Table of Contents

Introduction – The abused and the abuser: Victim–perpetrator dynamics 1. Weaponized sex: Defensive pseudo-erotic aggression in the service of safety 2. Extreme adaptations in extreme and chronic circumstances: The application of "weaponized sex" to those exposed to ongoing incestuous abuse 3. Conflicts between motivational systems related to attachment trauma: Key to understanding the intra-family relationship between abused children and their abusers 4. Through the lens of attachment relationship: Stable DID, active DID and other trauma-based mental disorders 5. Dying for love: An attachment problem with some perpetrator introjects 6. Predicting a dissociative disorder from type of childhood maltreatment and abuser–abused relational tie 7. Victim–perpetrator dynamics through the lens of betrayal trauma theory 8. Shame as a compromise for humiliation and rage in the internal representation of abuse by loved ones: Processes, motivations, and the role of dissociation 9. Knowing and not knowing: A frequent human arrangement 10. Mother–child incest, psychosis, and the dynamics of relatedness 11. Dissociation in families experiencing intimate partner violence 12. Organized abuse in adulthood: Survivor and professional perspectives 13. Treatment strategies for programming and ritual abuse 14. Issues in consultation for treatments with distressed activated abuser/protector self-states in dissociative identity disorder 15. Wilhelm Fliess, Robert Fliess, Ernest Jones, Sandor Ferenczi and Sigmund Freud Endnote – A personal perspective: The response to child abuse then and now

About the Author

Warwick Middleton was the primary author of the first published series on patients with dissociative identity disorder to appear in the Australian scientific literature. For over 20 years, he has been the Foundation Director of the Trauma and Dissociation Unit, Belmont Hospital. He is a pioneer researcher in the area of ongoing incest during adulthood; he chairs the Cannan Institute; and is a past president of the International Society for the Study of Trauma and Dissociation.


Adah Sachs is an attachment-based psychoanalytic psychotherapist. Her main theoretical contribution is outlining several subcategories of disorganised attachment, and linking those with childhood abuse and with trauma-based mental disorders. She is an NHS consultant and heads the Psychotherapy Service for Redbridge Borough, London, UK.


Martin J. Dorahy is Director of the clinical psychology programme at the University of Canterbury, New Zealand, and current immediate past-president (2018) of the International Society for the Study of Trauma and Dissociation. His published work has primarily explored cognitive and emotional underpinnings of dissociation and dissociative disorders, with a particular focus on shame. His clinical work is focused on the adult outcomes of abuse and neglect.