiatric and
trauma aftermath disorders.
Several editorial decisions that affect the structure
and format of this glossary are described below:
Diagnostic categories have been chosen for inclusion in
the glossary if there is a frequency of overlap with
In cases where there is a general psychiatric use of a
term and also a specific use of that term in the trauma
disorder field, this is noted.
The term "personality states" (rather than alters,
alternate personalities, or personalities) will be used
throughout the glossary except in direct quotations from
The word "client" (rather than "patient") will be used
throughout the glossary, except in direct quotations
from other sources.
Complex Post Traumatic Stress and
Dissociative Disorders Glossary
abreaction The discharge of energy
involved in recalling a dissociated event that was
consciously intolerable. The experience may be one of
reliving the trauma as if it were happening in the
present, complete with physical as well as emotional
manifestations (also called revivification). A
therapeutic effect sometimes occurs through partial
discharge of or desensitization to the painful emotions
and increased insight. Abreaction can be triggered
spontaneously or can be therapeutically induced through
verbal suggestion or hypnosis. See also
trauma recovery mandala therapy
Trauma Recovery Mandala Therapy is based on developments in
brain research together with clinical observations over many
years and can be used individually.
acting out Originally an analytic term
referring to the expression of unconscious feelings
about the analyst, the commonly used meaning is the
expression of unconscious feelings or conflicts in
actions rather than words. This can take many forms
including dangerous behavior such as
self-harm or suicidal gestures.
acute stress disorder A disorder first named in DSM-IV.
It is similar to
Post-Traumatic Stress Disorder (PTSD) in that it is
evoked by the same types of stressors that precipitate
PTSD. However, in this disorder, the symptoms occur
during or immediately following the trauma. The primary
criteria are the same as those for PTSD, except that the
disturbance lasts for a minimum of two days and a
maximum of four weeks and occurs within four weeks of
the traumatic event. Adapted from DSM-IV, p. 432.
adjunctive therapies In addition to individual
psychotherapy with a primary therapist, a client may
receive other therapy such as art therapy, psychodrama,
dance therapy, sensorimotor work or assertiveness
training. These are considered adjunctive therapies.
‘Accelerated trauma recovery Mandala’ created by Linda
Bearup, 2005 is an example of a specific therapy
designed to meet trauma theory criteria. Adjunctive
techniques can access memories not usually available
through talking therapy.
affect "A pattern of observable behaviors
that is the expression of a subjectively experienced
feeling state (emotion). Common examples of affect are
sadness, elation, and anger. In contrast to mood, which
refers to a more pervasive and sustained emotional
`climate,' affect refers to more fluctuating changes in
emotional `weather.'" DSM-IV, p. 763.
affect regulation The capacity to
manage and regulate feelings and body states, is
developed through a secure attachment relationship in
infancy. The affect
regulation of the care giver is passed on to the infant
through repeated interactions, where the care giver
soothes and regulates the infant when they are
distressed. This eventually builds into the infant the
capacity to self regulate.
The inability to recognize or describe what one feels.
This is common in
post-traumatic stress disorder, somatization, and
Another term for
personality part, alternate personality or
personality state; also called an identity or
dissociated part. A distinct identity or personality
state, with its own relatively enduring pattern of
perceiving, relating to, and thinking about the
environment and self. Modified from DSM-IV, p.
770. "Alters are dissociated parts of the mind that the
patient experiences as separate from each other."
ISSD Practice Guidelines Glossary, 1994.
amnesia "Pathologic loss of
memory; a phenomenon in which an area of experience
becomes inaccessible to `conscious' recall. The loss in
memory may be organic, emotional, dissociative, or of
mixed origin, and may be permanent or limited to a
sharply circumscribed period of time." American
Psychiatric Glossary, p. 13. See also
anniversary reaction The experience of reacting with
feelings or behavior on the "anniversary" of a previous
event. For example, an individual whose house burned
down on September 22nd may for years after the event
have intense feelings or reactions on or around
September 22nd. In some cases the person may not even
consciously recall why he or she is feeling differently
on that date. A common anniversary reaction is temporary
assertiveness training This is a
cognitive/behavioral technique that teaches clients
to express their feelings and needs rather than being
passive and letting other people take advantage,
overwhelm, or dominate them (a characteristic of people
who were abused in childhood). After a client and
therapist identify problem situations, the client
practices appropriate confrontation. Assertiveness, a
middle ground between being passive and
aggressive/hostile, may be learned on a one-to-one basis
or in a group.
attachment (bonding) Attachment is
built through an experience of security in infancy. The
attachment relationships with parents / care givers
promote feelings of protection and safety. A safe and
secure child will become curious and explore their world
(learn and develop), build trusting relationships with
others and feel good about themselves. Secure attachment
gives the child a deep feeling of being good and
lovable.The process of developing and maintaining a
healthy relationship between people; healthy attachment
between a parent and child, is characterized by a sense
attunement and ‘holding’ of the young
baby is essential for the establishment of regulation of
physiological functioning such that the developing child
becomes able to self-regulate over time. Emotional
attunement is both a verbal and a non verbal
autonomic arousal A physical symptom of PTSD which
occurs automatically when a person perceives a situation
to be life-threatening. Also known as nervous system
hyper-reactivity, this physical response bypasses the
cognitive/thinking process and generally includes an
elevated heart rate, dilation of pupils, perspiring, and
other fear responses. Trauma survivors may re-experience
autonomic arousal when remembering traumatic events. See
flight or fight response.
Axis II pathology
Axis II is one component of the diagnostic system
described in the DSM- IV. Axis II contains the
personality disorders, such as borderline personality
disorder, narcissistic personality disorder and avoidant
personality disorder. Personality disorders are defined
as personality traits that are inflexible, maladaptive,
and cause functional impairment or subjective distress.
When a person has both DID and an Axis II diagnosis the
treatment may be more complicated and chaotic. A person
may resolve the DID and still need to deal with the Axis
II diagnosis. Adapted from DSM- IV, p. 630.
The BASK model of dissociation developed by Bennett G.
