Stress Response Syndromes: PTSD, Grief, Adjustment, and Dissociative Disorders

323 Pages·2011·5.17 MB·English

by  Mardi J. Horowitz

Stress Response
Syndromes

Stress Response
Syndromes
PTSD, Grief, Adjustment,
and Dissociative Disorders
Fifth Edition
M J. H ,
ardi orowitz Md
JASON ARONSON
Lanham • Boulder • New York • Toronto • Plymouth, UK
Published by Jason Aronson
A wholly owned subsidiary of The Rowman & Littlefield Publishing Group, Inc.
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Copyright © 2011 by Jason Aronson Publishers, Inc.
All rights reserved. No part of this book may be reproduced in any form or by any electronic
or mechanical means, including information storage and retrieval systems, without written
permission from the publisher, except by a reviewer who may quote passages in a review.
British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data
Horowitz, Mardi Jon, 1934–
Stress response syndromes : PTSD, grief, adjustment, and dissociative disorders /
Mardi J. Horowitz — 5th ed.
p. cm.
Summary: “I kept the well-supported assertions from the earlier edition and added
essential new information. The most important changes involved diagnostic considerations
as we head for DSM-V and ICD-11. Treatment suggestions are updated with more
attention to the formulations needed for helping complex, ‘real world’ cases. I also updated
the emotional information processing theory.”—Provided by publisher.
Includes bibliographical references and index.
ISBN 978-0-7657-0839-7 (hardback)
1. Post-traumatic stress disorder. 2. Post-traumatic stress disorder—Case studies. I. Title.
RC552.P67H67 2011
616.85’21—dc23 2011021748
 ™
The paper used in this publication meets the minimum requirements of American
National Standard for Information Sciences—Permanence of Paper for Printed Library
Materials, ANSI/NISO Z39.48-1992. Printed in the United States of America
For those strangers who, roused by a shared sense of humanity, help others
overcome difficult events, providing compassion, restoration, and hope.

And, more personally, in loving memory of Lillian and Morris Horowitz,
who taught me compassion, restoration, and hope.

Contents
Foreword to the First Edition ix
Preface to the Fifth Edition xi
Acknowledgments xiii
Part onE: StrESS rESPonSE SyndromES
1 Intrusion and Denial: A Prototypical Case 3
2 Clinical Observations and Syndromes 9
3 Field Studies on the Impact of Life Events (with Nancy Wilner) 41
4 Experimental Findings (with Stephanie Becker and Nancy Wilner) 63
Part two: GEnEral thEory oF SymPtom Formation
5 Explanation of Symptom Formation 77
6 Reschematization 97
7 Mourning 109
Part thrEE: trEatmEnt and individual variationS
8 Treatment 127
9 Inhibitory Operations: Reactions to Stress and Psychotherapy
with Histrionic Personalities 157
10 Switching Maneuvers: Reaction to Stress and Psychotherapy
with Compulsive Personalities 165
11 Sliding Meanings: Reaction to Stress and Psychotherapy with
Narcissistically Vulnerable Personalities 175
vii
viii CONTENTS
Part Four: CliniCal ExamPlES
12 Loss of a Limb (with Robert Nadol) 185
13 An Automobile Accident (with Richard Olson, M.D.) 199
14 Visual Shock and the Compulsion to Look (with Erik Gann) 243
15 Suicide of a Parent (with Frederick Parris) 253
16 Suicide of a Friend (with Robert Hammer) 271
References 283
Index 303
About the Author 307
Foreword to the First Edition
This book by Dr. Mardi Horowitz on the psychological understanding and the
psychotherapeutic amelioration of specifically circumscribed psychopathological
entities, the Stress Response Syndromes, is an exciting and long-needed investi-
gation that reflects the creative interplay of psychotherapy, research, and prac-
tice. It is, after all, of the essence of the clinical, medical, and health disciplines,
the so-called healing arts, of which psychotherapy par takes, that continuing
advance in understanding and in practice should accrue from the effective and
creative interplay of formal research, basic investigation—in theoretical struc-
ture, in experi mental laboratory, or in field observation or survey—in interplay
with the clinical experience and clinical reflection of the bedside, or in our
instance, the consulting room. It is this creative inter play between research and
practice, leading to the enhancement of both, which has been so underdeveloped
in our “peculiar” science with its heretofore essentially one-sided development
of clinical insight and understanding without the signal benefit of concomitant
growth from the formal and systematic research side of any comparable insight
and understanding.
Mardi Horowitz’s book is a multifaceted model, or rather a series of models,
paradigmatic of a new genre, that brings psycho therapy research meaningfully
into the clinical picture; that is, where each influence furthers the other. What
is the nature then of these models? There is first a model of problem setting and
problem delineation in the field of psychological understanding and psychological
intervention. Through a sequence (1) of typical clinical case history in sufficient
detail; (2) of equally detailed and at the same time wide-ranging field observation
and survey drawing upon disaster and extreme circumstance, whether wartime
military combat or peacetime fire or shipwreck, whether such inhumane extreme
circumstances as concentration camps and nuclear holocaust or more “everyday”
ix