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Finding Solid Ground: Overcoming

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Advance Praise for Finding Solid Ground
Finding Solid Ground is easily one of the most helpful books available on the
treatment of clinical dissociation. Based on an extended clinical research study,
this guide is highly recommended for those who seek concrete, evidence-based
guidance in this area. Equally recommended is the associated workbook, which
provides detailed and compassionate information and exercises for clients
struggling with dissociative challenges.
—John Briere, PhD, Professor Emeritus of Psychiatry, Keck School of Medicine,
University of Southern California, author, Treating Risky and Compulsive Behavior
in Trauma Survivors. NY: Guilford (2019)
Finding Solid Ground is an enormous contribution to the field of trauma: the first
book on trauma and dissociation written by authors who are both scholars and
clinicians. They build a solid ground of research evidence to support an
understanding of dissociation combined with practical applications that can be
easily integrated into psychotherapy or serve as a stand-alone treatment. Well
done!
—Janina Fisher, PhD, author of Healing the Fragmented Selves of Trauma
Survivors, Transforming the Living Legacy of Trauma, and The Living Legacy Flip
Chart
Finding Solid Ground provides invaluable resources on the treatment of
dissociative trauma-related disorders. The authors are educators par excellence
who have used their expertise as researchers and clinicians to produce a highly
readable overview of dissociation along with treatment guidelines and exercises.
Their innovative TOP DD studies offer empirical support for their approach. A
major contribution!
—Christine A. Courtois, PhD, ABPP, Licensed Psychologist, Consultant/Trainer,
Author, Co-Editor, The Treatment of Complex Traumatic Stress Disorders (2020)
Finding Solid Ground
Overcoming Obstacles in Trauma Treatment

BETHANY L. BRAND, HUGO J. SCHIELKE,


FRANCESCA SCHIAVONE, AND RUTH A.
LANIUS
Oxford University Press is a department of the University of Oxford. It furthers the
University’s objective of excellence in research, scholarship, and education by publishing
worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and
certain other countries.
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America.
© Oxford University Press 2022
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means, without the prior permission in
writing of Oxford University Press, or as expressly permitted by law, by license, or under
terms agreed with the appropriate reproduction rights organization. Inquiries concerning
reproduction outside the scope of the above should be sent to the Rights Department,
Oxford University Press, at the address above.
You must not circulate this work in any other form and you must impose this same
condition on any acquirer.
Library of Congress Cataloging-in-Publication Data
Names: Brand, Bethany L., author. | Schielke, Hugo J., author. |
Schiavone, Francesca, author. | Lanius Ruth A., author.
Title: Finding solid ground : overcoming obstacles in trauma treatment /
Bethany L. Brand, Hugo J. Schielke, Francesca Schiavone, Ruth A. Lanius.
Description: New York : Oxford University Press, 2022. |
Includes bibliographical references and index.
Identifiers: LCCN 2022010860 (print) | LCCN 2022010861 (ebook) |
ISBN 9780190636081 (paperback) | ISBN 9780190670160 (epub) |
ISBN 9780190636104
Subjects: LCSH: Post-traumatic stress disorder—Treatment. |
Dissociative disorders—Treatment.
Classification: LCC RC552 .P67 B728 2022 (print) | LCC RC552 .P67 (ebook) |
DDC 616.85/21—dc23/eng/20220511
LC record available at https://lccn.loc.gov/2022010860
LC ebook record available at https://lccn.loc.gov/2022010861
DOI: 10.1093/med-psych/9780190636081.001.0001
CONTENTS

Foreword—Frank Putnam
Preface
Acknowledgments

1. Trauma-Related Disorders and Dissociation: Hidden in Plain Sight


at Great Cost

2. Assessment of Dissociation, Trauma-Related Disorders, and


Dissociative Disorders

3. The Neurobiology of Trauma-Related Disorders: What Patients


and Therapists Need to Know

4. An Overview of Complex Trauma-Related Disorder Treatment


and the Treatment of Patients with Dissociative Disorders (TOP
DD) Studies’ Research Findings

