Book Review: Intensive Psychotherapy for Persistent Dissociative Processes

If you have ever seen the movies The Three Faces of Eve or Sybil, you might have found yourself second guessing your own behavior or wondering whether close friends or family have multiple personalities, but the popularity and sensationalism of these movies do not necessarily reflect the many nuanced and serious components of dissociative disorders. That’s why so many mental health professionals have spent the years following the production of these two films attempting to explain dissociative disorders.  The latest attempt, Richard Chefetz’s Intensive Psychotherapy for Persistent Dissociative Processes: The Fear of Feeling Real, does a fantastic job of explaining the dissociative process of patients who have struggled with connecting their painful history to their current reality.

Early on, Chefetz makes it clear to the reader that his book is not about multiple personality disorder (or dissociative identity disorder), but rather the experience of separation from the self, external world, or emotions.  The author clarifies that most people engage in a form of dissociation that is not easily identifiable by others, even clinicians.

For some individuals who have endured traumatic experiences, the brain’s way of coping will result in lost memories or positive restructuring of life events. For other individuals, dissociation (i.e., the separation of the self from one’s own thoughts, feelings, and emotions) occurs and the individual is unable to connect the negative experience to their reality. When working with young clients who are showing symptoms and behaviors of dissociative processes, I often have to explain to parents that dissociation is basically like a severe out-of-body experience or daydream. Once the body and mind begin to dissociate, it is difficult to get that individual to identify when they need help.

Chafetz explains dissociation in multiple ways using a psychoanalytical and psychodynamic approach. He reviews the cases of two of his patients, and these case studies, although difficult to conceptualize for the first-time reader on the topic of dissociation, show how dissociation is not exhibited in ways you might imagine or assume. Chefetz explains the difficulty involved in identifying covert dissociative processes during a session and highlights the importance of treatment providers’ being aware of dissociative symptoms. Dissociative processes, according to Chefetz, are also sometimes overt and can be easily identified in patients as they contradict themselves during conversation, express contradictory emotions or desires, and/or send emails that include multiple inconsistencies in thought patterns. Chefetz demonstrates the fear that many of his client’s had in attempting to face reality, process their feelings, or cope with their dissociation.

Unfortunately, if you are not familiar with psychotherapy and struggle with a scientific explanation of behavior, this book is not for you. Although Chefetz does a great job of discussing the complexities of dissociative processes and “the fear of being real,” Chefetz risks losing his reader by incorporating technical terms that are not only complicated, but relative to psychobabble. Unfortunately, the technical terms can undermine the psychological knowledge the book strives to provide its reader. As a therapist, I would not recommend this book for laymen attempting to understand dissociative disorders, processes, or experience. This book is certainly better suited for a student in training, a mental health professional, or a layman with prior knowledge of the field of psychiatry and psychotherapy.

That said, Intensive Psychotherapy for Persistent Dissociative Processes is a great book for professionals working with client’s who dissociate. Overall, Chefetz offers readers a great deal to think about and consider when living or working with someone who suffers from dissociative disorders and dissociative experiences. Most important, Chefetz offers an  inside look at dissociative processes and stimulates the reader’s mind on how to intervene, heal, and care for someone struggling with dissociation.

Intensive Psychotherapy for Persistent Dissociative Processes: The Fear of Feeling Real
W. W. Norton & Company, April 6, 2015
Hardcover, 496 pages
$42.50