Pre-Conference Workshops

Thursday, 22 March 2018

P1 - THE IMAGE COMES FIRST: A GRAPHIC NARRATIVE TOOL FOR TREATMENT OF PTSD
Presenters: Tally Tripp and Linda Gantt

This workshop teaches an integrated set of techniques that can be used to bring about rapid and lasting treatment for post-traumatic stress disorder. The procedures can be applied individually and in groups. The first task of this method is to process and integrate the verbal and nonverbal trauma narratives without reliving the trauma. This is accomplished by doing a “graphic narrative” and then “re-presenting” it to the patient. The second task of reversing traumatic dissociation uses the externalized dialogue that involves using both the dominant and non-dominant hands. Participants will learn the essential tasks of trauma therapy and how to treat post-traumatic stress disorder. The training is appropriate for non- art therapists and will include a hands-on experience of working with art and narrative processes.

P2 - PRENATAL, PREVERBAL AND PRESCHOOL TRAUMA AND SUBSEQUENT DEVELOPMENT OF DISSOCIATION
Presenters: Fran Waters, Na'ama Yehuda, Renee Marks, and Laurie Parker

Prenatal and preverbal traumas, along with preschool trauma, are often unrecognized forms of trauma that nonetheless can profoundly impact the trajectory of a child's life in ways that continue into adulthood. Birth trauma, abuse, neglect, and early medical trauma—although often coded in sensory motor memory or implicit memory systems—remain largely unrecognized as the origins of dissociative responses and disorders that severely impair the child. Research increasingly recognizes how aversive conditions during pregnancy, such as malnutrition, domestic violence and maternal stress, can impact not only the mother but also the developing fetus, and predispose babies to exhibiting fear-based dysregulated patterns after birth.

Traumatized infants and very young children can only communicate their distress through crying, irregular and disrupted circadian rhythms, feeding disturbances, frequent and sudden startle reflexes, abnormal or erratic responses to eye contact and stimuli, developmental delays, and even dissociative shutdown marked by staring and non-responsiveness.

This workshop will review research on early trauma, and examine symptoms and warning signs of dissociative responses. Star Theoretical Model (Waters, 2016) which combines five theories—attachment, neurobiology, child development, family systems, and dissociation—will be delineated as a framework for evaluating and treating early trauma. Communication disorders, processing difficulties, somatic disturbances, and emotional dysregulation based in or complicated by traumatic origin will be illuminated. Clinical cases of dissociative infants, toddlers and preschoolers will be presented, utilizing various modalities (e.g. Sensorimotor psychotherapy, EMDR, art and play therapy) to illustrate the treatment process through to integration. Special attention will be given to repairing attachment disturbances. Artwork and videos will be shown.

P3 - COMPLEX ETHICS FOR COMPLEX TRAUMA: NAVIGATING UNCHARTED WATERS
Presenter: Kimber Olson

Complex Ethics for Complex Trauma will address the intimate relationship between therapist and client. Included in this is how the therapist reacts to clients with complex trauma histories, how enactments, re-enactments, transference and countertransference, dissociative attunement and projective identification play out in the therapeutic relationship between therapist and client. Participants will leave with the understanding that those professionals who have a high standard of connection to their theoretical model and also a high connection to their understanding of their own countertransference will fare the best when working with clients who have a complex trauma history. Participants will be taught specific techniques to address hot issues such as digital and social media, emailing and texting with clients, boundaries, therapeutic touch and dual/multiple relationships. We will look at how ethics may need to be modified for the practice location, agency vs private practice work, and rural vs urban issues. Providers have been shown to respond in a more reactive manner to trauma survivors than to other mental health populations, and research indicates that there is a necessity to hold firm but not rigid boundaries with this population. How do you know when to slide the boundary ruler? Attend this training to begin finding answers! 

P4 - EATING DISORDERS, TRAUMA AND TRAUMA-RELATED DISORDERS; A CASE OF DID AND OVERVIEW OF THE CLINICAL SCIENCE
Presenter: Tim Brewerton

This workshop begins by presenting a case of dissociative identity disorder (DID) and binge eating that spawned his clinical research interest in trauma and eating disorders (ED). Video clips taken at various stages during the course of treatment will illustrate the dissociative process and the various alters identified. He illustrate how these “alters” take on specific adaptive functions and separate identities, which protect the self and are often archetypal in nature. Evolving concepts from psychotherapy theory and neuroscience are highlighted during the presentation.