5. Understanding and Addressing the Impact of Trauma on


Relational Functioning

6. Addressing Challenges Related to Dissociation, Emotions, and


Somatic Symptoms

7. Understanding and Working with Dissociative Self-States

8. Stabilizing Unhealthy and Unsafe Behaviors

9. The Finding Solid Ground Program and How to Use It in


Individual and Group Settings
Appendix A: Assessment Measures: PITQ-t and PITQ-p
Appendix B: Grounding Script
Appendix C: Resources, Training, and Suggested Readings
Books and Guidelines About Complex Trauma-Related Disorders with an Emphasis
on Dissociation
References
About the Authors
Index
FOREWORD

FRANK PUTNAM

The year 2020 marks the 40th anniversary of the third edition of the
Diagnostic and Statistical Manual of Mental Disorders, commonly
referred to as “DSM-III” (1980). Unveiled to cries of acclaim and
alarm from the establishment, the DSM-III’s atheoretical, symptom-
driven, multi-axial, descriptive approach to psychiatric diagnosis was
a significant departure from earlier nosology based on outdated
theories of personality reaction formation. The DSM-III’s delineation
of specific symptom constellations, irrespective of theory or etiology,
helped to refocus clinicians on the clients in front of them.
While acute psychological effects of combat were recognized
under labels such as WWI “shell shock” and WWII “combat
fatigue/neurosis,” there was a need for psychiatric diagnoses that
encompassed delayed and/or chronic emotional, cognitive, somatic,
and behavioral responses to past trauma. In the United States this
was, in large measure, a response to a growing awareness of the
serious mental health problems in Vietnam War veterans that often
emerged years after their return from combat. To address this
deficit, the DSM-III introduced the diagnosis of posttraumatic stress
disorder (PTSD) as well as detailing a more accurate clinical profile
of multiple personality disorder, subsequently renamed dissociative
identity disorder (DID) in DSM-IV (1994). The DSM-III’s recognition
of delayed-onset posttraumatic disorders initiated a new field of
research and clinical practice—although it would struggle to gain
legitimacy and resources for years to come.
Forty years later, however, the existence of posttraumatic
disorders is rarely questioned, although a lively debate continues
about subtypes. As additional, noncombat forms of trauma were
studied (e.g., rape, child abuse, first responders, and natural
disasters), it became clear that there is a range of posttraumatic
responses that are complexly influenced by variables such as age,
gender, type(s) and duration of trauma, and relationship to
perpetrator(s), as well as factors such as degree of social support,
synergistic interactions among different types of trauma, and
individual differences. One of the posttraumatic psychological
processes that critically influences clinical presentation and
treatment response is the client’s degree of dissociation. The recent
addition of the diagnosis, PTSD—dissociative subtype in DSM-5, for
example, reflects a growing appreciation of the importance of
dissociation in influencing clinical features of trauma-related
disorders (TRDs).
Despite an initial lack of professional awareness and widespread
skepticism about the existence of dissociative disorders, much has
been learned over the past four decades that demystifies these
conditions. Dissociation is now measured with the same
psychometric precision as depression and anxiety. Epidemiological
studies in general population and clinical samples find that the
dissociative disorders are common psychiatric conditions (see
Chapter 1 of this book). High levels of dissociation are correlated
with refractoriness to standard treatments for a variety of psychiatric
conditions, including PTSD, eating disorders, and borderline
personality disorder.
Pathological dissociation is strongly linked to a history of severe
trauma. This etiological relationship of severe trauma and
subsequently increased levels of dissociation holds for a wide range
of types of trauma across culture and time. Severe, repetitive, often
early-life traumas such as childhood sexual abuse are recognized as
a necessary—but not sufficient—cause of dissociative disorders.
Longitudinal parent–child dyad studies outline a generational
dissociative trajectory in which certain parental deficits in caretaking,
together with early-life trauma, are associated with Type D
attachment in infants. Type D attachment in infancy, in turn, predicts
increased levels of dissociation later in adolescence and early
adulthood, which is associated with emotional dysregulation and
impaired executive functions. Impaired executive functions are linked
to difficulties learning from life experiences, problems controlling
