Dissociation, Therapeutic Enactment, and Transference—Countertransference Processes: A Discussion of Papers on Childhood Sexual Abuse by S. Grand and J. Sarnat

Dissociation in the simplest of terms signals a failure to bring into associative contact two mental images or events which might be well thought of as belonging together. It is an integrative failure. In its defensive, dynamic incarnation it is an active severing of associational links. Depending upon the presence or absence of trauma in the patient's history, and the severity of such trauma where it is present, dissociation can occur at many different levels. It can affect the connection between events and the affects associated with them. It can affect the connection between events and the meaning or significance with which they become imbued. Where trauma has been most profound, dissociation can come to interfere with the patient's ability to record these traumatic events in long-term verbal memory.

From the time of Pierre Janet to the present (for a discussion of janet's work on trauma, see Van der Hart and Horst [1989]; for Janet's influence on contemporary relational psychoanalysis, see Davies [1996a, b];