Conclusion And Contraindications

The dissociative patient can find a group program to be most helpful in the recovery process provided his level of anxiety is kept at a reasonable level. As a patient's memory begins to return he begins recalling events from many years gone by which increases his anxiety level. Prior to our program, this patient's memory was mostly a blank.

It has also been demonstrated that when exposed to extremely stressful traumatic situations, containment for the reduction in anxiety through structure, and change of physical environment can contribute to maintaining the integrity of the patient's ego functioning in the "here and now." This provides the patient with the opportunity of multiple options in coping with sudden and unexpected trauma. It is hoped that upon repetitive experiences with these new options, the patient will be able to implement same when he begins to feel the increase in futures anxieties during his road to recovery.

A salient contraindication is that it is not advisable to work in a group setting with such patients outside a Hospital setting unless one is a very experienced clinician. The possibility of sudden decompensation and dissociation is not always predictable and could present considerable difficulties for the neophyte therapist.


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Edition. Washington, DC: American Psychiatric Press Inc. Hinshelwood, R.D. (1994). Attacks on the reflective space: Containing primitive emotional states. In V.L. Schermer & M. Pines (Eds.) Ring of Fire (pp. 86-106). London: Routledge. Klein, M. (1975). Envy and Gratitude. London: Hogarth.

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