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Secondary structural dissociation involves one ANP and more than one EP. Examples of secondary structural dissociation are complex PTSD, complex forms of acute stress disorder, complex dissociative amnesia, complex somatoform disorders, some forms of trauma-relayed personality disorders, such as borderline personality disorder, and dissociative disorder not otherwise specified (DDNOS).. Secondary structural dissociation is characterized by divideness of two or more defensive subsystems. For example, there may be different EPs that are devoted to flight, fight or freeze, total submission, and so on. (Van der Hart et al., 2004). Gail, a patient of mine, does not have a personality disorder, but describes herself as a "changed person." She survived a horrific car accident that killed several others, and in which she was the driver. Someone not knowing her history might see her as a relatively normal, somewhat anxious and stiff person (ANP). It would not occur to this observer that only a year before, Gail had been a different person: fun-loving, spontaneous, flexible, and untroubled by frightening nightmares and constant anxiety. Fortunately, Gail has been willing to pay attention to her EPs; she has been able to put the process of integration in motion; and she has been able to heal. p134

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In projecting onto others their own moral sense, therapists sometimes make terrible errors. Child physical abusers are automatically labeled __mpulsive," despite extensive evidence that they are not necessarily impulsive but more often make thinking errors that justify the assaults. Sexual and physical offenders who profess to be remorseful after they are caught are automatically assumed to be sincere. After all, the therapist would feel terrible if he or she did such a thing. It makes perfect sense that the offender would regret abusing a child. People routinely listen to their own moral sense and assume that others share it.Thus, those who are malevolent attack others as being malevolent, as engaging in dirty tricks, as being __n it for the money,_ and those who are well meaning assume others are too, and keep arguing logically, keep producing more studies, keep expecting an academic debate, all the time assuming that the issue at hand is the truth of the matter.Confessions of a Whistle-Blower: Lessons Learned Author: Anna C. Salter. Ethics & Behavior, Volume 8, Issue 2 June 1998 p122

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Punishment symptoms Many of the other types of programming produce psychiatric symptoms, usually administered as punishments by insiders who are trained to administer them, if the survivor has breached security or disobeyed the abusers' instructions in other ways. These symptoms serve a variety of purposes, such as disrupting therapy, getting the survivor into hospital, or getting the survivor to return to the perpetrators to have the programming reinforced. p126

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Alison Miller

Becoming Yourself: Overcoming Mind Control and Ritual Abuse

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The first thing you need to know if you are a survivor is that parts of you have probably been trained to create a variety of symptoms and behaviours. Abusers actually train child parts to cut the body, to make other parts cut, to attempt suicide, to create flashbacks by releasing pieces of visual or auditory memories, to create body memories of pain or electroshock, and to create depression, terror, anxiety, and despair by releasing the emotional components of memories to the rest of the personality system. The front person and most of the rest of the system do not know that this is the source of these feelings and behaviours. p126

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Alison Miller

Becoming Yourself: Overcoming Mind Control and Ritual Abuse

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Rikki looked over at me.__hy now?" she asked, looking back at Arly. __hy is this happening now?""Hard to say." Arly [therapist] replied. "DID usually gets diagnosed in adulthood. Something happens that triggers the alters to come out. When Cam's father died and he came in to help his brother run the family business he was in close contact with his mother again. Maybe it was seeing Kyle around the same age when some of the abuse happened. Cam was sick for a long time and finally got better. Maybe he wasn't strong enough until now to handle this. It's probably a combination of things. But it sure looks like some of the abuse Cam experienced involved his mother. And sexual abuse by the mother is considered to he one of the most traumatic forms of abuse. In some ways it's the ultimate betrayal.

CW
Cameron West

First Person Plural: My Life as a Multiple

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Admitting the need for help may also compound the survivor's sense of defeat. The therapists Inger Agger and Soren Jensen, who work with political refugees, describe the case of K, a torture survivor with severe post-traumatic symptoms who adamantly insisted that he had no psychological problems: "K...did not understand why he was to talk with a therapist. His problems were medical: the reason why he did not sleep at night was due to the pain in his legs and feet. He was asked by the therapist...about his political background, and K told him that he was a Marxist and that he had read about Freud and he did not believe in any of that stuff: how could his pain go away by talking to a therapist?

JH
Judith Lewis Herman

Trauma and Recovery: The Aftermath of Violence - From Domestic Abuse to Political Terror

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I consider therapy successful when the family members (or individual clients) have discovered ways to get what they need from their relationships with the people in their lives, so that their relationship with me is no longer necessary to sustain them. Like a chemical catalyst that facilitates a reaction between two other substances, the therapeutic relationship catalyzes the transformation of relationships in the lives of clients. But the real healing takes place not in the therapeutic relationship but in the client's relationships with significant others.

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Joseph A. Micucci

The Adolescent in Family Therapy: Harnessing the Power of Relationships

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More often than not, it__ disrespectful to them (our children) - and disrespectful to their struggle with their tasks in life- if our own anxiety as parents makes us cling to our children. It__ disrespectful is we demand more intimacy than they are willing or able to give. Too much involvement with our children is not an act of love- it__ an act of selfishness.

DG
Daniel Gottlieb

Voices in the Family: A Therapist Talks About Listening, Openness & Healing

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As our children turn even five or six degrees away from us, we have to be aware of our fear and our excitement and our hope for them. And as that five or sex degrees turns into ten or twenty degrees, even ninety degrees, we have to monitor those feelings every step of the way-and ultimately realize that our child is another human being and not necessarily and extension of us.

DG
Daniel Gottlieb

Voices in the Family: A Therapist Talks About Listening, Openness & Healing