Table Of ContentTreating Dissociative and Personality Disorders
A motivational systems approach to theory and treatment
Edited by
Antonella Ivaldi
First published 2016
by Routledge
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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: 978-0-41564137-1 (hbk)
ISBN: 978-0-41564140-1 (pbk)
ISBN: 978-1-31563729-7 (ebk)
Typeset in Times New Roman
by Florence Production Ltd, Stoodleigh, Devon
Contents
Foreword Giovanni Liotti
Foreword Joseph D. Lichtenberg
Introduction
ANTONELLA IVALDI
1 Theorizing about theory
JOSEPH D. LICHTENBERG
2 Theoretical foundations
ANTONELLA IVALDI
Where this model fits among other theoretical perspectives in
psychotherapy
Motivational systems theories
A comparison of the two theories: a personal synthesis
3 The therapeutic relationship from the theoretical perspective of
motivational systems
JOSEPH D. LICHTENBERG AND GIOVANNI LIOTTI
Introduction – Antonella Ivaldi
Motivational systems and the problems of patients with narcissistic,
borderline, and dissociative disorders Joseph D. Lichtenberg
The debate between Joseph Lichtenberg and Giovanni Liotti. From infant
research to evolutionism: two motivational perspectives in dialogue
Giovanni Liotti and Joseph D. Lichtennerg
4 Complex trauma theories and psychopathology: the difficult patient
ANTONELLA IVALDI
Who is the difficult patient?
Trauma and dissociation
Psychophysiology of trauma
5 Personality disorders: diagnosis and treatment
MARIANGELA LANFREDI AND
ANTONELLA IVALDI
Empirically supported psychological approaches to the treatment of
personality disorders
Why do different treatment models prove to be equally effective? A
hypothesis based on motivational theories
6 The relational/multi-motivational therapeutic approach (REMOTA)
ANTONELLA IVALDI
FIRST PART
The structure of the dual setting REMOTA: a simple structure for a
complex process
The therapeutic relationship and its complexity
How the therapist trains for the complexity of the relationship
The first phase of treatment: individual therapy
Setting and relationship: negotiating the therapeutic alliance
The metacontext: therapy in the real context of the patient’s life
Working with emotions
Empathy: a complex process?
The body in therapy: the use of non-verbal communication in the
relationship
SECOND PART
The group: methodological considerations
Is affiliation an inborn motivation?
Being in a relationship using two session rooms
The therapeutic relationship and the group Why does the integration of the
individual and the group setting improve working conditions? A
biopsychosocial hypothesis based on evolution theory
Conclusion
7 Some methodological considerations on outcome research in
psychotherapy and results of a naturalistic study in the treatment of
patients with severe axis I/II comorbidity disorders
GIOVANNI FASSONE
Some food for thought
The Gold Standard for research on outcomes in medicine and
psychotherapy: is all that glitters gold?
Some problems with RCTs in psychotherapy
Conclusion
Results from a controlled naturalistic study in the treatment of severe
comorbid axis I/II patients
8 Group psychotherapy: addressing impediments to engaging the
affiliative motivational system
ROSEMARY SEGALLA
Functioning in groups
Affiliation and group membership
Aspects of affiliation in group therapy
Impediments to the activation of the affiliative motivational system
From individual to group: a case
Summary
References
Index
Foreword
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.
