Treating Dissociative and Personality Disorders: A Motivational Systems Approach to Theory and Treatment

By Antonella Ivaldi (Italy)

ivaldicover0616wTreating Dissociative and Personality Disorders (Routledge, 2016) draws on major theorists and the very latest research to help formulate and introduce the Relational/Multi-Motivational Therapeutic Approach (REMOTA), a new model for treating such patients within a clinical setting. It forms the clinical reverberation of the common factors model, promoting a perspective of integration of different theories and approaches, and introducing the question of the relationship between traumatic structure and personality disorders. REMOTA constitutes an integrative and comparative new approach that will be indispensable for combining relational clinical knowing and Lichtenberg’s and Liotti’s motivational system theories, which identify the universal invariants that govern human relatedness, starting from evolutionism and infant research.

Supported by her contributors, Antonella Ivaldi provides an overview of existing theories and evidence for their effectiveness in practice, and sets out her own theory in detail through rich and compelling case histories. The narratives in this book show how it is possible to integrate different contributions within a multidimensional etiopathogenic treatment model, which considers the mind as a manifestation of the relationship between body and world. From a conceptual perspective, according to which consciousness emerges and develops in the interpersonal dimension, this book proves how it becomes possible to understand, in the therapeutic space, what stands in the way of sound personal functioning, and how to create the conditions for improving this.

Treating Dissociative and Personality Disorders will be highly useful in addressing the particular clusters of symptoms presented by patients, stimulating therapists of different backgrounds to explore the complexity of human nature. It will appeal to psychoanalysts and psychotherapists, especially those in training, clinicians of different backgrounds interested in comparative psychotherapy, as well as social workers and graduate and postgraduate students.


“This is an important and creative contribution to the psychotherapy integration movement. It brings together two different yet overlapping perspectives in the treatment of some of the most difficult—and painfully suffering—patients we work with.  It does not gloss over differences, yet creatively seeks commonalities and complementarities.  Moreover, by adding group work to the work with individuals it still further extends the reach of the integration and contributes valuably to the effort to relieve human suffering”.

 – Paul L. Wachtel, PhD, Distinguished Professor,
doctoral program in clinical psychology,
City College of NY and CUNY Graduate Center

“Relationship, theory, and clinical acuity all come together in the wonderful synthesis that is central to Antonella’s presentation and personhood. Using rich clinical examples, she demonstrates how her use of motivational theory enables her to navigate the challenges of treating difficult patients”.

 – Joseph Lichtenberg, MD,
psychiatrist and psychoanalyst,
founder and training analyst at the Washington Institute for Contemporary Psychotherapy and Psychoanalysis,
past president of the International Association for Psychoanalytic Self Psychology,
Editor-In-chief of the journal Psychoanalytic Inquiry.

“Antonella Ivaldi’s Relational/Multi-Motivational Therapeutic Approach (REMOTA) is an important text for clinicians seeking to impact severely traumatized individuals whose intersubjective possibilities have been severely compromised. In bridging two major multi-motivational systems theorists, Lichtenberg and Liotti, Ivaldi further extends the terrain to include data from multiple sources—infant and attachment research, neuroscience, trauma theory, the treatment of dissociative disorders, individual and group therapies. With beautifully illustrated clinical sensitivity, with vibrancy and fluidity, and with a dialogic touch, Ivaldi continuously questions and postulates afresh the strengths and limitations always intrinsic to this complex field of mind and soul.”

 – Hazel Ipp, PhD, Joint Editor-in-chief,
Psychoanalytic Dialogues: The International Journal of Relational Perspectives;
past president of IARPP

To my knowledge Antonella Ivaldi’s is the first attempt at a comparison of two different theories focused mainly on the lived experience of a psychotherapist, who is dialoguing simultaneously with herself, her professional mentors, and each of her difficult patients.

–Giovanni Liotti, psychiatrist and psychotherapist;
teaches “Clinical Applications of Attachment Theory” at the
APC postgraduate School of Psychotherapy in Rome, Italy; past president of the Italian Society of Behavioral and Cognitive Therapy (SITCC)

“Antonella Ivaldi’s book expresses all the determination, but also the creativity, of a passionate clinician. When the writing seems heavily theoretical, it melts in the clinical dimension; and when it is likely to become fervently clinical, it turns to the dialogue with the theoretical dimension. It is a useful and complete book, capable of holding together different approaches. The relational breath of Ivaldi’s multidimensional model hosts a brilliant and critical exchange with Lichtenberg’s and Liotti’s motivational theories. When we read the clinical histories written by Ivaldi we find ourselves not only thinking about clinical cases described by a sensitive colleague; it is as if the voices and behaviors of our “real” patients are coming to life”.

– Vittorio Lingiardi, psychiatrist and psychoanalyst,
full professor of dynamic psychology at the
Faculty of Medicine and Psychology of the
Sapienza University of Rome,
director of the postgraduate school of clinical psychology

This book is an intriguing and very important attempt by Antonella Ivaldi to create a new approach to personality disorders. In a very sophisticated and yet clear and expressive way she uses motivational theories of different approaches to create a unique theory and a unique treatment. I frankly believe that every clinician, but also every person interested in psychotherapy, will greatly enjoy this book and find it extremely useful.

 – Gianni Nebbiosi, psychoanalyst,
founding member and president of ISIPSé,
vice president of IARPP,
member of the IAPSP International Council

“Today there are so many psychotherapy books that it is really difficult to get oriented. This book by Antonella Ivaldi is surely worth reading: it goes right to the heart of crucial issues of contemporary psychotherapy. It deals with theory of motivation and with the possibility of integrating different therapeutic approaches. And what is most fascinating is that while it shows the importance of theory, it never loses sight of the nuances of clinical encounter. In this book the patient seems even more “real” when seen through the lens of theory”

 – Paolo Migone, MD, Editor, Psicoterapia e Scienze Uman

“This fascinating and inspiring book edited by Antonella Ivaldi has many clinical and scientific merits, the main of which is its successful attempt to harmoniously integrate theories and methods originating from different perspectives in a new multidimensional etiopathogenic treatment model for patients with personality and dissociative disorders. Thanks to a series of well-described and enlightening clinical cases, Antonella Ivaldi convincingly guides the reader through her innovative model in which individual and group psychotherapy are efficaciously combined. Using the therapeutic relationship in a complex way, she builds a bridge between contemporary psychoanalysis and cognitive-evolutionary model. This really is a brilliant book, which I strongly recommend”.

– Rita B. Ardito, PhD, president of the Italian Society of
Behavioural and Cognitive Therapy

About the Author/Editor:

Antonella Ivaldi is a training analyst at the psychotherapy postgraduate program of the LUMSA University, the Institute of Relational Psychoanalysis and Self Psychology (ISIPSÉ), and the School of Cognitive Psychotherapy.



ivaldiphoto0616wAntonella Ivaldi, PhD
Via Delle Fornaci 35, 00185
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