Braun, M.D., conceptualizes dissociation as dimensions
of Behavior, Affect, Sensation, and Knowledge. For
example, a client with DID may experience the behavior
personality states as separate, or may experience
the intense feelings of a personality state as separate,
or may have body sensations of pain with no memory of
trauma, or one personality state may have "knowledge" of
trauma but no feelings or physical sensations. The goal
of treatment is the integration of the BASK components
over time. Braun, "The BASK Model of Dissociation," pp.
behavioral memory A lay term for
implicit (or habit) memory. This type of memory is
encoded in terms of a pattern of behavior rather than
explicit knowledge. This term often refers to
actions or fears which may indicate unconfirmed
memories. (Lenore Terr, M.D., personal correspondence,
31 August 1994).
body memory This popularly-used
term is actually a misnomer. The body does not have
neurons capable of remembering; only the brain does. The
term refers to body sensations that symbolically or
literally captures some aspect of the trauma. Sensory
impulses are recorded in the parietal lobes of the
brain, and these remembrances of bodily sensations can
be felt when similar occurrences or cues restimulate the
stored memories.(Lenore Terr, M.D., personal
correspondence, 31 August 1994). For example, a person
who was raped may later experience pelvic pain similar
to that experienced at the time of the event. This type
of bodily sensation may occur in any sensory mode:
tactile, taste, smell, kinesthetic, or sight. Body
memories may be diagnosed as
somatoform disorder. See also
somatic memory. Treatment may include enabling
dispersement of the remembered energy of the trauma
through the body.
borderline personality disorder
Borderline personality disorder is best understood as an
attachment disorder. "The essential feature of
Borderline Personality Disorder is a pervasive pattern
of instability of interpersonal relationships,
self-image, and affects, and marked impulsivity that
begins by early adulthood and is present in a variety of
contexts," as indicated by five (or more) of the
frantic efforts to avoid real or imagined abandonment
a pattern of unstable and intense interpersonal
relationships characterized by alternating between
extremes of idealization and devaluation
identity disturbance: markedly and persistently unstable
self- image or sense of self
impulsivity in at least two areas that are potentially
recurrent suicidal behavior, gestures, or threats, or
self- mutilating behavior
affective instability due to a marked reactivity of mood
chronic feelings of emptiness
inappropriate, intense anger or difficulty controlling
transient, stress-related paranoid ideation or severe
In Borderline Personality Disorder, like DID, there is a
strong likelihood of a trauma history: "Physical and
sexual abuse, neglect, hostile conflict, and early
parental loss or separation are more common in the
childhood histories of those with Borderline Personality
Disorder." Adapted from DSM-IV, pp. 650-654.
boundaries For the comfort and
safety of the client, therapist, and other outsiders,
behavioral boundaries often need to be established.
These limits may affect a range of issues from details
of personal and therapeutic interactions, such as length
of therapy sessions; appropriate touching; number, and
duration, of phone calls to prevention of assault and
suicide. Setting boundaries is particularly important in
the treatment of dissociative disorders since lack of
boundaries is usually a part of the history of a person
who has been abused.
brief reactive psychosis
One of the trauma related disorders listed in the
DSM-III-R. It consists of a sudden and brief
psychosis (loss of reality contact) lasting from a few
hours to no more than one month. It is preceded by a
major stressor which would be extremely stressful to
almost anyone in similar circumstances in that person's
culture. This has been renamed
Brief Psychotic Disorder in DSM-IV with a
slight modification in the criteria. Adapted from
DSM-III-R, p. 207.
brief psychotic disorder The DSM- IV criteria are:
The presence of one or more psychotic symptoms
The episode lasts at least one day but less than one
month with eventual return to previous functioning
The disturbance is not better accounted for by another
mental illness and is not due to the physiological
effects of a substance or general medical condition.
For this condition there are three specifiers: with
marked stressor(s), without marked stressor(s), and with
postpartum onset. Adapted from DSM-IV, p. 304.
For the client with a
Dissociative Disorder this is the sitting together with
other parts of the self.
co-existing disorders Refers to cases in which an
individual has more than one diagnosis as described in
the DSM-IV. Also known as co- morbidity. See also
treatment A treatment approach that focuses
both on observable behavior and on the thinking or
beliefs that accompany the behavior. In psychotherapy,
dysfunctional or maladaptive behaviors, thoughts, and
beliefs are replaced by more adaptive ones. This
approach is increasingly being used in the treatment of
DID (MPD) and BPD.
cognitive distortion An error in thinking or reasoning
based on drawing incorrect conclusions about past
experience. For example, a trauma survivor who was
sexually abused by a man with a beard might
overgeneralize from the trauma experience and conclude
that all men with beards are dangerous.
cognitive therapy A form of therapy that focuses on
what the client thinks or believes. In this model,
faulty thinking is seen as the basis for negative
emotions and maladaptive behavior. Therapeutic
intervention helps clients explore erroneous thoughts
and beliefs and replace them with a more realistic
assessment of themselves and their situation.
complex PTSD (also complex, chronic
PTSD) A term used to refer to the aftermath of severe,
protracted and often childhood trauma with dissociative
features. See also
Posttraumatic Stress Disorder.
confabulation This term originally referred to a
neurological deficit in which a person who is unable to
recall previous situations or events fabricates stories
in response to questions about those situations or
events. It is now used more broadly to refer to
"false memories" that are supposedly created in
response to questions asked by a therapist or
congruent coalescence –
Parts of the self consciously and willingly sitting
together in accord.
co-consciousness For a person with DID, this is the
awareness of the thoughts, feelings, beliefs, needs,
etc. of other
containment The process of managing
emotional and physiological arousal levels whilst
consciously postponing dealing with intrusive PTSD
symptoms and memories, being able to notice a symptom,
communicate about it, set it aside (contain it), and
revisit it later.
context dependent memory
state dependent memory.
contracts Verbal or written agreements made
between therapist and client for the express purposes of
setting safe and reasonable
boundaries for the client, to nurture the client's
sense of cause and effect, and to encourage the internal
personality system to take responsibility for its
conversion disorder Often precipitated by psychosocial
stress, people with trauma histories have a higher than
average rate of conversion disorder. The DSM-IV criteria
One or more symptoms or deficits affecting voluntary
motor or sensory function that suggest a neurological or
other general medical condition
The initiation or exacerbation of the symptom or
deficits is preceded by conflicts or other stressors
The symptoms or deficits are not intentionally produced
The symptoms or deficits cannot be fully explained by a
general medical condition, by the direct effects of a
substance, or as a culturally sanctioned behavior or
The symptoms or deficits cause clinically significant
distress or impairment in functioning or warrant medical
The symptoms or deficits are not better accounted for by
another mental disorder.
Adapted from DSM-IV, p. 457.
co-presence This occurs when two or
more personalities are simultaneously present with or
without knowledge of each other's existence or current
presence. They may or may not exert influence on each
countertransference A therapist's conscious
or unconscious emotional reactions to a client. It is a
therapist's job to monitor his or her reactions to a
client and to minimize their impact on the therapeutic
relationship and treatment.
Dissociative Disorder Interview Schedule.
delayed memory Not a term used in trauma theory
language. This term is used to describe the experience
of an individual who recalls a memory for which he or
she was previously amnestic. The recollection may occur
spontaneously or in the context of therapy. This is a
controversial concept: some individuals believe that
delayed memory is an understandable response to
traumatic stressors and others believe that important
events, especially traumatic ones, are not forgotten.
