Antonella Ivaldi - Treating Dissociative and Personality Disorders: A Motivational Systems Approach to Theory and Treatment

Treating Dissociative and Personality Disorders

A motivational systems approach to theory and treatment

Edited by
Antonella Ivaldi

First published 2016

by Routledge

2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

and by Routledge

711 Third Avenue, New York, NY 10017

Routledge is an imprint of the Taylor & Francis Group, an informa business

2016 selection and editorial matter, Antonella Ivaldi; individual chapters, the contributors

The right of the editor to be identified as the author of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Cataloging in Publication Data
Names: Ivaldi, Antonella, editor.

Title: Treating dissociative and personality disorders : a motivational systems approach to theory and treatment / edited by Antonella Ivaldi.

Description: Milton Park, Abingdon, Oxon ; New York, NY : Routledge, 2016. | Includes bibliographical references and index.

Identifiers: LCCN 2015047617| ISBN 9780415641371 (hbk) | ISBN 9780415641401 (pbk) | ISBN 9781315637297 (ebk)

Subjects: LCSH: Dissociative disorders Treatment. | Personality disorders Treatment.

Classification: LCC RC553.D5 T74 2016 | DDC 616.85/23 dc23

LC record available at http://lccn.loc.gov/2015047617

ISBN: 978-0-415-64137-1 (hbk)

ISBN: 978-0-415-64140-1 (pbk)

ISBN: 978-1-315-63729-7 (ebk)

Typeset in Times New Roman

by Florence Production Ltd, Stoodleigh, Devon

Contents

ANTONELLA IVALDI

JOSEPH D. LICHTENBERG

ANTONELLA IVALDI

JOSEPH D. LICHTENBERG AND GIOVANNI LIOTTI

ANTONELLA IVALDI

MARIANGELA LANFREDI AND ANTONELLA IVALDI

ANTONELLA IVALDI

The therapeutic relationship and the group

GIOVANNI FASSONE

ROSEMARY SEGALLA

Giovanni Liotti

The continuously shifting different motives that underpin any affectively significant and durable exchange between human beings are a key focus of interest for psychotherapists in general and psychoanalysts in particular. In contemporary clinical practice, it is likely that the majority of psychoanalysts and even a wider proportion of dynamic psychotherapists of any orientation do not rely any more on the classical theory that reduces these motives to two basic instinctual drives, sex (libido) and destructive aggression (mortido). Multi-motivational approaches to human relatedness considering attachment, intersubjectivity and other systems of motives together with sex and aggression are emerging substitutes for the classical dual drives theory. Two multi-motivational theories the psychoanalytic one advanced by Joseph Lichtenberg and a cognitive-evolutionary one provide comprehensive conceptual backgrounds both for the study of the multiple primary systems that regulate human relationships and for the applications to clinical practice of the emerging multifarious view of the basic underpinnings of relational experiences and behaviour.

In this book, Antonella Ivaldi provides the lively picture of a clinical practice influenced by both these multi-motivational theories. She does so by narrating not only her experience of the clinical exchange with difficult patients with a history of chronic childhood traumatization, but also her lived dialogues with Joseph Lichtenberg and with myself as a supporter of the cognitive-evolutionary theory of motivation. To my knowledge Antonella Ivaldis is the first attempt at a comparison of two different theories that focuses more on the lived experience of a dynamic psychotherapist both in her formative encounters with senior professionals and in her exploration of clinical realities than on abstract theorizing. Going through the pages of this book, readers not only can learn which are the basic tenets of the two multi-motivational theories, the number and types of motivational systems considered by each and their similarities and differences, but they can also figure out the mental processes of a clinician who is engaged, during her practice, in dialogic thinking between herself, two of her professional mentors and each of her difficult patients. In dialogic thinking there is not room for defending the superiority of ones own preferred theory, because the focus of attention is in the exchange of ideas and experiences as a source of intellectual riches that vanish when one is too strongly defending one side of the dialogue and striving to prove the other side wrong. In dialogic thinking, one is always hoping that the inner or outer interlocutor, rather than the self, is right. One hopes so because she or he is aware that this is the only way both to support the robustness of ones preferred theory and to expand it by amending it of mistakes. When dialogic thinking between the different theories of two interlocutors is going on in the mind of a third party that is remembering the personal encounters with the proponents of the two theoretical positions, as is the case with Ivaldi, it may rise to the apex we call open-mindedness and versatility. In her book, Ivaldi is not interested in arguing which one of the two theories is to be preferred because of its scientific rigor, its width of scope or its clinical usefulness. Rather, she is interested in sharing with colleagues her enthusiasm for the perspectives opened up by the continuous comparison of the two theories in her professional life. The final result of putting this comparison in the pages of a book is not only deeply informative, but also quite refreshing reading for any clinician.

Joseph D. Lichtenberg

Antonella Ivaldi has written a book about relationships. Read her sensitive human interchange with Angie for an introduction to her clinical relationally-focused sensitivity. She describes for the reader the depth of the connection she has made to her two principal mentors of whom I have the honor and satisfaction of being one. In the spirit of her book, Antonella tells not only about Liotti and Lichtenberg as two theoreticians whose concepts converge, differ, and overlap, but also about her personal attachment to each of us. Relationship, theory, and clinical acuity all come together in the wonderful synthesis that is central to Antonellas presentation and personhood. Many components of the book cover new ground in the treatment of very troubled patients in an easy-to-read and informative manner. Particularly rich is the discussion of the place in day-to-day therapy of theory, especially a well-formulated theory of motivation. Using rich clinical examples, she demonstrates how her use of motivational theory enables her to navigate the challenges of treating difficult patients.

Antonella in her writing, and Giovanni and I in our debate, carefully avoid polarizing stances, instead keeping issues open for what can be gained from each. This dialogic perspective enables her to use two theories and two treatment methods individual and group. The combination facilitates her sensitivity to both a patients and therapists ever-shifting motivations. Antonellas empathy and willingness to be an involved presence radiates throughout the pages giving the presentation a liveliness reflective of its author.