Jon Frederickson, MSW : The Man Who Awoke from a Coma: Treatment of a Dissociative Patient

To treat patients with low ego adaptive capacity Davanloo designed a treatment format known as the Graded technique (Davanloo 2000; Whittemore 1996). In this technique the therapist focuses on building the patient’s ego adaptive capacity (Ten Have de Labije 1999a, 1999b, 2001) and restructuring his pathway of unconscious anxiety discharge first before attempting any breakthrough into the unconscious. In the following case vignettes we will observe a variety of techniques that can be used to help build a patient’s capacity for attention, anxiety regulation and affect experience. The patient, 52, entered treatment suffering from what he described as problems with his attention. He had entered graduate school but was on probation, on the verge of being kicked out of school because of his late papers, poor judgment in his placements, failure on the comprehensive exams, and inability to concentrate while at home or in class. A psychiatrist had diagnosed him with attention deficit disorder and put him on strattera, cymbalta, and wellbutrin. However, the patient reported little benefit from the medications.