Re:PSTD

This isn't so much a comment on your particular case as a general comment.

Sometimes the most ethical action for a given therapist is to refer a patient out if the therapist cannot meet the needs of that client. Dissociative clients in particular often find themselves disappointed because most therapists can't meet their needs, either in terms of in-between session contact (which most therapists can't do) or because they are not trained to treat dissociation.

In such cases, the right thing for the therapist to do is to recognize the needs of the client, their own limitations, and make an appropriate referral. Having said that, most of us who treat dissociative disorders already have our share, and other therapists needs to get the training to treat dissociative clients.

Finally, dissociative clients are very likely to feel abandoned if referred out, no matter how rational the referral. Dissociative clients are very likely to feel abandoned no matter what the therapist does, because reenactment of original trauma is what its all about.

Any client feeling abandoned has an opportunity in working with the next therapist to talk about their abandonment feelings and what it reminds them of from their past.

Replies:

Re:PSTD, by ellen, 07/24/03

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