The term "delayed memory" is often used interchangeably
repressed memory, or
false memory, but there are different meanings for
disorder One of the dissociative disorders
described in DSM-IV. The criteria include:
Persistent or recurrent experiences of feeling detached
from, and as if one is an outside observer of, one's
mental processes or body
During the depersonalization experience, reality testing
The depersonalization causes clinically significant
distress or impairment in functioning
The depersonalization experience is not attributable to
another mental disorder, the effects of a substance, or
a general medical condition.
Adapted from DSM-IV, p. 490.
derealization A feeling of estrangement or
detachment from one's environment. A sense that the
external world is strange or unreal. Often accompanied
Dissociative Experiences Scale.
Statistical Manual of Mental Disorders
The fourth edition of Diagnostic and Statistical
Manual of Mental Disorders (DSM- IV) was published
in 1994 by the American Psychiatric Association. It
contains standard definitions of psychological
disorders. DSM-III-R refers to the third edition,
revised, of the same manual, published in 1987. The
diagnostic categories referred to in the trauma
literature published in the late 1980s and early 1990s
are those from the DSM-III-R.
dissociative identity disorder.
dissociation A form of withdrawal, in which a
child cuts off contact with others and the world -
causing the child to become numb, unfeeling, or unaware.
It is a form of mental freezing or 'absence' to avoid
being overwhelmed by fear. Dissociation is the separation of ideas, feelings,
information, identity, or memories that would normally
go together. Dissociation exists on a continuum: At one
end are mild dissociative experiences common to most
people (such as daydreaming or highway hypnosis) and at
the other extreme is severe chronic dissociation, such
as DID and other dissociative disorders. Dissociation
appears to be a normal process used to handle trauma
that over time becomes reinforced and develops into
dissociative amnesia One of the dissociative
disorders described in DSM-IV. The three criteria
One or more episodes of inability to recall important
personal information, usually of a traumatic or
stressful nature, that is too extensive to be explained
by ordinary forgetfulness
The disturbance does not occur exclusively during the
course of another mental disorder, is not due to the
effects of a substance, a neurological and/or other
general medical condition.
The symptoms cause clinically significant distress or
impairment in functioning. There are several types of
memory disturbances including: localized amnesia,
selective amnesia, generalized amnesia, continuous
amnesia, and systematized amnesia.
Adapted from DSM-IV, pp. 478-481.
For individuals with DID (MPD), amnesia may exist
differentially between various
personality states or personality
fragments. In one-way amnesia Personality A is
unaware of Personality B; however, Personality B knows
everything about Personality A. In two-way amnesia
neither Personality A or B is aware of the existence of
Dissociative Disorder Interview
Schedule (DDIS) A structured interview developed
for both clinical and research purposes to standardize
the diagnosis of DID. It takes 30-45 minutes to
complete. The DDIS has shown that DID is a valid
diagnosis with a consistent set of features and that
both dissociative experiences and dissociative disorders
are common. Developed by Ross, Heber, Norton and
Anderson, the DDIS has been used in several research
studies and has good clinical validity. Ross,
Multiple Personality Disorder, p.135.
not otherwise specified (DDNOS)
In DSM-IV this is the diagnostic category for
individuals who have dissociative symptoms but do not
meet the minimum criteria for any of the specific
dissociative disorders. A client who has some (but not
all) DID symptoms, and who does not have amnesia for
important personal information, would be an example of a
person with DDNOS. DSM- IV, p. 590.
dissociative disorders A group of psychiatric conditions
with the disruption in the integrated functions of
consciousness, memory, identity, or perception of the
environment. DID (MPD) is one disorder in this category.
dissociative identity disorder,
dissociative disorders not otherwise specified.
Adapted from DSM-IV, p. 477.
Dissociative Experiences Scale (DES)
Developed by Frank W. Putnam M.D. and Eve B. Carlson,
Ph.D., the DES is a 28-item self-report instrument that
can be completed in about 10 minutes. It asks the
respondent to indicate the frequency with which certain
dissociative or depersonalization experiences occur. An
example of a typical DES question is "Some people have
the experience of feeling that their body does not seem
to belong to them. Circle a number to show what
percentage of the time this happens to you."
dissociative fugue One of the dissociative disorders
described in DSM-IV. The diagnostic criteria are:
Sudden, unexpected travel from home or work, with the
inability to recall some or all of one's past
Confusion about personal identity or assumption of a new
The disturbance does not occur exclusively during the
course of DID and is not due to the effects of a
substance or general medical condition
The symptoms cause clinically significant distress or
impairment in functioning.
The onset of dissociative fugue is usually related to
traumatic, stressful, or overwhelming life events. In DSM-III- R, this was called psychogenic fugue.
Adapted from DSM- IV, pp. 481-483.
dissociative identity disorder (DID)
One of the dissociative disorders in DSM- IV.
There are four diagnostic criteria:
The presence of two or more distinct identities or
At least two of these identities or personality states
recurrently take control of the person's behavior
Inability to recall important personal information that
is too extensive to be explained by ordinary
The disturbance is not due to the direct physiological
effects of a substance or a general medical condition.
Diagnostic and Statistical Manual of Mental Disorders.
This refers to the co-existence of a mental disorder and
substance abuse disorder. The current term for this is
co-existing disorders, also called co-morbidity. See
refers to sadness and depression
eating disorders A category of mental disorders
described in DSM-IV. Individuals with these
disorders, such as anorexia nervosa and bulimia, show a
marked disturbance in eating behavior. Some individuals
with DID and PTSD also have an eating disorder.
An organized system of behavior and experience in which
the elements (ego states) are bound together by some
common principle. In this theory of dissociation,
developed by Helen H. and John G Watkins, ego states
occur naturally in people and are separated from each
other by boundaries that are more or less permeable. A
problem arises only when the boundaries between ego
states become non-permeable or maladaptive. The goal of
treatment in ego state therapy is not the
integration of ego states, but the harmonious
cooperation between ego states. Watkins & Watkins, "Ego-
State Therapy in the Treatment of Dissociative
Disorders," in Kluft & Fine, Clinical Perspectives on
Multiple Personality Disorder, pp. 277-299.
Eye Movement Desensitization and Reprocessing.
empathy The ability to imagine and share
what another is experiencing. The ability to put one's self into
the psychological frame of reference or point of view of
another, to feel what another feels.
