Commentary on Paper by Debra Rothschild

In my response to this paper, I begin by appreciating Debra Rothschild's relational approach and pointing to the links with our work at the Clinic for Dissociative Studies. For example, we all respond differently to child alters/states than to adult ones, consider the attachment relationship to be the crucial tool, do not like to see distancing mechanisms privileged by abusing the original concept of “neutrality,” and consider honesty and authenticity are essential when working with extreme trauma. In this we agree with Bass (2007) Bass, A. 2007. When the frame doesn't fit the picture. Psychoanalytic Dialogues, 17: 1–27. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar] that one size does not fit all. We consider patients need to choose between integration or separateness. Where integration is sought we speak of “merger not murder.” I express concern at the prevailing idea that a person with Dissociative Identity Disorder needs safety, stabilisation, and symptom reduction initially when the most needy clients are those who will never be safe. I also raise issues around secondary traumatisation to the therapist, the meaning of self-injury, and the language used to describe the angry alter.