Letter From The President

This is the Sound of All of Us

Kevin Connors, MS, MFT

Greetings ISSTD

How do we advocate for survivors?

Our mission is to promote understanding and treatment of complex trauma and dissociative disorders. Our clients are among the most traumatized people in the world. Their experiences shake even the most seasoned of us. Yet despite the growing mountain of evidence, we find that some sectors of society still won’t hear or acknowledge what happens in the dark corners of human relationships.

Statistics pile up. Study after study shows the alarming frequency with which children are hurt. More research shows the impact of trauma on the individual and on society; increased medical costs, legal complications, families in crisis, lost productivity. Even more studies show that trauma persists across the lifespan. That trauma inhibits peoples’ ability to stand up for themselves, to set appropriate boundaries and protect themselves.

With this dynamic active in the best of times, we see the added strain on our clients as they confront these challenges in a time of growing conflict, hostility, and incivility. Without taking sides in the current polarized political arena, I note how many colleagues have shared their clients’ struggles and exacerbated feelings of betrayal, hurt, and fear in recent times. Regardless of the clinician’s point of view, the political has invaded the personal.

Perhaps it is a mark of distinction that our clients feel safe enough and accepted enough to come to us sharing their fears and outrage. As children, many of them did not feel they could turn to a responsive nurturing parent. Now they turn to us looking for support, guidance, and safety.

How do we respond to them?

I will share that more than one of my clients tearfully described feeling alone and abandoned, reliving the dark times when they had to pretend that all was well in the house, despite being molested the night before. The fake smiles across the breakfast table as both parents played parts in pretending they were a happy, ordinary family, going about a happy ordinary day.

I was able to share with these clients the carefully chosen words from ISSTD’s new Rapid Response Team (headed by Bob Slater with Christine Forner, and Michael Salter). Our public statement on Therapy and Sexual Abuse Memory published on 20 September 2018 meant the world to many of my clients. They know of our Society, of our annual conferences which pull me away for a week or more every year. They saw us as a group of professionals getting together to train and teach each other. But they saw us as an abstract; as something outside of their immediate experience. That statement made us their advocates and allies. Sharing that statement strengthened the therapeutic alliance in ways I would not have imagined. ISSTD became a group of people who really gave a damn!

I also let my clients know that I shared our public statement on my Facebook page. That I felt so strongly about standing up for people who had been victimized that I wanted friends and colleagues to read our post. Again, the dividends, in terms of the shift in our therapeutic relationship, were tangible and positive.

This letter is not meant to be a clinical consultation , so I won’t belabor the time spent addressing how my clients and I explored the need for them to speak their truths, to raise their voices and to empower themselves. Nor will I elaborate on time spent carefully and delicately defining my stance and my efforts in sharing ISSTD’s statement as my advocating for an ideal and not enacting the role of an idealized protective parent.

I will note that there were other important social reactions and responses. Many of my non-clinician friends: teachers, traffic management engineers, entertainment production executives, etc. “liked”, and appreciated the stance ISSTD took. They noted that our position helped them understand and, in some cases, explain their experiences and the experiences of other close to them. That our public statement resonated with so many “civilians” was truly heartening. That these friends, from other walks of life, appreciated our making the statement and came to hear of ISSTD was an important step forward.

ISSTD has a key strategic goal: to break out of our small silo; to enter fully into the world, sharing our knowledge and our message about complex trauma and dissociative disorders. The role of our Rapid Response Team in achieving this is truly appreciated.

And now I challenge you gentle reader.

How do you promote the work we do?
How do you speak up for those who voices were stifled and stilled?
When the opportunity next arises, will you add your voice?

Thanks for what you do and for being a part of ISSTD.

Best,
Kevin

PS: The title of my letter: “This is the sound of all of us” is taken from a beautiful song, One Voice written by Ruth Moody of The Wailin’ Jennys. Here’s a link to the song

News You Can Use

News You Can Use

Kate McMaugh, Editor, ISSTD News

Website on Psychogenic Seizures

ISSTD Member Lorna Myers, PhD

ISSTD Member Lorna Myers, PhD, developed a comprehensive website (nonepilepticseizures.com) on dissociative seizures (also known as, psychogenic non-epileptic seizures-PNES). It features a diverse array of informational topics including frequently asked questions (FAQs), reading recommendations both for professionals and patients, webinars, useful links and downloadable information forms for patients and caregivers. There is also an associated Facebook page and blog on PNES that can be visited from the launching site.

As of this year, she invited a group of specialists in PNES from around the globe to join the website and to work together to build public awareness and a greater reservoir of information for health professionals. The purpose of nonepilepticseizures.com is now to create the most comprehensive consumer information, public and professional education website on PNES in the US and other English-speaking countries.