strong emotions, and failure to consolidate a unified sense of self.
Adults with high levels of dissociation are more likely to use harsh
parenting tactics associated with having Type D offspring. Thus, far
more than for many psychiatric disorders, there is an empirically
supported etiology and developmental theory for how early trauma
and impaired caregiving produce pathological dissociation and
identity fragmentation. Few other psychiatric disorders can marshal
equivalent levels of evidence for their putative etiologies and
developmental trajectories.
Research on the underlying neurobiology of TRDs in general and
dissociative disorders in particular has been remarkably productive,
despite low levels of funding. Brain imaging studies find activation
patterns that differentiate classic PTSD hyperarousal from
dissociative responses to traumatic reminders (see Chapter 3 of this
book). Multiple studies using an array of imaging technologies detect
reliable brain state differences associated with the identity states of
individual DID subjects. Research with a variety of types of trauma
finds that experimental activation of dissociative responses to recall
of past trauma is associated with decreased autonomic arousal,
especially decreased heart rate. This is consistent with theories that
analogize human dissociative reactions to the “freezing” behaviors
seen in young animals such as fawns and baby rabbits in response
to predators.
Posttraumatic effects on memory, cognitive associations, and
logical reasoning are now well documented for different forms of
trauma. Emotional dysregulation manifest by rapid shifts in affect
and mental state produces disruptions in an individual’s continuous
sense of self. Longitudinal and cross-sectional studies find that
severe early trauma alters the long-term development of adrenal
and gonadal hormonal systems as well as acute responses to
stressors. Prepubertal sexual abuse, for example, accelerates the
onset of puberty in females. Even a victim’s genes may be altered by
trauma through epigenetic mechanisms such as stress-induced DNA
methylation. These trauma-induced genetic changes may be
transmitted to future generations, providing a genetic contribution to
the tragic cycles of family violence.
Progress in the treatment and prevention of TRDs, especially the
dissociative disorders, has lagged behind developmental, cognitive,
and neurobiological scientific advances. Treatments for classic PTSD
that have been proven by randomized clinical trials (RCTs) exist,
including psychotherapies, exposure and desensitization models, and
pharmacotherapies. Until recently, however, treatment models for
DID and other dissociative disorders were, at best, limited to the
descriptive case series level, usually reflecting the experience of a
single clinician’s practice.
By systematically following the progress of hundreds of
independent client–therapist dyads with longitudinal evaluations, the
Treatment of Patients with Dissociative Disorders (TOP DD) studies
have significantly advanced our therapeutic knowledge of the
dissociative disorders. While short of gold-standard RCTs, the TOP
DD Network study findings are based on repeated, independent
client and therapist assessments with standard self- and therapist-
report measures. After viewing a set of safety-oriented videos, TOP
DD Network clients scoring in the higher ranges on dissociation
measures (previously associated with clinical failure) showed
clinically relevant improvements on behaviors such as nonsuicidal
self-injury, number of hospitalizations, and degree of emotional and
impulse control. In contrast to prior studies, clients with higher levels
of dissociation showed faster rates of improvement than subjects
with lower (but still abnormal) levels of dissociation, indicting a
specificity of TOP DD therapeutic approaches for highly dissociative
clients.
Finding Solid Ground: Overcoming Obstacles in Trauma Treatment
and the accompanying workbook distill the lessons of the TOP DD
studies into a coherent therapeutic approach. Because dissociative
clients are likely to read this text, it is sprinkled with motivational
encouragement to practice the TOP DD-tested interventions. In
addition to the TOP DD insights, the authors add their own wealth of
therapeutic expertise from years of working with patients with
dissociative TRDs. As individuals, they have all achieved recognition
for their contributions to the field. Together, the authors present an
inclusive and comprehensive therapeutic approach to dissociative
TRDs. While more remains to be learned, this volume and workbook
translate 40 years of progress into a new, evidence-informed,
generalizable approach to the treatment of dissociative TRDs
surpassing many of the limitations inherent in earlier individual
clinician-based case series.
PREFACE