In the internal
system of a person with a dissociative disorder,
authority over the body and its behavior by a particular
personality state, usually the
experiential therapies Therapeutic techniques
that utilize symbolism, metaphors and analogies to help
clients understand and change their behaviors,
traditionally in a group format. These techniques
encourage the client to directly experience feelings and
thoughts by participating in activities such as art,
group sculpting, outdoor challenge courses, etc.
explicit memory Consciously recalled facts or
events (knowing that) which have verbal components. This
is the form of memory used, for example, when a person
recounts the events of his or her day at work or at
school. Also referred to as narrative or declarative
memory. See also
expressive therapies Specific therapeutic
techniques that facilitate expression of feelings
through language or movement. Examples include dance,
art, and poetry therapy. Most often used as
adjunctive therapy to gain access to feelings or
memories, expressive therapies are increasingly used for
primary treatment in trauma cases. Since traumatic
memories may be stored on sensory motor or visual
levels, the use of these therapies may ‘Accelerated
trauma recovery Mandala’ created by Linda Bearup, 2005
is an example of a specific therapy designed to meet
trauma theory criteria. Adjunctive therapy techniques
can access memories not usually available through
Eye Movement Desensitization and
Reprocessing (EMDR) A procedure which produces rapid
eye movements in a client while a traumatic memory is
recalled and processed. This technique seems to lessen
the amount of therapeutic time needed to process and
resolve traumatic memories. Developed by Francine
Shapiro, this technique requires training and following
of specific protocols for appropriate use.
false memory A term developed in the early 1990s
by the False Memory Syndrome Foundation to describe
memories that are not based on actual events. This term
is popular in the media, although the concept of false
memory is not based on clinical research or accepted
The terms false memory,
delayed memory, and
repressed memory are often used interchangeably in
the popular literature but they actually have distinct
False Memory Syndrome (FMS)
"False memory syndrome" is a term coined in the early
1990s by the False Memory Syndrome Foundation (FMSF).
The FMSF defines the syndrome as "a condition in which
the person's personality and interpersonal relationships
are oriented around a memory that is objectively false
but strongly believed in to the detriment of the welfare
of the person and others involved in the memory."
Goldstein, Confabulations: Creating False Memories -
Destroying Families, p. iv
This organization was founded by parents of adult
children who reported delayed memories of child abuse
usually uncovered in psychotherapy. These parents deny
the abuse and believe false memories have been implanted
by therapists in the minds of their adult children.
The term "false memory syndrome" is popular in the media
but is not based on clinical research or accepted
theoretical formulations. It is not listed as a
diagnosis or symptom in the DSM-IV, nor is there
a known treatment or cure. See also
delayed memory and
flashbacks A type of spontaneous
abreaction common to victims of acute trauma. Also
known as "intrusive recall," flashbacks have been
categorized into four types:
dreams or nightmares
dreams from which the dreamer awakens but remains
under the influence of the dream content and has
difficulty making contact with reality
conscious flashbacks, in which the person may or may
not lose contact with reality and which may be
accompanied by multimodal hallucinations
unconscious flashbacks, in which a person "relives"
a traumatic event with no awareness at the time or
later of the connection between the flashback and
the past trauma.
Putnam, Diagnosis and Treatment of Multiple
Personality Disorder, pp. 236-237.
Flight fight and freeze
response An automatic response to an
experience that is perceived to be a threat to survival.
The part of the brain that regulates metabolic and
autonomic function and prepares muscles to act -- to
either flee or fight. This survival mechanism works well
when the situation allows for an active response. In
repeated traumatic situations, when there is no
opportunity to fight or flee, this response may result
in a chronic state of physiological arousal which is
very stressful to the body. See
autonomic arousal. See Neuroception.
flooding The process of becoming overwhelmed
by intrusive emotions, sensory experiences, or intense
re-living experiences; commonly associated with
posttraumatic stress disorder.
False Memory Syndrome.
fragment Within the personality system of a
person who has a dissociative disorder, a fragment is a
dissociated part of that person which has limited
function and is less distinct or developed than a
personality state. Usually a fragment has a
consistent emotional and behavioral response to specific
situations. For example, a fragment may handle the
expression of feelings through drawing. The term
"special purpose fragment" refers to a part with an even
more narrowly defined function.
fusion The moment when personality states
or fragments come together as a single entity. The
breaking down of dissociative barriers may occur
spontaneously or as part of a specific therapeutic
process. Fusion is different from
grounding Reality based awareness in the here
and now, a sense of connectedness to yourself and your
environment. See ‘Presentification’ Elert Neijenhaus.
In dissociative identity disorder, the personality state
that most frequently has control of the body and its
behavior. The host is often initially unaware of the
other identities and typically
loses time when they appear. The host is the
identity that most often initiates treatment, usually
after developing symptoms, the most common being
depression. See also
hyperarousal A constant state of emotional and
physiological stress showing extreme reactions and
over-responsiveness to stimuli.
hypermnesia This experience of
heightened memory is a symptom of PTSD. It is the
amnesia, which is the forgetting of events.
Hypermnesia consists of abnormally sharp or vivid
recall. For example, a trauma survivor may vividly
remember a traumatic event with total recall of all
details--sight, sound, feel, smell, and touch.
Hypermnesia may be intrusive and may interfere with
hypervigilance One of the symptoms of PTSD.
Responding to the environment as if there is imminent
danger, being hyper alert, constantly scanning for
this state an individual is overly sensitive to sounds
and sights in the environment, scans the environment
expecting danger, and feels keyed up and on edge. In
addition, a traumatized person may have an exaggerated
startle response and problems with memory and
hypnosis An altered state of consciousness
which is subjectively experienced by an individual as
different from normal alertness. This may occur
spontaneously, as in spontaneous trance, or may be
suggested by a therapist or hypnotist. The individual
who is hypnotized may experience altered perception or
Hypnosis is often used in the treatment of DID to
facilitate communication between
personality states, to overcome amnesiac barriers
and to promote healing through managed
abreaction. Before using hypnosis in treatment it is
recommended that the client be provided with enough
information to give his or her
informed consent and that this be documented.
Hypnosis is also referred to as being in a
trance state. The process of
dissociation itself may be a form of
iatrogenesis When medical treatment or
psychotherapy causes an illness or aggravates an
existing illness. In psychotherapy, this may occur as a
result of the comments, questions, or attitudes of the
therapist. There are those who feel that DID is an
iatrogenic illness produced by a client to meet the
expectations of a therapist. There is also a concern
that traditional DID treatment approaches may encourage
the development of additional personality states.
