Plenary Sessions


 saturDay, 16 November 2013, 8:30 aM - 10:00 aM

Pierre Janet Plenary Address

Stephen W. Porges, Ph.D.
The Polyvagal Theory; Implications for Understanding and Treating Trauma and Dissociation

The Polyvagal Theory provides a new perspective to explore how autonomic nervous system function relates to social behavior, emotional regulation, and health. The Polyvagal Theory links the evolution of the autonomic nervous system to affective experience, emotional expression, facial gestures, vocal communication, and contingent social behavior.  The theory, by being informed by the phylogeny of the autonomic nervous system, expands our understanding of normal and atypical behavior, mental health (e.g., coping with stress and novelty), experiences (e.g., dissociative states), and psychiatric disorders (e.g., autism, anxiety disorders, PTSD). The theory emphasizes that the core deficits in behavioral and affective regulation associated with several psychiatric disorders is related to neural regulation of the autonomic nervous system. By incorporating a developmental perspective, the theory explains how typical and atypical maturation and regulation of autonomic function forms the neural “platform” upon which social behavior and the development of safe trusting relationships are based.  The theory explains how the nervous system evaluates risk in the environment, without awareness and often independent of a cognitive narrative, through a process labeled “neuroception.” Neuroception attempts to support adaptive behaviors by matching autonomic state with the neuroceptive state of risk (i.e., safe social environment, danger, and life threat). Abuse and trauma may reset neuroception to protect the individual from others when there is no “real” danger resulting in defensive and often aggressive responses to friends and caregivers.

Learning Objectives:

At the end of this presentation participants will be able to:

Describe an explicit statement of the Polyvagal Theory.
Illustrate how a Polyvagal perspective provides insights into clinical assessment and treatment.
Describe a face-heart connection that defines a social engagement system that links our bodily feelings with facial expression, vocal intonation, and gesture. 
Explain that maladaptive behavior, including states of dissociation, may be an emergent property of an adaptive physiological state triggered by survival mechanisms.
 Sunday, 17 November 2013, 2:00 PM - 3:00 PM

Plenary Address

Ambassador Mark P. Lagon, Ph.D.
International human rights leader and author
Trafficking, Trauma, and Trust: Re-empowering Betrayed and Blamed Survivors of Human Trafficking

Human trafficking is in essence gross exploitation for sex or labor robbing autonomy.  Its over 20.9 million victims globally (International Labor Organization, 2012) chiefly come from vulnerable groups denied access to justice (e.g., women, children, documented and undocumented migrants, and minorities).  Many suffer traumas predating trafficking (e.g., domestic abuse before prostitution).   Recruiters and exploiters (“traffickers”) subject them to psychological manipulation, fraud, and/or force; often including high-volume sexual activity, trauma is cumulative.   Effects can manifest as betrayal trauma, traumatic subordinate relationship, “Stockholm Syndrome,” complex trauma and PTSD, as well as dissociative disorders.   Prostituted and/or undocumented, society treats them as at fault, criminal, or disposable.  When identified they are pressured to testify against perpetrators as a gateway to care.  Beyond shelter and physical health care, lack of resources (funding, personnel, or training) deny them clinical care for complex trauma, making economic viability and reintegration into society far harder.

Survivors’ well-being, and broader systemic change to reduce the incidence of trafficking globally depend on trust.  First, interventions must prioritize building survivors’ trust, to accept help, become employable, thrive, and cooperate with law enforcement to derive justice.   Interventions must be tailored to account especially for (a) betrayal trauma, and (b) law enforcement and societal attitudes “blaming the victim” which compound traumatization.  Second, another kind of trust is needed: between  government, caregivers, nonprofits, international agencies, and even private sector actors as necessary partners to offer survivors holistic help and catalyze their agency and reempowerment.  Both clinical care and successful partnerships are crucial, and require the existence of the other.  

Learning Objectives:

At the end of this presentation participants will be able to:

Describe the nature of human trafficking and how the complex trauma of its victims comes about.
Discuss how trauma for human trafficking survivors is similar and different from other separate or overlapping populations (internally displaced, refugee, mass rape, or domestic violence contexts).
Describe how clinical care fits into robust partnerships with other caregivers, law enforcement, immigration officials, international agencies, and even business entities, to  help survivors transcend trauma to thrive in society and employment.