This book grew out of our determination to help people with


complex trauma-related reactions and symptoms, a group of
patients who are often overlooked, misunderstood, and underserved
by the mental health field. This book describes the Finding Solid
Ground educational program and treatment approach for individuals
who have experienced interpersonal trauma and, as a result,
struggle with trauma-related reactions and symptoms, including
dissociative reactions.

A RESEARCH-INFORMED AND RESEARCH-REFINED


PROGRAM FOR SURVIVORS AND TREATMENT
PROVIDERS
The Finding Solid Ground program is based on what we and our
colleagues in the trauma field have learned over decades of trauma
treatment and research, including our series of studies on the
Treatment of Patients with Dissociative Disorders (the TOP DD
studies; TOPDDstudy.com).
We developed this program, this book, and the companion
workbook to address the alarming gap between the limited number
of therapists who have been trained in treating complex trauma-
related reactions and the vast number of individuals who urgently
want and need treatment. This gap is particularly pronounced for
patients struggling with trauma-related dissociation. We often heard
from individuals who had tried to find a therapist who understood
and could help them with trauma-related dissociation, only to find
out that “no one in my area knows how to treat dissociation” or “the
therapists who know how to treat dissociation are so busy they can’t
take on new patients.”
Out of this urgent need was born the idea of creating an online
program that patients and their therapists could participate in
together that would help stabilize patients’ struggles while also
teaching therapists an approach to stabilizing these individuals. The
TOP DD researchers, a subset of whom are the authors of this book
and the accompanying workbook, are researchers in addition to
therapists with expertise in treating severely traumatized,
dissociative individuals. Based on our treatment research and clinical
experience, and with feedback from trauma survivors, we developed
an online educational study that therapists and dissociative patients
could engage in as research participants for 2 years, which we called
the TOP DD Network study.
The results of the study were very encouraging. As Chapter 4 will
discuss in greater detail, participating patients showed significant
improvements in symptoms and in their daily living. Specifically, they
showed significant decreases in PTSD and dissociation symptoms,
significant increases in emotion regulation ability, and reductions in
self-injury (called nonsuicidal self-injury [NSSI] throughout this
book), suicide attempts, and hospitalizations (Brand et al., 2019).
The individuals who had been engaging in NSSI over 6 months
showed they could stabilize and dramatically improve their safety,
including many of those who had engaged in NSSI hundreds of
times. No treatment study had shown improvements with individuals
who struggled with such frequent, severe dissociation along with
NSSI, PTSD, depression, and related difficulties. Furthermore, both
patient and therapist participants demonstrated large changes in
stabilization-related knowledge at study completion (Schielke &
Brand, 2019), offering validation of the joint patient/therapist
education program approach. (A brief disclaimer and research
update: Although participants showed meaningful improvements and
offered comments attributing improvements to participating in the
program, only studies that use random assignment of participants to
a control group and treatment group can prove convincingly that the
intervention caused the changes. With this in mind, we are
conducting additional research to determine with certainty whether
these changes can be attributed to patients’ participation in the
educational program.)
Because it is important to us to keep learning from the people we
aim to help (the TOP DD slogan is “work together, learn together,
heal together”), the study’s materials have been refined based on
feedback from the patients and therapists who participated in the
TOP DD Network study and participants in subsequent in-person
trauma symptom management treatment groups that made use of
these materials. The refined educational program is called the
Finding Solid Ground program. The exercises and handouts are
presented in the workbook that accompanies this book, The Finding
Solid Ground Program Workbook: Overcoming Obstacles in Trauma
Recovery (Schielke et al., 2022).