However, there is no scientific research to support the
idea that DID (MPD) is an iatrogenic illness.
ideomotor signaling A hypnotic technique wherein the
client and therapist agree on prearranged body movements
to answer questions non-verbally. The most common
technique uses finger signals to stand for "yes," "no,"
and "stop." This allows nonverbal communication of
unconscious material during hypnosis. Often the client
will experience the movement of the fingers as "outside
conscious control." The technique may be used to contact
personality states without direct emergence of those
imagery Using your imagination to manage
stress responses and feelings.
implicit memory Behavioral knowledge of an
experience (knowing how) without conscious recall or
verbal components; habit memory. Driving, riding a
bicycle, or reading are examples of skills which people
implicitly remember how to do without consciously
remembering steps involved. This type of memory is
almost always irretrievable in words. (Lenore Terr, M.D.,
personal correspondence, 31 August 1994.) Also called
procedural or sensorimotor memory. See also,
impulse An action urge.
informed consent In psychotherapy, informed consent
occurs when a client is informed of:
the nature of the treatment being considered
the risks and benefits of such treatment
the likely outcome with and without treatment
alternative approaches to relieve the symptoms
The information must be presented in a form the client
can understand and consent must be given without
coercion. Often this information is presented in written
form which the client signs, thereby giving permission
for treatment. While this has historically been common
for medical procedures and psychological research, it is
now also being done during psychotherapy, especially
with specific techniques such as
sodium amytal interviews.
inner self-helper (ISH)
personality state, often a helper or protector, that
has knowledge of the
system and works with the therapist to facilitate
integration The ongoing process of
bringing together all dissociated aspects of self,
whether they are thoughts, feelings, behavior, or are
personality states or
fragments. This process continues throughout the
There is lack of agreement about the end goal of DID
treatment. Some therapists and clients consider
integration the treatment goal while others do not. This
complex decision is best discussed together by therapist
internal working model Develops from the repeated
experiences of relationship with the primary care giver.
The IWM informs us how the child see's themself and how
they will respond to future relationships. Abused and
neglected children often develop a negative internal
working model. They see themselves as unlovable, expect
rejection, see the world as unsafe and do not believe
that relationships can be relied upon to keep then safe.
International Society for the Study
of Dissociation (ISSD)
Formerly the International Society for the Study of
Multiple Personality and Dissociation (ISSMP&D). The
organization voted to change its name in the spring of
1994 after the classification of MPD was changed to
dissociative identity disorder (DID) in the DSM-IV.
The International Society for the Study of Dissociation
is a not-for-profit professional association organized
to promote research and training in the identification
and treatment of Dissociative Identity Disorder and
other dissociative states. ISSD provides professional
and public education about DID and other dissociative
states and serves as a catalyst for international
communication and cooperation among clinicians and
investigators working in this field. ISSMP&D
Membership Directory, 1994, p. 2.
International Society for the Study of Multiple
Personality & Dissociation (ISSMP&D)
The original name of the ISSD when it was founded in
1984. It was changed in 1994 after the term MPD was
changed to dissociative identity disorder (DID). See
International Society for the Study of Dissociation.
for Traumatic Stress Studies, Inc. (ISTSS)
A non-profit organization to "promote the advancement of
knowledge about the immediate and long-term human
consequences of extraordinary events and to promote
effective methods of preventing or ameliorating the
unwanted consequences of them." ISTSS Membership
Directory, 1993, p. iii.
Intra-psychic The complex processes
that occur within the mind or system of an individual
rather than inter-psychic dynamics between individuals
or between an individual and the environment.
International Society for the Study of Dissociation.
International Society for Traumatic Stress Studies.
journal writing The process of using structured
exercises to write about thoughts, feelings, and stress
responses in an effort to increase self-awareness and
learned helplessness A term developed by Martin
Seligman, pioneering researcher in animal psychology, to
describe what occurs when animals or human beings learn
that their behavior has no effect on the environment.
The impact of this experience leaves an individual
apathetic, depressed, and unwilling to try previous or
This concept is relevant to people with dissociative
disorders who may show some degree of learned
helplessness due to repeated exposure to traumatic
events which they could not change or avoid by their
losing time Specific to the dissociative
disorder field, having no recollection of one's
activities during a given time period (hours, days,
years). Unaccounted-for periods of time are generally
confusing and frightening to an individual who has DID
and may allow for the person's
mapping A technique used in psychotherapy
with DID clients to gain knowledge about the internal
system. The client is asked to draw a map or diagram
personality states to explain the inner world of
personalities. This provides useful information about
the system, such as the connections or lack of
connections between personality states. The map may need
to be updated as therapy progresses and can be used for
integration work to help ensure that all internal parts
have been integrated. Also known as personality mapping;
system mapping. Mapping can also be used to understand
the relationships among feeling states as well.
medical model The view that abnormal behavior
results from a physical/biological cause and should be
treated medically. This emphasis on biological or
pathological causes of mental disorder is in contrast
cognitive/behavioral approaches that see beliefs and
socially reinforced behavior as a cause of mental
As non-medical disciplines have become more involved in
the treatment of mental disorders, the conflict between
the medical model and social/behavioral models has
Trauma theory takes a middle position. Both nature and
nature affect the way the psyche develops. Nurture
affects psycho-neurophysiological development which in
turn predisposes how experiences are organized in the
brain and thus responded to throughout life. Perry,
Shore, Siegal, Cozlino etc.
memory "The ability, process,
or act of remembering or recalling; especially the
ability to reproduce what has been learned or
explained." American Psychiatric Glossary, p.
The question, "What is a memory?" has become
increasingly controversial in the last decade. As PTSD
and dissociative disorder clients report delayed and
dissociated memories of childhood trauma, the accuracy
or validity of these memories has been questioned. While
the presence of corroborating evidence (or even
witnesses) may support a survivor's memories, at the
present time there is no reliable ‘scientific’ method to
assess the self-report of traumatic events.
The MSE, which is conducted by a mental health
professional, is a formal evaluation of a client's
current psychological, emotional, and behavioral
functioning. Areas of assessment include: orientation to
time, place, and person as well as thought content,
cognition, mood, affect, insight, and general
intelligence. This evaluation is usually summarized on
the five axes of DSM-IV and in a narrative report.
multiple personality disorder (MPD)
In DSM-III-R, MPD was classified as a dissociative
disorder. The diagnostic criteria were:
The existence of two or more distinct personalities or
personality states within one person with each
personality having a distinct and consistent pattern of
relating to self and the environment.
At least two of these personalities or personality
states recurrently take full control of the person's
In general, individuals with MPD have a background of
child abuse or other forms of severe childhood trauma.
Dissociative identity disorder (DID) is the current name
for this disorder in DSM-IV. In addition to the name
change two items have been added to the criteria. See
dissociative identity disorder for the current
criteria. Adapted from DSM-III- R, p. 272.
numbing A symptom common to individuals
with PTSD. It represents an individual's attempt to
compensate for intrusive thoughts, memories, or feelings
of the trauma by shutting down and becoming numb to
internal or external stimuli. Also called psychic
describes how neural circuits distinguish whether
situations and people are safe, dangerous or life
threatening. Which in turn triggers neurologically
determined prosocial or defensive behaviours.
Porges,2004.See Polyvagal theory.
