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The past year has been a time for taking stock of progress in the field of dissociative disorders and complex trauma. ISSTD published its Expert Consensus Guidelines for Treating DID in Adults (3rd Revision). And two well-known experts came out with books on the same subject. James Chu, M.D., published the second edition of his noted 1998 text, Rebuilding Shattered Lives: Treating Complex PTSD and Dissociative Disorders (Hoboken, NJ: Wiley), and Elizabeth Howell, Ph.D. published a new text: Understanding and Treating Dissociative Identity Disorder: A Relational Approach (NY: Routledge).
There is little disagreement among these authors about basic principles of diagnosis or treatment. This is hardly surprising, since Dr. Chu was chair of the committee that wrote the ISSTD guidelines, and Dr. Howell was a member of the committee. The authors quote freely from one another and cite each other's work. The differences are those of style and voice.
As one might expect, the ISSTD Guidelines, written by committee, are the most impersonal and abstract. There are no case examples or clinical anecdotes. They have the benefit, however, of simplicity and clarity. They are published both in a short, summary form, and in a longer, fully referenced version. The topics covered include epidemiology of dissociative disorders, diagnostic criteria and differential diagnosis, treatment goals, an outline of phase-oriented psychotherapy, and a review of adjunctive treatment modalities. The guidelines also briefly touch on the special challenges of working with this population: the temptations to breach the boundaries of the therapy relationship, and the credibility issues that often arise concerning the validity of patients' memories. The authorial voice is calm, reasoned, and straightforward throughout.