THE GOALS OF THE FINDING SOLID GROUND


PROGRAM AND THIS BOOK
Our overarching goal in publishing this book and its companion
workbook is to help trauma patients and their therapists find solid
ground for successful collaboration toward healing and recovering
from trauma. We share this information to help therapists provide
research-informed encouragement and guidance as their patients
work to learn how to manage and reduce complex trauma-related
reactions and symptoms, including dissociation.
The Finding Solid Ground program workbook presents patient
information and techniques that can increase patients’ ability to
manage trauma-related symptoms and reactions in recovery-focused
ways, and help them develop compassionate curiosity about
themselves as they come to gradually understand how to help
themselves get and feel safer. Most importantly, it presents this
information in a sequence aimed at giving patients the most
practical, useful information first, and in a way that is designed to be
as understandable, easy to follow, and manageable as possible given
the many interlocking challenges and dynamics involved in treatment
for these underserved individuals.
Our specific goal with this book is to discuss the individual and
group therapy implications and application of this information so that
providers can have some sense of solid ground in the face of the
sometimes seemingly overwhelming challenges their patients (and,
therefore, they themselves) face in this work. Toward these ends,
we have strived to make this book and the program workbook
practical and accessible so that therapists and patients alike can
benefit from them regardless of their level of experience or
knowledge about trauma and dissociation, in a way that is hopefully
applicable across many cultures. (Note: The TOP DD studies have
been conducted with participants from around the world, so the
approach has demonstrated some evidence of cross-cultural
applicability.)
Trauma is overwhelming and terrifying. For most individuals with
recurrent dissociation, multiple traumas occurred over time,
repeatedly causing dysregulation and overwhelm. Many such
individuals first experienced trauma in childhood, and the related
emotional and physiological overwhelm continually recurred and
reverberated in the person’s life. Although trauma-related reactions
may have waxed and waned over the years (often in response to
retraumatization or progress in recovery, respectively), they tend to
continue to echo across the lifespan in the form of “flooding”
emotion (“feeling too much”) or “shutdown” moments of freeze or
other forms of dissociation (“feeling too little”) when faced with
internal or external reminders of trauma. In these states, people
with complex trauma histories are at risk of engaging in behavioral
reenactments and/or unhealthy, risky, or unsafe behaviors. We view
each of these as attempts to manage situations that may have felt,
and may continue to feel, life-threatening. Safety problems are
attempts at self-regulation; sometimes they are also attempts at
regulating relationships with others. Thus, they are adaptations to
trauma—adaptations that can be especially difficult to shift when
trauma is continuing to occur or when trauma reminders continue to
overwhelm.
As you will see in these books, this is why the Finding Solid
Ground program places a strong emphasis on helping survivors (1)
learn and make use of recovery- and healing-focused coping skills
(to reduce overwhelm) and (2) work toward getting their healthy
needs met safely (to increase health and safety). This work is
approached with a sense of compassion for the understandable
reasons survivors may have developed and maintained trauma-
driven adaptations that helped them survive the past alongside a
goal of identifying and moving away from adaptations that now
place them at increased risk for retraumatization and/or
inadvertently prolong their pain and suffering.

