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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. Houghton Mifflin.
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.
References
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.
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