The experience of professionals receiving patients with manifestations of traumatic dissociation: a qualitative study

Traumatic dissociation is defined as a disruption or disturbance in the integration of various cognitive functions in response to a traumatic event and has been the subject of extensive research in recent decades. For mental health professionals, exposure to patients with a history of trauma can have both negative and positive effects on their well-being. However, few studies have focused on the specific experiences of professionals encountering patients with traumatic dissociation.
This study analyzed the experiences of 23 professionals (psychiatrists, psychologists, and residents in psychiatry) working with patients presenting manifestations of traumatic dissociation, using Interpretative Phenomenological Analysis (IPA) methodology.
This approach led to the identification of three key themes: (1) professionals’ reactions to patient dissociation, (2) professionals’ emotional and dissociative response, and (3) factors influencing reactions and impact on professionals’ life.
In light of these findings, we propose several key points for training and supervision: taking into account the question of the body and physical contact; addressing the emotions experienced by professionals, particularly helplessness and loneliness, and carefully utilizing the diffusion of emotions and dissociation from the patient to the professional as a therapeutic tool to help patients self-regulate and reintegrate dissociated parts of themselves.

Professionals report insufficient training on dissociation, relying on experience and peer support to recognize and manage symptoms.
Patient dissociation elicits fear, helplessness, guilt, confusion, and sometimes dissociative states in professionals; while destabilizing, this emotional resonance and contagion can be used therapeutically to enhance connection and understanding.
Professionals respond through action, presence and attentiveness, or distance. They adapt according to experience, context, and institutional support and often use tools similar to those they recommend to their patients to manage effects on both their professional practice and personal life.

Professionals report insufficient training on dissociation, relying on experience and peer support to recognize and manage symptoms.
Patient dissociation elicits fear, helplessness, guilt, confusion, and sometimes dissociative states in professionals; while destabilizing, this emotional resonance and contagion can be used therapeutically to enhance connection and understanding.
Professionals respond through action, presence and attentiveness, or distance. They adapt according to experience, context, and institutional support and often use tools similar to those they recommend to their patients to manage effects on both their professional practice and personal life.

创伤性解离（traumatic dissociation）被定义为个体在遭遇创伤事件后，多种认知功能的整合过程出现断裂或紊乱，近数十年来该主题已得到广泛研究。对于精神卫生从业者而言，接触有创伤史的患者会对其自身身心健康产生正反两方面影响，但目前鲜有研究聚焦于从业者在接诊创伤性解离患者时的具体体验。
本研究采用解释现象学分析（Interpretative Phenomenological Analysis, IPA）方法，对23名曾接诊创伤性解离患者的从业者（含精神科医师、心理咨询师及精神科住院医师）的体验展开分析。
通过该分析方法，本研究提炼出三大核心主题：其一，从业者对患者解离症状的反应；其二，从业者自身的情绪与解离性反应；其三，影响从业者反应及对其个人生活产生影响的各类因素。
基于上述研究结果，本研究针对从业者培训与督导提出若干核心要点：需关注躯体与躯体接触相关议题；需正视从业者自身的情绪体验——尤其是无助与孤独感，并可审慎地将患者向从业者传递的情绪弥散与解离现象作为治疗工具，辅助患者实现自我调节与解离部分的整合。
从业者普遍反映，自身在解离症状相关培训方面存在不足，多依靠临床经验与同行互助来识别与处置此类症状。
患者的解离症状会引发从业者产生恐惧、无助、愧疚、困惑等情绪，部分从业者甚至会出现解离状态；尽管这种情绪共振与情绪传染会破坏从业者的心理稳定，但也可被用于治疗场景，以强化治疗联结与理解深度。
从业者通常会通过主动行动、在场与专注，或是保持距离的方式来应对此类场景；他们会结合自身临床经验、具体情境与机构支持调整应对策略，且常使用与向患者推荐的同类工具，来缓解该情况对自身临床工作与个人生活造成的影响。
从业者普遍反映，自身在解离症状相关培训方面存在不足，多依靠临床经验与同行互助来识别与处置此类症状。
患者的解离症状会引发从业者产生恐惧、无助、愧疚、困惑等情绪，部分从业者甚至会出现解离状态；尽管这种情绪共振与情绪传染会破坏从业者的心理稳定，但也可被用于治疗场景，以强化治疗联结与理解深度。
从业者通常会通过主动行动、在场与专注，或是保持距离的方式来应对此类场景；他们会结合自身临床经验、具体情境与机构支持调整应对策略，且常使用与向患者推荐的同类工具，来缓解该情况对自身临床工作与个人生活造成的影响。