ABSTRACT
A recent surge in writing about dissociation within the relational psychoanalytic literature has provided the clinical reader with poignant and prosaic examples of the travails and potentially transformative experience of analytic work with highly dissociative patients (MacIntosh, 2015). Key writers in this field provide detailed case descriptions along with thoughtful theoretical commentary to guide clinicians in their approach to this challenging work (Bromberg, 2011; Davies, 2001; Stern, 2010). An emphasis on working within the dissociative enactments and in attempting to bridge the dissociative gap between the symbolized and that which is outside of the patient’s current capacity to be symbolized is suggested as a key mechanism in the process of change (Bromberg, 2012; Stern, 2011). Bromberg argues that while dissociation is protective, it robs the traumatized patient of the capacity for self-reflection, intersubjectivity, intrapsychic conflict, and self-regulation (Bromberg, 2011). These key writers would argue that working at the level of the dissociative enactment is not only necessary but, in fact, inevitable and ubiquitous (Bromberg, 2006, 2011; Davies, 1999; Stern, 1997, 2003, 2010).
