ESTD European Society for Trauma and Dissociation

Plenary Speakers

Giovanni Liotti (IT)

From infant attachment disorganization to adult dissociation: Discussion of Karlen Lyons-Ruth’s presentation

BIO:
Psychiatrist and psychotherapist practicing in Rome, Italy. Currently teaches “Implications of attachment theory for psychotherapy” in the APC School of Psychotherapy and in the Post-graduate School of Clinical Psychology of the Salesian University, Roma, Italy.
His interest for the clinical applications of attachment theory and research dates back to 1975, and was first expressed in a book co-authored with V.F. Guidano, (“Cognitive processes and emotional disorders”, New York, The Guilford Press, 1983). Since then, this interest has focused mainly on the links between dissociative psychopathology and disorganization of attachment. For the papers published on this theme, he received the 2005 Pierre Janet’s Writing Award (The International Society for the Study of Dissociation). He has been an invited speaker at the John Bowlby Memorial Conference, London 2007 and will be Keynote Speaker to the Royal Australian and New Zealand College of Psychiatrists Section of Psychotherapy Annual Bi-National Conference, 2008, on the theme of attachment disorganization in trauma-related disorders.

Biographical Sketch

TALK ABSTRACT:
In my discussion of Professor Karlen Lyons-Ruth’s presentation, I’ll focus on three themes that are particularly interesting for clinicians.

The first one is a theoretical and research theme, concerning the controlling strategies and the hostile-helpless mental states, insofar as these strategies and mental states may clarify (1) the non overtly dissociative, but highly maladaptive features of their patients' attitudes in between the recurrences of overt dissociative symptoms, and (2) how these attitudes may be related to dissociation. It is very interesting for clinicians to understand that such untoward and seemingly opposite attitudes as hostility and compulsive care-giving may protect from (or defence against) the experience of "fright without solution" and the annihilating disassociation (disorganization - disorientation) of mental functions.

The second theme regards the conceptually extremely interesting even if statistically rather feeble relation between early attachment disorganization and later dissociative pathology. Disorganization of attachment may take place not only in infancy, but also in childhood or even in adolescence as the outcome of abusive or otherwise deeply confusing child-parent attachment interactions. If this is true, then the model of attachment disorganization in infancy as an early example of dissociation may apply also to later phases of development.

The model explains the particular importance of activating a cooperative system of dialogue rather that an attachment-caregiving system during the treatment of dissociative and borderline patients. This will constitute the third theme of my comments, hinting at the usefulness, in difficult cases, of parallel integrated treatments in counterbalancing with more cooperative attitudes the strong tendency toward the activation of the attachment system during the psychotherapy of these deeply suffering patients.