THE FOUR CORE SKILLSETS


The Finding Solid Ground program views unhealthy and unsafe
behaviors and relationship patterns through a trauma- and
attachment-informed lens: Often, these patterns and behaviors have
been powerfully shaped by dysfunctional or abusive relationships.
Early relationships, in particular, are especially influential in our lives;
when caretakers or other adults neglect or abuse children, children
develop trauma-based senses of themselves and expectations of
others and view abuse, neglect, and unhealthy patterns as expected
and/or unavoidable. Viewing trauma survivors’ problems through
these lenses clarifies why changing these patterns is often so
difficult.
The Finding Solid Ground program presents the rationale and
steps for developing healing-focused recovery skills in four crucial,
interrelated capacities; these are foundational for healing from
complex trauma, especially for dissociative individuals:
Grounding when first beginning to feel too much or too little to
prevent emotional overwhelm and/or dissociation
Separating past from present (Rothschild, 2000; Loewenstein, 2006),
including containment of intrusive imagery, recollections, and bodily
sensations, and interrupting cognitive and behavioral reenactments
related to trauma (e.g., trauma-based beliefs and behavioral
“scripts”)
Emotion regulation (including self-compassionate use of grounding
and other recovery-focused skills) as alternatives to unhealthy, risky,
or unsafe behaviors, dissociation, trauma-related reactions that are
no longer necessary, and/or habitual avoidance of emotions
Getting healthy needs met safely, including through the use of
healing-focused recovery skills and the development of distress
management plans to help patients recognize and interrupt patterns
of risky, unhealthy, or unsafe behavior that are no longer adaptive.

It is crucial for therapists and individuals who have experienced


trauma to realize that, for some patients, decreasing their use of
unhealthy methods of managing trauma-related feelings, memories,
and symptoms can be terrifying and may feel downright dangerous
—even more dangerous than using risky or unsafe methods of
coping such as NSSI. For individuals who may have never known
safety, the idea of “getting safe” can feel entirely unconceivable, and
“getting safer” can seem like a trick and/or feel impossible. Many of
these individuals may feel they do not have the right to feel good or
to have a good, safe, stable life.
The good news is that the approach outlined in Finding Solid
Ground has helped many people make these changes. Related
comments from Network study participants have included:
“Hearing that many other people have the same symptoms as I have
supports me in believing more strongly that these symptoms are
consequences of trauma.”
“It’s like you wrote the program based on my struggles! This was
very validating.”
“It was astonishing for me how personal and encouraging this
program was.”
“This program makes me believe that it is possible to heal from
trauma.”

In summary, we developed this program, this book, and the


accompanying workbook to provide a foundation to help trauma
patients and their therapists find solid ground for successful
collaboration toward getting and feeling safer and healing and
recovering from trauma. This work can help trauma patients
manageably work toward reclaiming all of who they are (rather than
seeing themselves strictly in relation to, and through the lenses of,
their trauma history), increase their capacity to feel peaceful and
safe, and create a life that they can feel good about. By working,
learning, and healing together, patients, therapists, and researchers
can help people who have experienced trauma find solid, safe
ground.
ACKNOWLEDGMENTS