 Sunday, 17 November 2013, 5:00 PM - 6:00 PM

          Dr. Turkus

        Dr. Courtois

           Dr. Dell


Plenary panel Address

Joan A. Turkus, M.D.; Christine A. Courtois, Ph.D., ABPP; Paul F. Dell, Ph.D., ABPP


DSM-5, the fifth version of The Diagnostic and Statistical Manual of Mental Disorders, was released this spring. DSM-5 is the outcome of international planning conferences, suggestions submitted to the DSM website, and thousands of hours of work DSM-5 Work Groups and other committees of the American Psychiatric Association.

This panel of senior clinicians will highlight the changes from DSM-IV, discuss DSM-5’s essential principles, and provide some guidelines for diagnosis and coding of the dissociative disorders and posttraumatic stress disorder.

There will be time for questions by the moderator and from the audience to create an active dialogue.

Learning Objectives:

At the end of this presentation participants will be able to:

Use DSM-5 diagnoses and codes in clinical practice.
Compare the DSM-IV and DSM-5 criteria for the diagnosis of Posttraumatic Stress Disorder.
Know the changes in the criteria for the diagnosis of Dissociative Identity Disorder.



MONday, 18 November 2013, 10:30 aM - 12:00 PM

Plenary Address

Christine A. Courtois, Ph.D.
The Treatment of Complex Trauma: A Sequenced Relationship Based Approach

Many forms of complex trauma have been identified over the course of the past several decades. Complex trauma is generally defined as repeated, chronic, and cumulative interpersonal victimization including physical, sexual, and emotional abuse and neglect that occurs over the course of childhood. Its occurrence during formative years has been found to impact the child victim’s neurophysiological and psychological development in ways that can have lifelong impact on identity and personal integration. Its occurrence within significant attachment relationships makes relational betrayal and mistrust of others a prominent dynamic. Complex trauma can also take place de novo in adulthood or it can be a continuation of trauma from earlier in life. For some unfortunate individuals, their exposure is continuous and never-ending but for others, it is more ambient. Dissociation has been recognized as a prominent feature of chronic childhood traumatization but also develops from other forms as well. Of note: a dissociative subtype of PTSD has been added to the DSM-V and the ICD-11 will include dissociation as among the criteria for the newly included diagnosis of Complex PTSD.

Following an overview of some of the recent developments in defining complex trauma, this keynote will emphasize the multifaceted aftereffects and adaptations found in complex traumatic stress disorders and how they present in therapy. The primary focus is on the science and art of a sequenced, relationship-based and integrated treatment for complex trauma. This will include a review of relevant research findings and effectiveness studies, clinical consensus and survey results, and sets of treatment guidelines that are newly published or under review. Treatment strategies for complex dissociative traumatic stress disorders have evolved over many years and will continue to do so with additional research and the increasing attention being paid to diversity and multicultural issues and adaptations. Since integration of personal experience is at the core of the mission of ISSTD, it seems especially appropriate that the treatment model itself integrates a wide array of topics and areas of inquiry and a variety of treatment approaches, with attention to accumulated clinical wisdom and guidance.

Learning Objectives:

At the end of this presentation participants will be able to:

Identify several types of complex trauma.
2.Understanding of the philosophy and sequencing of treatment for complex posttraumatic conditions.
3.Identify a variety of treatment techniques for complex posttraumatic conditions, including the rationale for relationship-based treatment.


Updated October 10, 2013

2013 PROGRAM content DETAILS


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Future Annual Conference Dates

October 23 & 24 - Pre Conferences
October 25-27  Full Conference
Westin Long Beach
333 East Ocean Boulevard, Long Beach, California 90802
United States

April 16 & 17 - Pre Conferences
April 18-20 - Full Conference
Hilton Orlando Lake Buena Vista
1751 Hotel Plaza Blvd
Lake Buena Vista, FL 32830
United States