Dissociative Patients Who Take Undergraduate Abnormal Psychology Courses: Guidelines for their Therapist
Prepared by the Sub-Committee for Public Education and the Media. This was drafted by Dr. Harold D. Siegel, Ph.D. and reviewed by Annita B. Jones, Psy.D. and Lisa D. Butler, Ph.D. Special thanks to Eli Somer, Ph..D. for his input.
The purpose of this document is to help therapists whose dissociative patients are taking or planning to take undergraduate abnormal psychology classes, or considering doing so. Unfortunately, studying abnormal psychology may be extremely disruptive to patients, and frequently to their therapists as well. This is particularly true if the patient exhibits resistance to his or her diagnosis.
Patients may have different motivations for studying abnormal psychology: some may see it as just another step toward the goal of earning a degree, but others may be seeking an opportunity to learn more about themselves and material that is relevant to their therapy. While these issues need to be examined in therapy, it is also worth exploring the possibility of having the patient postpone studying abnormal psychology until they are ready emotionally. If this is not possible, it is very important to prepare the patient for what they are likely to experience.
A review of ten undergraduate abnormal psychology textbooks (Siegel, 2005; 2006) revealed a tendency to present DID in a sensationalized manner, rather than presenting the mundane, but more common examples of the disorder (see Table 1 for a list of the texts reviewed). They usually view the dissociative disorders, particularly DID, as being extremely rare. While most texts attempt to assume a posture of neutrality with respect to the false memory syndrome, most dwell on the topic. Many of the books emphasize the alleged iatrogenic basis of DID and the view that DID is essentially role-playing. There have even been texts that suggest that abuse might not be a factor in bringing about psychopathology.
Table 1: Ten Textbooks Reviewed:
1. Butcher, J.N., Mineka, S., & Hooley, J.M.. (2004) Abnormal Psychology, Twelfth Edition.
Allyn and Bacon.
2. Carson, R.C., Butcher, J.N., & Mineka. (2000) Abnormal Psychology and modern life,
Eleventh Edition. Allyn and Bacon.
3. Comer, R.J. (2004) Abnormal Psychology, Fifth Edition. Worth.
4. Halgin, R.P., & Whitbourne, S.K. (2005) Abnormal Psychology: Clinical perspectives
on psychological disorders, Fourth Edition. McGraw Hill.
5. Holmes, D.S. (2001). Abnormal Psychology, Fourth Edition. Allyn and Bacon.
6. Nevid, J.S.., Rathus, S.A., & Greene, B. (2005) Abnormal Psychology in a changing
world, Fifth Edition. Prentice Hall.
7. Oltmanns, T.F.., & Emery, R.E. (2004). Abnormal Psychology, Fourth Edition. Prentice Hall.
8. Raulin, M. (2003) Abnormal Psychology. Allyn and Bacon.
9. Sarason, I.G., & Sarason, B.R. (2002) Abnormal Psychology: The problem of maladaptive
behavior, Tenth Edition. Prentice Hall.
10. Sue, D., Sue, D.W., & Sue, S. (2003). Understanding abnormal behavior, Seventh Edition.
There are potential risks to both the patient's therapy and their education. For example, resistant alters might be persuaded to accuse the therapist of bringing about iatrogenesis. On the other hand, patients might be tempted to try to “educate” professors about dissociation. Such an interaction risks being a negative experience for the patient, and his or her inclination to do this should be thoroughly discussed in therapy.
Another situation that is sometimes difficult is if the patient is faced with an exam question that requires an answer that the patient believes to be false. If this situation arises, patients should be reminded of their goals and encouraged to do what is in their best interest. Any stance of principled defiance on tests should be thoroughly addressed in therapy first. Moreover, the risk of abnormal psychology and the accompanying texts to the well-being of patients is something to be taken seriously.
Siegel, H.D. Critical issues: Dissociation and undergraduate abnormal psychology text books. The International Society for the Study of Dissociation News, 2005, 23 (3), 8-9.
Siegel, H.D. Dissociation and undergraduate abnormal psychology textbooks: A follow-up. The International Society for the Study of Dissociation News, 2006, 24 (5), 15-16.