From Metaphor to Interpretation: “Haunting” as Diagnostic of Dissociative Processes

Patients with psychogenic voice disorder (PVD), a disorder of voice in the absence of identifiable pathology, present a particular challenge to clinicians. Although the voice can usually be restored by the use of speech therapy, recurrences can only be prevented by psychotherapeutic intervention. Psychological factors have been long recognized as playing a role in these disorders, but the nature of this contribution has been unclear. Various conceptual frameworks have been used to understand this disorder. While for much of the last century, “conversion” has been seen as the primary process that underpins this disorder, little attention has been paid to the role of dissociation in this regard. This paper explores the utility of viewing PVD through a lens of Self. In so doing, PVD can be considered as a symptomatic expression of a compromised sense of Self which has its genesis in relational trauma and maladaptative defensive maneuvers. These are underpinned by complex dissociative processes which operate largely outside of conscious awareness. A clinical vignette demonstrates the utility of treating this disorder with both speech therapy techniques and a specific mode of psychotherapy, the Conversational Model, which is focused on the fostering of a sense of Self. It will be shown that this perspective not only provides a clear view of the genesis of thisdisorder, but also describes a pathway for effective treatment.

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Nonverbal communication in the context of dissociative processes.

Psychoanalytic Psychology ◽

10.1037/0736-9735.25.3.443 ◽

2008 ◽

Vol 25 (3) ◽

pp. 443-457 ◽

Cited By ~ 9

Author(s):

Thomas G. Arizmendi

Keyword(s):

Nonverbal Communication ◽

Dissociative Processes

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Radiative, collisional and dissociative processes in triplet acetone

Chemical Physics Letters ◽

10.1016/0009-2614(85)85149-6 ◽

1985 ◽

Vol 115 (4-5) ◽

pp. 362-368 ◽

Cited By ~ 31

Author(s):

Richard A. Copeland ◽

David R. Crosley

Keyword(s):

Dissociative Processes

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Inorganic solution chemistry at elevated pressures

Canadian Journal of Physics ◽

10.1139/p95-037 ◽

1995 ◽

Vol 73 (5-6) ◽

pp. 258-266 ◽

Cited By ~ 6

Author(s):

T. W. Swaddle

Keyword(s):

Reduction Process ◽

Outer Sphere ◽

Solution Chemistry ◽

Pressure Effects ◽

Inorganic Systems ◽

Oxidation Reduction ◽

Adiabatic Electron Transfer ◽

Pressure Independent ◽

Experimental Values ◽

Dissociative Processes

Recent interest in pressure effects on inorganic systems in solution has been centred upon the use of volumes of activation ΔV‡ as criteria of reaction mechanism. Work in our laboratory has sought to determine whether ΔV‡ is indeed a useful parameter in this respect, i.e., whether it is substantially independent of pressure and reaction conditions and whether it can be quantitatively predicted for suitably "simple" reactions. For solvent exchange on metal ions (the simplest conceivable substitution process), a semi-empirical model predicts ΔV‡ for limiting dissociative (bond breaking) and associative (bond making) mechanisms in water, but experimental values lie between these extremes, vindicating the Langford–Gray "interchange" model in which associative and dissociative processes are viewed as being concerted. For adiabatic electron transfer reactions of the outer-sphere type (the simplest conceivable oxidation–reduction process) in water, an adaptation of Marcus theory accounts for the essentially pressure-independent ΔV‡ satisfactorily, and failures of such predictions can be ascribed to complications such as nonadiabaticity or the incursion of inner-sphere (ligand-bridged) reaction pathways. The theory is less successful in nonaqueous solvents. Experimental methods used for these and related studies include high pressure adaptations of nuclear magnetic resonance, UV–visible spectrophotometry, stopped-flow techniques, cyclic voltammetry, and sampling under pressure.

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