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Overview
This seminar seeks to contextualise dissociation in the spectrum of ways in which individuals and societies seek to distance themselves from, or to not know about individual and collective trauma.
The evolution of the human brain is based on how life really is rather than on how we'd like to believe it to be. Part of society's distancing itself from trauma is to reassign those symptoms or syndromes that result from trauma to paradigms that emphasise other, less confronting, aetiologies.
Maintaining a personal strategy which emphasises, clear thinking, objectivity and the use of meaningful metaphor while at the same time avoiding going beyond verifiable data in theory and clinical practice, is a necessary requirement for those who choose to work with the complexities of personal trauma.
Such considerations form a backdrop to the elaboration of the course, treatment options and outcomes for those suffering complex trauma/dissociative disorders.
Learning Objectives
1. To form an understanding of the extent and type of psychological co-morbidity that results from chronic severe childhood trauma.
2. To form an understanding of the abuse and deprivation histories of those fulfilling diagnostic criteria for Dissociative Identity Disorder/Dissociative Disorder NOS.
3. To form an appreciation of how the construct of 'schizophrenia' evolved and of how readily, down the years traumatised and dissociative patients have been prone to inherit that diagnostic description.
4. To form an appreciation of how trauma has impacted both on the evolution of the brain and on how it grows and wires itself at the individual level.
5. To form an appreciation of a logically based, staged therapy model that has general application with individuals who have suffered complex developmental trauma.
The 8 sessions will cover the following topics:
Dissociation & Other Mechanisms of Not Knowing
The Surviving Brain
The Nature of the Dissociative Individual
Dissociative Disorders and the Construct of Schizophrenia
Therapy: Staging and Objectives
Therapy: Techniques, Challenges and Outcomes
Remembering Trauma
Seeking a Better Frame of Reference
Day One
| 9:00 – 10:30 |
Session 1: Dissociation and other Mechanisms of Not Knowing
Definitions of dissociation
Dissociation viewed in the context of the spectrum of ego-defences
Child abuse and the mechanisms of 'not knowing'
Wars, disasters and global catastrophe
Attachment vs narcissism and the 'false self'
Countertransference to trauma |
| 10:30 – 11.00 |
Morning Tea |
| 11.00 – 12:30 |
Session 2:
The Surviving Brain
Des Carte and notions of dualism
The evolution of the Triune brain
Brain development during the life cycle
The brain of those with PTSD or with Complex PTSD
The effect of treatment on the brain: functional neuroimaging |
| 12:30 – 1:30 |
Lunch |
| 1:30 – 3.00 |
Session 3:
The Nature of the Dissociative Individual
The concepts of hysteria, dementia praecox, schizophrenia and the evolution of the 'borderline' syndrome
Positioning Australia in the evolution of the modern era of studying dissociative disorders
Co-morbidity, Complex PTSD and Disorders of Extreme Stress NOS
Abuse histories and symptomatology of patients with Dissociative Identity Disorder
The nature of contemporary diagnostic practices |
| 3.00 – 3:30 |
Afternoon Tea |
| 3:30 – 5:00 |
Session 4:
Dissociative Disorders and the Construct of Schizophrenia
The spectrum of dissociative symptomatology.
Hallucinations as dissociative phenomena.
The role of trauma in the genesis of psychosis.
Schneiderian first rank symptoms, schizophrenia and dissociative
disorders.
Kraepelin, Bleuler, Schneider, Read, Bental, Ross - conceptualizing schizophrenia.
The DSM-IV-TR diagnostic criteria for dissociative disorders and schizophrenia
The assessment of dissociative disorders. |
Day Two
| 9:00 – 10:30 |
Session 5:
Therapy: Staging and Objectives
Assessment and the goals of therapy.
The three stage model of therapy.
Safety, the work of therapy (including the processing of trauma), mourning, integrated functioning, follow-up.
Personal responsibility, empathy and the therapeutic alliance.
Awareness of transference, countertransference and Karpman's Triangle. |
| 10:30 – 11.00 |
Morning Tea |
| 11.00 – 12:30 |
Session 6:
Therapy: Techniques, Challenges and Outcomes
Dealing with alters/dissociative ego states.
Maintaining and emphasizing a focus on the emergence of individual selfhood.
Self-harming, addictions and suicidality.
Dealing with the repetition-compulsion.
Cognitive restructuring.
Involvement of partners.
Medication.
Stances taken with perpetrators/legal issues.
The importance of therapeutic competence, consistency and clearly modelled boundaries. |
| 12:30 – 1:30 |
Lunch |
| 1:30 – 3.00 |
Session 7:
Remembering Trauma
The nature of memory and the particular nature of traumatic memory.
Dissociative amnesias in the context of the full spectrum of traumatised patients.
Child abuse, betrayal trauma and the recovered memory controversy.
Hallucinations, pseudo-hallucinations, flashbacks and re-enactments viewed as manifestations of traumatic memory.
Professional position statements and the concept of therapeutic neutrality.
|
| 3.00 – 3:30 |
Afternoon Tea |
| 3:30 – 5:00 |
Session 8:
Seeking a Better Frame of Reference
Distilling out the factors that foster & perpetuate interpersonal trauma
Dealing with society's automatizations and compartmentalization
The functions of professional skepticism
The best interests of society
Working in the trauma field - roles, responsibilities and future challenges. |
The session time will comprise:
Lecture format
Case Discussion
Slide presentation
Question and answer
Audience/group discussion
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