Next, the workshop = will present an overview of the current state of clinical science and practice regarding traumatized ED patients. Individuals with EDs report very high rates of lifetime traumatic events, and they are especially sensitive to stress/adversity. Participants will become familiar with literature describing the clinical characteristics of ED patients with comorbid posttraumatic sequelae, e.g., PTSD, Complex PTSD, and Dissociative Disorders. Important principles for treating traumatized individuals with EDs, including the necessity of moving beyond sequential treatment to the development of integrated treatment protocols, are discussed in detail using clinical vignettes. Integration of existing evidence-based treatments including CBT for EDs, DBT, Cognitive Processing Therapy (CPT) Prolonged Exposure (PE), and Eye Movement Desensitization Reprocessing (EMDR) are emphasized.

P5 - SHAME IN COMPLEX TRAUMA AND DISSOCATION: PSYCHOLOGY MEETS NEUROBIOLOGY 
Presenters: Ulrich Lanius, Frank Corrigan, Rick Hohfeler, Sarah Krakauer 

Shame can be understood as an emotional process and as a traumatic state of mind and body.  Shame lies at the heart of individual and collective human experience, and as such reveals much about our sense of self, other, and relationship.  Not surprisingly, then, those of us who work psychotherapeutically with complex, relational trauma and dissociation regularly encounter shame both directly, for example in our patient's self-loathing, and indirectly, when dissociation, both as process and state of mind and body, provides a partial escape from obliterating shame.  Shame as emotion and traumatic state reveal much not only about the nature of self and relationship, but also point toward powerful happenings in the brain and body. These shame-related happenings include dysregulating states of hyperarousal and hypoarousal, and further suggest we would be wise to give special attention to the Periaqueductal Gray (PAG) region of the midbrain. 

This workshop brings together two psychotherapists with expertise working with shame in complex trauma and DID in both inpatient and outpatient settings (Rick Hohfeler, PhD and Sarah Krakauer, PsyD), and two seasoned psychotherapists who will share their expertise in neurobiology and brain/behavior relationships as pertains to shame, complex trauma and dissociation (Frank Corrigan, MD and Ulrich Lanius, PhD).  Ken Benau, PhD, a psychotherapist with special interest in working with shame and pride in psychotherapy, will serve as moderator and facilitator of a conversation both between our four presenters, and between our presenters and workshop participants.  We hope to foster an exciting exchange of ideas illuminating different ways of understanding the psychology (including phenomenology) and neurobiology of shame with respect to complex trauma and dissociation.  Likewise, we hope our shared conversation will further highlight creative ways to apply these understandings of shame, as observed in the mind, brain and body, to our work as psychotherapists.  We intend to pay particular attention to those points of intersection between mind, brain, body and behavior as relates to shame and complex trauma, in order to inspire psychotherapists and researchers alike.

Friday, 23 March 2018

P6 - DISSOCIATION 101: THE BEGINNING, THE MIDDLE AND THE...HOW TO SET UP A CAREER WORKING WITH DISSOCIATIVE DISORDERS
Presenter: Christine Forner

For many students and emerging professionals who first enter the field of dissociation and trauma, there is often not a great deal of information that describes the theoretical foundations and history of the dissociative field. This workshop is intended for students, emerging professionals and others who are interested in learning about the fundamentals of dissociation as a distinct response to trauma.  The premise of this workshop is to cover very basic fundamental information regarding dissociation and the dissociative disorders field. This course will cover 1) basic theories of trauma and dissociation, 2) the history of the dissociative field, including theories and treatment recommendations from the 1800's, through to the eighties, nineties and today, 3) The impact of the false memory "war", 4) finer details of current dissociative models (covering various theoretical foundations, e.g. Structural dissociation, dissociative symptoms/phenomena (the DSM), dissociative defenses 5) rate and prevalence 6) a breakdown of the dissociative disorders, 7) basic neurobiology of trauma and dissociation, 8) assessment and evaluation, and 9) current treatments. The basic goal of the pre-conference session is to equip those who attend with enough basic information to take into their scholarly or new professional practices as well as have a solid foundation for the rest of the conference. This workshop is designed to demystify dissociation and provide participants with a broad based understanding of it as a response to overwhelming stress.

