no win situations

Jim - I am interested in your hypothesize about the role of MPD and testing- you could be right and some of the behaviors we see in treatment might be a patient's way to get information from therapists, or caretakers. We also might, as you suggest, be seeing reproductions of some of the traumatic scenarios that the patient had to deal with. But it is clear that when very young children are exposed to severe emotional and physical trauma, intensive dissassociative processes could be needed, and adaptive, as you said. The young child must find away to know and not know what they are dealing with. Weiss explains it as the child has to love the father (for example) and receive caretaking from him. The child wants and needs to find a way to enjoy her father in the day time so she must forget the evening's activities, yet it is unadaptive to do so. The child must also prepare her psyche and body to withstand the evenings activities and can't allow oneself to forget- the dilemma is solved throughout a separation of what is happening to whom - so to speak.

I was wondering where Jim saw the reference to it being safer to guess that a particular behavior is a transference test rather than a passive into active one- it is interesting to think about what one assumes- I tend to judge the test and it's origin by how it effects me. If I am made very uncomfortable in an unusual way, I tend to think more about a passive into active test rather than a transference test. When the patient is treating you as the authority figure it usually is easier on my psyche. For the patient it is usually safer to turn passive into active as then you are receiving the treatment instead of them and they are in the drivers seat. It is always case specific of course! But there is a lot of discussion about when, and whether one should interpret passive into active to the patient at all. That is because there is a danger that the patient will hear it as you telling them to stop testing. I think one can and usually should interpret your understanding of the patient's behavior. It must be carefully timed to help a patient understand and gain control over one's behavior.

• Found It! by Jim Duffy, 3/13/98