We are able to treat, research, consult, and provide training about


working with individuals with interpersonal trauma histories because
we have been extremely fortunate to have been able to start our
careers with training from some of the contemporary masters in the
trauma field. First, we would not have been able to develop and
carry out the TOP DD studies without the wise input, consistent
support, statistical acumen, and depth of knowledge about treating
trauma and dissociation we found among our “dream team” of TOP
DD collaborators and consultants, so with deep gratitude we
acknowledge and thank Suzette Boon, Catherine Classen, Paul A.
Frewen., Ellen K. K. Jepsen, Willemien Langeland, Richard J.
Loewenstein, Amie Myrick, Clare Pain, Frank W. Putnam, Karen
Putnam, and Kathy Steele. This incredible group of researchers are
gifted clinicians, superb writers, and unfailing cheerleaders and
friends. We are also indebted to the colleagues and mentors who
have most deeply inspired, supervised, supported, and taught us,
notably Pamela Alexander, Judith Armstrong, Christine Courtois, Nel
Draijer, Barton Evans, Catherine Fine, Richard Kluft, Richard
Loewenstein, Frank Putnam, Joyanna Silberg, Kathy Steele, and
Bessel van der Kolk.
We have been able to continue our learning and deepen our
knowledge through the collegial discussions, research partnerships,
and consultations with incredibly gifted, wise, and compassionate
clinicians and researchers. We owe them our gratitude. Our clinical
work with traumatized individuals and our conceptualization of
assessment and treatment, our publications, and our research have
been strongly shaped and influenced by many inspirational
colleagues, authors, and researchers who are too numerous to
name. These individuals include, but are not limited to, Su Baker,
Peter Barach, Ruth Blizard, John Briere, Dan Brown, Laura Brown,
Lisa Butler, Eve Carlson, Richard Chefetz, James Chu, Constance
Dalenberg, Paul Dell, Martin Dorahy, Brad Foote, Julian Ford, Steve
Frankel, Jennifer Freyd, David Gleaves, Steve Gold, Naomi Halpern,
Judith Herman, Ingunn Holbæk, Elizabeth Howell, Phil Kinsler, Peter
Levine, Roberto Lewis-Fernandez, Giovanni Liotti, Karlen Lyons-Ruth,
Alfonso Martínez-Taboas, Warwick Middleton, Andrew Moskowitz,
Ellert Nijenhuis, John O’Neil, Simone Reinders, Colin Ross, Vedat Sar,
Alan Schore, Daniel Siegel, Daphne Simeon, Eli Somer, David
Spiegel, Joan Turkus, Onno van der Hart, and Eric Vermetten.
We have learned a tremendous amount from the individuals we
have worked with in treatment over the decades. Their creativity,
resilience, and courage in the face of the depth of their pain and
struggles have moved and inspired us beyond what we can convey
in words. Thank you for taking the risk of trusting us to work with
you on your healing journeys, and for helping us learn how to be of
better help to you and others. We feel humbled by the time we have
spent with you, and earnestly hope to share what we learned
together with others who have also felt the searing angst of being
neglected and harmed.
We are also deeply indebted to the participants in our TOP DD
studies, those hard-working and thoughtful patients and therapists
who completed hours of surveys, watched our educational videos,
completed the practice exercises, and gave us invaluable feedback
along the way that shaped and improved the Finding Solid Ground
program and the TOP DD research studies.
We would also like to express our sincere gratitude to our panel of
people who live with the impact of trauma and dissociation who
generously reviewed our materials and gave us insightful
suggestions about making the program more user-friendly and
beneficial. Your input has contributed to making this program useful
to people around the world.
On a more personal level, we would like to give our warm thanks
to our dearest friends and family members who tolerated our
enthusiastic (and perhaps sometimes nonstop?) talk about our
research and this book, and who have tolerated the times when we
Another random document with
no related content on Scribd:
Turks, see “Orthodox Sects,” and also under “Muhammadan,” and
226, 227, etc.
Turkistán, 278

Ula, 246
Unitarians, 25, 26
Usury, 45

Vaghas, Sád, 24
Valley of Mina, see “Mina”
Viands, forbidden, 32, 33
Victims, 56, 57, 58
Vitr, 36

Wady Fatima, 283, 284


Wagner, 107
Wahabis, 236
Wusta, 246
Wuzú’h, 33, 35

Yazid, 71
Yemen, 71, 123, 165
Youm-ul-Arafat, Chapters IX., X., XI., Part II.
Youm-ul-Nahre, Chapter XII., Part II.
Youm-ul-Tarvih, Chapter VII., Part II.

Zaideh Gate, 114


Zakani, 88
Zanzibar, 145
Zem-Zem well, 116, 142, 145, 165, 257, 259
Zikat, 54, 304
Zobeir, 70
Zú-’l-hijjah, 26, 27, 28, 48, 55, 56, 60, 62, 173, 174, 175
Zú-’l-ka’dah, 26, 27, 48, 55

Transcriber’s Note
Clear printer’s errors have been corrected by the transcriber; as far as possible, however,
original spelling, punctuation, and accented characters have been retained. All changes
listed in the errata have also been made.
In the printed book, images occupied whole pages. In this file, some images have been
moved from their original positions to avoid breaking paragraphs.
*** END OF THE PROJECT GUTENBERG EBOOK WITH THE
PILGRIMS TO MECCA: THE GREAT PILGRIMAGE OF A.H. 1319;
A.D. 1902 ***

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