Chronic shame, an experience of being without value, is often at the center of the aftermath of traumatic experience accompanied by active dissociative processes. Infant attachment strategies are generated in the face of fear and seek proximity to a caretaker. Such seeking is compromised when the attachment relationship is itself a source of terror, horror, or other physical or psychic pain. Enlivenment, both longed for and feared, is hidden in the wish to heal from trauma and may become trapped in the tension between seeking safety by connection and seeking safety by maintaining distance from an abusive caretaker, an attackment relationship (Chefetz, 2015). In DID we see both of these dynamics playing out internally via dissociative states of self attempting to regulate via extinguishing enlivened affects before they become visible. Placing the search for enlivenment and the need for safe relating in the center of the therapeutic relationship allows prediction of clinical constellations of experience that can assist in safely navigating these complex treatments. An active combination of theory and case presentation is used to illustrate how to understand attackment relating and the search for enlivenment as being at the center of intensive psychotherapy for the treatment of trauma and dissociation.
Identify how chronic shame prevents the enlivenment of felt experience
Develop strategies to engage with attackment presentations
Describe the internal interplay between dissociative and shame-based processes
Explain how shame defenses often facilitate negative treatment reactions
Explain internal psychodynamics between self states in DID as partly mediated by shame defenses