Organised Perpetrator Group (OPG)
Organised networks whose purpose is paedophilia, power
and control, spiritual rituals or financial gain.
original personality A misnomer. This term is no longer
commonly used but is found frequently in the historical
MPD literature. In earlier MPD theory, this refers to
the personality state with which an individual is born
and from which other
personality states were "split off." See also
splitting. More recent psycho-neurobiological
research into the way the psyche is formed has
demonstrated that the psyche is a gradual ‘coming
together’ of developing neural pathways. When brain
trajectory has been impacted by trauma development of
various parts of the psyche is inhibited. Some parts are
emancipated by continual use whilst others are immature
and less developed because of the effects of trauma.
Defense strategies both conscious and unconscious, often
devised intrasystemically, which are used to protect but
inevitably have a self sabotaging outcome.
passive influence Individuals with dissociative
disorders often experience their actions or thoughts as
being controlled by dissociated aspects of the self.
Some may feel that a passive outside or inside force has
control without an overt or visible expression of that
influence. Automatic writing is an example of passive
personality states In the dissociative disorders
field, this refers to a part of the psyche that has the
a consistent and ongoing set of response patterns to
a significant confluent history
a range of emotions available (anger, sadness, joy,
and so on)
a range of intensity of affect for each emotion (for
example, anger ranging from neutrality to
frustration and irritation to anger and rage).
Also known as
ego states, personalities,
alters, parts, etc. Braun, Treatment of Multiple
Personality Disorder, p. xii.
post traumatic stress disorder (PTSD) An anxiety disorder based on how an
individual responds to a traumatic event. According to
DSM-IV, the following criteria must be met:
The person has experienced a traumatic event that
involved actual or threatened death or serious
injury, or a threat to the physical integrity of
self or others, and the person's response involved
intense fear, helplessness, or horror.
The traumatic event is re-experienced in specific
ways such as recurrent and intrusive distressing
recollections or dreams of the event
Persistent avoidance of stimuli associated with the
trauma or numbing of general responsiveness
Persistent symptoms of increased arousal, such as
hypervigilance or irritability
Duration of the disturbance (symptoms in Criteria B,
C, and D) is more than one month
The disturbance causes clinically significant
distress or impairment in functioning.
PTSD may be acute, chronic, or with delayed onset. Many
individuals with DID (MPD) also have PTSD. The
literature sometimes describes DID(MPD) as complex
and/or chronic PTSD. Adapted from DSM-IV, p.
presenting personality The personality state
that first comes to therapy. It is often the
pseudo-memory A non- technical term to describe
memory of events that did not occur. This term is often
used interchangeably with
false memory, another non-technical term coined by
members of the
False Memory Syndrome Foundation.
pseudoseizures "Pseudoseizures are
sudden changes in a person's behavior and/or mental
state that resemble epileptic seizures but which are not
caused by a physical disorder of the brain. They may
look like any type of epileptic seizure: staring
unresponsively, generalized stiffening and rhythmic
jerking, movements of only a few body parts, or
alterations of awareness. During these spells, brain
cells are firing normally and the brain wave tracing
does not show the changes which are characteristic of
"Several research studies have found that many
pseudoseizures are really dissociative trance episodes,
dissociative switching of ego states, or dissociative
states in which unconscious emotional distress is
expressed. Many studies have noted high rates of sexual
and physical abuse among pseudoseizure patients and
pointed to abuse as one cause of pseudoseizures.
Pseudoseizures have been reported in dissociative
identity disorder patients and may be the symptom that
leads to seeking treatment. There are non-dissociative
causes for pseudoseizures, so persons who suffer from
them should not be assumed to have a dissociative
disorder." (Elizabeth S. Bowman, M.D., personal
correspondence, 22 August 1994.)
psychodrama A group psychotherapy
technique. Under the direction of a therapist,
individuals re-enact life situations or feelings in
order to gain insight or learn new ways of coping. It is
one of the
adjunctive therapies used in treating trauma
psychodynamic A theoretical
orientation that recognizes the role of the unconscious
in determining behavior. It also considers the interplay
of the unconscious with the current situation, cognitive
ability, and life experience.
psychogenic amnesia A type of dissociative disorder
described in DSM-III-R. The name was changed to
dissociative amnesia in DSM-IV. See also
psychogenic fugue A type of dissociative
disorder described in DSM-III-R. The name was
changed to dissociative fugue in DSM-IV. See also
posttraumatic stress disorder.
Rational Emotive Therapy (RET)
cognitive psychotherapy approach developed by Albert
Ellis which focuses on the client's thoughts and
beliefs. The goals of therapy are to identify
unrealistic and illogical thoughts (such as "I must
always be happy"), question these thoughts or beliefs,
and replace them with more reasonable and constructive
views. In this school of thought, behavior is understood
to be based on beliefs rather than external conditions.
This form of therapy is used to help trauma survivors to
identify mistaken beliefs brought on by the traumatic
reality check A technique that helps you to
become aware of the true state of affairs in a
reflection The ability to pay attention to the
content of our own mind and to think about the minds of
others. This leads to the ability to understand why
things happen and why people behave the way they do.
Developing our reflective capacity means we can think
regression The return to earlier
or younger behavior and thinking. Trauma often
overwhelms everyday defenses and brings about behavioral
personality states are an example of trauma-based
regression. In "age regression," a person experiences
him or herself at a specific earlier age. The person
does not always return to the age of a child, however;
age regression may take a client back a few years
earlier in adult life.
If an adult has regressed to an earlier child state it
is important to understanding the cue or trigger of this
repetition compulsion Originally defined by Freud as the
repetitive re-enactment of earlier emotional
experiences, this type of behavior may be seen in the
lives of trauma survivors. For example, a survivor of
traumatic abuse may put herself in a situation where
there is a risk of additional abuse in an attempt to
psychologically master the previous traumatic
repression An unconscious defense
mechanism which occurs when unacceptable ideas, images,
or fantasies are kept out of awareness. This is done
without an individual consciously knowing that it has
taken place. Repression is one psychological mechanism
that may account for
amnesia of traumatic events.
resilience A key quality that supports children (and
ultimately adults) to respond to adverse events or
experiences. Nurture, protection and attunement give
children a secure base - this secure base is the
foundation of resilience.
re-traumatizing Re-enacting or
reinforcing a traumatic experience or belief.
revictimization Describes the experience of a
survivor being victimized or traumatized after the
original trauma. Examples of revictimization include
psychological abuse that may occur in a survivor's
interactions with authorities such as the courts, law
enforcement personnel, or therapists. This process is
important to address in therapy. In some cases it seems
that a survivor may unconsciously allow or encourage
this subsequent trauma to occur.
revivification The vivid remembering of past
experiences. When remembering traumatic events the
client may see, hear, taste, smell, and feel as though
the event is happening in the present. This is common
flashback of previous trauma.