P7 - FOUR PATHWAYS TOWARD THINKING THROUGH THE THERAPY OF DID
Presenter: Richard P. Kluft

This is a workshop designed to enhance professional competence and problem solving in the present, and to instill a stance that promotes ongoing skill acquisition. The learner will have the opportunity to learn new concepts, constructive attitudes, and effective techniques. Those taught will be initially framed in the context of how they emerged from clinical experience, and discussed further as they evolved and were refined. The workshop will begin by addressing the challenge of learning to develop a philosophy of treatment derived from within the matrix of successful treatments rather than from constructs imposed upon it.

Next, it will illustrate the process by which numerous hypnotic techniques were developed by the presenter on that basis. Thereafter it will demonstrate how a scholarly search led to the discovery that the longstanding rift between hypnosis and psychoanalysis was ill-founded, and gave birth to persistent shortcomings in both approaches; in fact, objective scrutiny of the ideas involved rapidly suggests at least a dozen ways in which hypnosis can enrich psychoanalysis and psychoanalysis can enrich hypnosis without violating the rules and procedures governing each of these approaches. Following this, a range of hypnotic and analytic techniques useful in the treatment of DID will be explored from the perspectives developed earlier in the course. Finally, the importance of the study of details in work with DID will be explored with a series of clinical illustrations. The presenter will show that while the devil may be in the details, so is the deliverance from the distress and dysfunction that is so painful and disruptive in the lives of those who suffer, endure, and are entrapped within DID.

P8 - TRACKING THE SOMATIC NARRATIVE OF MULTIPICITY IN TRAUM AND DISSOCATION
Presenter: Rochelle Sharpe Lohrasbe

Client perspectives oriented towards action systems of survival and/or daily life contain their own varying psychological presentation that includes cognitive, emotional but also somatic components.

P9 - THE CENTRALITY OF RELATIONSHIP: CLIENT AND THERAPIST GROWTH PERSPECTIVES
Presenters: Joan Turkus and Phil Kinsler

The presenters, Philip J. Kinsler, Ph.D., ABPP, and Joan A. Turkus, MD, have worked for many years in observing/facilitating client’s growth through the provision of safe, healing, and bounded relationships. Dr. Kinsler’s recent book, Complex Psychological Trauma: The Centrality of Relationship provides an outline of client’s relational challenges over the three-stage trauma treatment model advocated by ISSTD and other authorities. As mentors of therapists, the authors have also noted and written on how therapists grow over time in their relational work with clients, and thereby in their own self-respect and competence. Dr. Turkus has described the arc of therapist growth as involving further education, careful professional practice, remaining up to date with relevant research, and self-reflection. In this day-long training event, the authors will present client relational challenges and therapist growth opportunities typically encountered in implementing complex psychological trauma and dissociation therapy. Experiential exercises of typical therapeutic choice points and therapist responses will be provided.

P10 - EXTREME ABUSE: THE CRIME, THE VICTIMS, THE PERPETRATORS AND THE CLINICAL WORK
Presenters: Michael Salter, Ahad Sachs, and Lynette Danylcluk

Extreme abuse involves the deliberate, severe traumatization of victims, often in the context of organized abuse, criminal networks, cults and institutions. Although extreme abuse has been documented by clinicians for over thirty years, it remains a poorly understood and challenging area of clinical practice. This session will bring together three leading figures in the extreme abuse field.

The session will highlight the criminal  aspect of extreme abuse, and discuss the similarities and differences with other forms of trauma and dissociation. It will also examine very closely the process of devastation that extreme abuse has on both victims and perpetrators.

Victims and perpetrators both end up alienated from the rest of society, disbelieve their own humanity and feel unable to be understood or comforted by others. This dynamic, and others, present unique challenges to the therapeutic work.

Updated August 31, 2017

2018 Conference Supporter