Parry, Sarah and Simpson, Jane (2015) Qualitative explorations of talking therapies with CSA survivors and therapeutic relationships discussed by people experiencing dissociation : what are the experiences of therapeutic relationships on hospital wards of people who experience dissociation? PhD thesis, Lancaster University.
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Abstract
Initially, this thesis presents an idiographic systematic review that explored how adult survivors of childhood sexual abuse experience talking therapies. The key findings suggest that although the process of healing is challenging and often viewed as an ongoing process, talking therapies can facilitate healing through developing trust, safety, relational equality and establishing interpersonal connections. Additionally, the experiential learning of choice, control, respect and being believed was essential for long-term healing, which could facilitate intrapersonal reconnection. Secondly, the findings of an empirical study are presented, which qualitatively explored how people who dissociate experience therapeutic relationships with ward based staff through interpretative phenomenological analysis. The three superordinate themes suggest that the participants faced a number of challenges. For instance, managing their dissociative experiences alongside the inconsistent relationships on the wards, the difficulties of having differing interpersonal needs at varying times and the importance of working with alters, not around them. The findings reaffirmed the importance of therapeutic relationships for the purposes of feeling safe, being able to connect to others and then the self, feeling recognised as a whole person and accepted rather than judged. The results discuss how staff can facilitate this process and the implications for ward based treatment are considered in relation to the existing literature. Thirdly, the systematic review and empirical study are reflected upon through a critical appraisal, primarily focussing on the empirical paper, which concludes the thesis. Further findings from the empirical study are presented that discuss how participants reported experiencing dissociation on wards and the impact of their experiences for therapeutic relationships. The experience of completing the study is also considered, in accordance with changing perspectives in light of the meaning making processes of the participants.