This term has been defined in a variety of ways by
different authors and researchers. One definition
developed for a study of abuse in child daycare defined
ritual abuse as "abuse that occurs in a context linked
to some symbols or group activity that have a religious,
magical, or supernatural connotation and where the
invocation of these symbols or activities, repeated over
time, is used to frighten and intimidate the children."
Finkelhor, D., & Meyers, L. M., Nursery Crimes:
Sexual Abuse in Day Care, p. 59.
Another definition developed by the Los Angeles
Commission for Women (1989) refers to ritual abuse as,
"A brutal form of abuse of children, adolescents, and
adults, consisting of physical, sexual, and
psychological abuse, and involving the use of rituals.
Ritual does not necessarily mean satanic. However, most
survivors state that they were ritually abused as part
of satanic worship for the purpose of indoctrinating
them into satanic beliefs and practices. Ritual abuse
rarely consists of a single episode. It usually involves
repeated abuse over an extended period of time." Report
of the Ritual Abuse Task Force, Los Angeles County
Commission for Women, 1991, p. 1.
At the present time there is tremendous controversy
about the objective reality of ritual abuse. While some
clinicians, researchers, and police believe that ritual
abuse occurs, others do not. They believe that reports
of ritual abuse are part of a mass hysteria fed by media
accounts and talk show programs. There is no consensus
about the reality and/or extent of ritual abuse.
Describes "extreme adverse experiences which include
sadistic sexual and physical abuse, acts of torture,
over-control, and terrorization, induction into
violence, ritual involvements, and malevolent emotional
abuse. Sadism was defined by Freud's mentor,
Krafft-Ebing (1894-1965), in the nineteenth century, as
follows: 'The experience of sexual or pleasurable
sensations... produced by acts of cruelty, as bodily
punishment inflicted on one's own body or witnessed in
others, be they animals or human beings. It may also
consist of innate desire to humiliate, hurt, wound, or
even destroy others. . . .'" See also
ritual abuse. Goodwin, "Sadistic Abuse: Definition,
Recognition, and Treatment," Dissociation, 6:3,
sand tray therapy
A therapeutic technique, similar to play therapy, in
which a tray of sand with figures and toys is provided
for a client to create a scene or story to be discussed
with a therapist. The "world" that a client creates may
directly or symbolically represent previous life
experiences, conflicts, feelings, or fears. This
technique, when used to process traumatic events, allows
a client emotional distance and the opportunity to
process the feelings, thoughts, and beliefs that may
accompany a traumatic experience.
satanic abuse Abuse that evokes the name, image,
or concept of satan as part of the abuse. Even though
this term is used interchangeably with ritual and
sadistic abuse they each have specific meanings.
Abuse could be ritual and sadistic but not satanic if
the concept of satan is not used as a part of the abuse.
ritual abuse for a more detailed explanation of that
screen memory A partially true memory that an
individual subconsciously creates because the actual
memory is intolerable. For example, a client may report
abuse by a distant uncle when actually the abuser was
the father. This disguised presentation allows the
client time to adjust to aspects of the abuse before
accepting the total reality of the situation.
Structured Clinical Interview for DSM-IV Dissociative
script memory A type of memory that is created
during ritual or cult abuse when a person is given a
scripted identity and memories. For example, a victim
may given a historical identity and the information and
memories related to that identity. Mungadze, "Scripts
and screen memories in victims of ritual abuse:
etiological and treatment implications," November 1992
self-harm The action of harming oneself
without the intent to commit suicide. The many forms of
self-harm include cutting, burning, eating disorders,
etc. For trauma survivors, self-harm can function as
tension reduction, punishment, trauma re-enactment, or
rage expression. Also called self-inflicted violence or
self-injury. See also
self-hypnosis "Spontaneous or purposeful hypnotic
trance states produced within his or her own psyche.
These states may include any or all of the full range of
hypnotic phenomena such as sensory alterations,
anesthesia, time distortion, relaxation, age regression,
and alterations in physiological functioning." ISSD
Practice Guidelines, Glossary, 1994.
self-mutilation A form of self-harm motivated
specifically by the desire to scar or disfigure one's
body; "Defined by Walsh and Rosen (1988) as `deliberate,
non- life-threatening, self-effected bodily harm or
disfigurement of a socially unacceptable nature' (p.10),
self-mutilation most typically involves repetitious
cutting or carving of the body or limbs, burning of the
skin . . . ." Briere, Child Abuse Trauma: Theory and
Treatment of the Lasting Effects, p. 66. See also
self-regulation The ability to manage, and
organise our own feelings and emotions e.g. calm
ourselves down when stressed. The process of consciously managing
different internal states by 1. experiencing them as
they come up, 2. expressing what you are experiencing,
3. consciously postponing dealing with traumatic
material or overwhelming aspects of feelings, and 4.
retrieving part of what you have contained when you are
better able to manage it.
sleep disorders A category in DSM-IV which
includes various disorders of sleep: primary sleep
disorders such as insomnia and secondary sleep disorders
due to medical conditions. Sleep disturbances are common
in people with PTSD.
sodium amytal A hypnotic sedative drug
occasionally used in psychotherapy with trauma clients
to access repressed or unconscious material including
feelings and memories. This procedure, an IV drip
infused with sodium amytal, is usually done on an
inpatient basis due to the slight risk of medical
complications. Even though sodium amytal has been
referred to as a "truth serum" it does not guarantee
truth any more than any other interview technique.
It is suggested that
informed consent be obtained before using this
technique in the treatment of dissociative disorder or
somatic memory "A physical sensation
or change in physical functioning without the presence
of organic illness, that represents a dissociated aspect
of a traumatic or abusive experience." ISSD Practice
Guidelines, Glossary, 1994. See also
somatoform disorder According to DSM-IV,
the common feature of somatoform disorders is the
presence of physical symptoms that suggest a general
medical condition but are not fully explained by a
general medical condition, by the direct effects of a
substance, or by another mental disorder. These
conditions may represent the unconscious conversion of
psychological conflicts to medical problems or medical
concerns. Examples of somatoform disorders include:
conversion disorder, and hypochondriasis. Adapted
from DSM-IV, p. 445.
split screen phenomenon A hypnotic therapeutic
technique which enables a client to see the past trauma
on a mental screen in which one half is the historical
event and the other half is the current therapeutic
situation. This allows the client to deal with a
traumatic memory without being emotionally overwhelmed.
The technique may be helpful for
abreactive and intense memory work.
splitting In general psychiatric literature
splitting is "a mental mechanism in which the self or
others are reviewed as all good or all bad, with failure
to integrate the positive and negative qualities of self
and others into cohesive images. Often the person
alternately idealizes and devalues the same person."
American Psychiatric Glossary, p.199. Splitting is a
borderline personality disorder.
