Dissociation and trauma:

Dying for love: An attachment problem with some perpetrator introjects

This paper focuses on some problematic victim-perpetrator dynamics in psychotherapy with patients with Dissociative Identity Disorder where there has been longstanding multi-perpetrator organized abuse described, which also involves family members. Additionally, in this specific sample, there have been reported experiences of serious assaults from attachment figures in which the patient felt close to death. The clinical concern is expressed that only in the nearness of death is a connection felt to the attachment figure and this leads to extra suicidality in the patient and extra vulnerability to secondary traumatization for the therapist. This group faces not only relational betrayal dynamics with their reported external abusers, who provide toxic "love", but with internal perpetrators, victim-perpetrators, and victims too. The impact of an incestuous and rivalrous civil war in the body and mind that replicates the external system and is projected into the therapeutic encounter poses particular problems for therapists and patients. There are different problems for the treatment according to how the perpetrator-identified dissociative system is in need of a near-death connection.