In the trauma/dissociative disorder field "splitting" is
an outdated term, although it is still used.
Historically, the formation of an
alter personality state was conceptualized as a
split from the
original personality or birth personality,
suggesting there is a finite number of personalities
that can occur during the splitting process. Current
thinking by leaders in the field (Putnam, Kluft, and
others) indicates that pretending to be other people, or
trying out different roles, is a normal dissociative
phenomenon in young children, which is intensified when
trauma occurs, resulting in the creation of alter
personality states. Thus, the terms "splitting" and
"split personality" are no longer relevant when
referring to the formation of
startle reaction This symptom of both PTSD and
generalized anxiety disorder occurs when an individual
reacts strongly to new and unexpected stimuli in the
environment. An example of a startle reaction would be
jumping out of a chair when a door is slammed. Also
called startle response.
state dependent memory A similar concept to state
dependent learning. Based on research and clinical
experience, it appears that information and events may
be stored and remembered in the same emotional or
physiological state in which it was learned. Memory is
stored and recalled through ‘association’ in the left
brain. Some trauma memory is not processed and stored in
the left brain and thus cannot recalled during normal
everyday conditions, including in psychotherapy. For
trauma survivors an event that produced extreme fear may
not be processed through the hippocampus but rather
managed in the limbic system. Recall of this past event
may only be available to consciousness at another time
of extreme fear arousal or high arousal state where the
limbic system is activated This is one reason why a
current traumatic event with a high arousal state, may
trigger memory of dissociated earlier trauma. Also
referred to as context dependent memory.
Treatment must include a moderate limbic arousal.
Structured Clinical Interview for
DSM-IV Dissociative Disorder (SCID-D)
This is the first diagnostic instrument for the
comprehensive evaluation of dissociative symptoms and
disorders. It was developed by Marlene Steinberg, M.D.,
to enable a clinically trained interviewer to assess the
nature and severity of dissociative symptoms in a
variety of clinical disorders (including Posttraumatic
Stress Disorder, eating disorders, etc.) and to make
diagnoses of disociative disorders, based on DSM-IV
switching The process of changing from one
personality state or
fragment to another personality state or fragment.
Switching may be set off by outside stimuli such as an
environmental trigger, or by internal stimuli, such as
feelings or memories. Switching may be observable, such
as changes in posture or facial expression, as well as
changes in voice tone or speech patterns. Switching may
also be observed by changes in mood, regressed behavior,
and variable cognitive functioning.
system Coming from systems theory. An
organised structure. A description of the intrapsyche
experience. A descriptive term for all the aspects or
parts of the mind in an individual with DID. This
personality states, memories, feelings, ego states,
, and any other way of describing dissociated aspects of
an individual. Understanding the parts as a system
rather than as separate personality states provides an
important frame of reference for treatment. Also called
internal system or personality system.
talking through The therapeutic technique of
talking to the personality
system as a whole or talking to one or more
personality states that are not in
executive control. For example, a therapist may say
"I am talking to the whole system’ . Talking this way
encourages the system to work together and to dissolve
the dissociative barriers.
trance Used interchangeably with
hypnosis. A person in a trance or in an altered
state of consciousness is in a hypnotic state.
trance logic The ability of a
dissociated person to tolerate the existence of
inconsistent and incongruent perceptions or ideas. "The
inconsistent perceptions are not kept isolated but
appear in juxtaposition . . . The essence of this
phenomenon seems to be the suspension of critical
thinking." Udolf, Handbook of Hypnosis for
transference "The unconscious
assignment to others of feelings and attitudes that were
originally associated with important figures in one's
early life." The psycho-dynamically oriented clinician
uses this to help the client understand the origins of
emotional problems. The transference phenomena is
complicated in MPD because each alter may have its own
transference relationship with the therapist.
American Psychiatric Glossary, p. 211. See also
trauma Traumatisation occurs when the
child's inner resources are overwhelmed by a perceived
or actual external threat. An acute alarm reaction
occurs, triggering a response of fight, flight or
freeze. Long term damage can be done to key neurological
and psychological systems. Trauma caused by abuse and
neglect in childhood invariably impacts attachment. A medical term for any sudden
injury or damage to an organism. Psychological trauma is
an event that is outside the range of usual human
experience and which is so seriously distressing as to
overwhelm the mind's defences and cause lasting
Psychological traumata include natural disasters,
accidents, or human actions, such as the experience of
totalitarian control, child abuse, rape, torture, etc.,
which cause the victim to be terrified, helpless, and
under extreme physical stress. Most individuals with DID
have been victims of repeated trauma and generally also
exhibit symptoms of post traumatic stress disorder. See
Type I and Type II Trauma.(Terr)
traumatic transference The unconscious assignment to a
therapist of feelings and attitudes associated with an
abuser during earlier traumatic events. For example,
recalling being beaten in childhood, a client may ask
the therapist not to hit or hurt her, as if she were
talking to the abuser. Working through the traumatic
transference may be an important aspect for
understanding early childhood trauma.
trigger An event, object, person, etc. that
sets a series of thoughts in motion or reminds a person
of some aspect of his or her traumatic past. The person
may be unaware of what is "triggering" the memory (i.e.,
loud noises, a particular color, piece of music, odor,
etc.). Learning not to overreact to triggers is a
therapeutic task in the treatment of dissociative
Type I and Type II
Trauma Terms developed by Lenore Terr to
describe different types of trauma. A single traumatic
event such as a fire or single rape episode is
considered to be Type I Trauma. Repeated, prolonged
trauma, such as extensive child abuse, is considered to
be Type II Trauma. According to Terr's formulation of
this concept, these two types of trauma result in
different coping styles. Individuals with Type I Trauma
receive support from family and friends and usually
remember the trauma event. Individuals with Type II
Trauma are more likely to have severe PTSD symptoms,
such as psychic numbing, and dissociation. Type II
Trauma is often kept a secret and support from family
and friends may be absent. Terr, Unchained Memories,
p. 11, 30.
unification "An overall, general
term that encompasses both
integration." Kluft, "Clinical Approaches to the
Integration of Personalities," in Clinical
Perspectives on Multiple Personality Disorder,
V-codes These are categories of problems
that may need therapeutic intervention but are not
considered psychological disorders or mental illness.
Conflict between parents and teenagers would be an
example of this. Adapted from DSM-IV, p. 681.
Describes the experiences of mental health providers who
become overly empathic after listening to accounts of
abuse or violence by trauma survivors. Symptoms of
vicarious traumatization are similar to those
experienced by individuals with PTSD, and include
psychic numbing, hypervigilance, difficulty sleeping,
and intrusive thoughts of the trauma, which were
reported by the client. Also called secondary PTSD or
compassion fatigue. Kluft and Fine, Clinical
Adapted from Sidran Foundation