One additional feature of nonepilepticseizures.com that has proven highly useful is a referral page that lists mental health professionals with an expertise or interest in PNES. Please note, having treated a patient/s with PNES at some point and being interested in treating this condition qualifies you to be listed as a potential referral. At this time, the list includes therapists in nearly 20 US states as well as in Australia and Canada. It is completely free of charge to be listed.
Check out the website at www.nonepilepticseizures.com.

Reflections from the Aftermath of an Historic Child Abuse Scandal

ISSTD member Sue Richardson found herself, in 1987, in the centre of a major national child abuse scandal. Despite not wanting to be a ‘key figure’ in a high profile case, she nevertheless became one.
Sue, a psychotherapist in independent practice, and a colleague, Heather Bacon, have recently updated a book they have edited about this experience.
However, this book is not just above this specific experience, it is also an academic treatise about the role of such enquiries, how we respond to them, and ways in which we can better respond to childhood trauma.
Now re-issued with a substantial new introduction and concluding reflections, this book provides the only account by key professionals directly involved in the Cleveland cases, allowing readers to understand what really took place in Cleveland and why it continues to matter today.
The book discusses complex issues such as the medical diagnosis of child sexual abuse; the continuum of disclosure; child protection issues and concludes by discussing how we, as a society, have progressed, or failed to progress, in issues of child protection.
It analyses the many failures to address the plight of sexually abused children and makes constructive suggestions for the way forward to provide more effective interventions for children at risk.

The book is available from Amazon here.

(Remember to use your Amazon Smiles to raise money for ISSTD.)

New Book for Child Survivors of Sexual Abuse

ISSTD Member Agnes Wohl, LCSW has teamed with psychotherapist Irene Wineman-Marcus and illustrator Jackie Bluzer to produce a new book for children who have been sexually abused: Fawn’s Touching Tale: A Story for Children Who Have Been Sexually Abused.

While a number of books focus on prevention of child sexual abuse and on educating children, this book is one which aims to support children who have been abused. The book uses animal characters to allow children to process painful, complex and mixed emotions.

Parents, psychotherapists and school professionals can use this book as a point of entry into complex feelings that the child, or any sexually abused person, might frequently experience. The authors say that “It is our hope is this book will help the child or adult begin the process of healing, and gradual resumption of his or her healthy psychological development.”

The book is available in Kindle and paperback at Amazon. Remember to use your Amazon Smile account to raise money for ISSTD!

Thesis on Dissociative Disorders wins University Medal

Mary Anne Kate, PhD, receiving her graduation certificate and medal

ISSTD Student Member, Mary-Anne Kate has won a University medal, Chancellor’s Doctoral Research Medal, for her PhD: The prevalence of dissociation and dissociative disorders, and trauma and parent-child dynamics as etiological factors: implications for the validity of the Trauma Model and Fantasy Model of dissociation. This award was given to five PhD students across the university in recognition of their research being of “exceptional merit and at the forefront of the field”. Mary-Anne Kate has been a PhD student at the University of New England, Australia and was supervised by Dr Graham Jamieson and ISSTD Past President, Professor Warwick Middleton.

If you would like to know more about Mary-Anne and her research you can read our interview with her in the September edition of ISSTD News.

Positions available

ISSTD Members may be interested in two new positions available at the Trauma Center, at the Justice Resource Institute.

Clinical Director
The Trauma Center at JRI is pleased to announce a national search for an experienced clinician who is committed to trauma-informed practice to serve as Clinical Director (CD). The Trauma Center plays an important role in advancing trauma-informed treatment, research, and education within JRI, the commonwealth of Massachusetts and nationally. As an integral member of the management team, the CD develops and maintains clinical programming, provides oversight for the daily operations of the clinic, and manages the delivery of therapeutic services and coordination of client care.

For more information please click here.

Clinician
The Trauma Center at Justice Resource Institute has an opening for a part- or full-time clinician in our Brookline, MA office. We are looking for a committed and flexible clinician interested in joining a stimulating and supportive community of professionals, dedicated to serving children, adults and families impacted by trauma & life adversity, and receiving extensive training opportunities to expand their expertise.
This position with include a combination of fee-for-service and salaried hours, and the clinician will hold a position on an exciting new mobile comprehensive clinical treatment team (CTTT), providing trauma-informed, evidence-based treatments to diverse groups in the greater Boston region.
For more information please click here.

More Podcasts

ISSTD Member Susan Pease Bannitt has recently featured in two podcasts talking about patient centred therapy technique, attachment in the therapeutic relationship and preventing attachment rupture in therapy. She also discusses the concepts of ‘superhuman empathy’ and intuition.

Listen to Susan speak with Laura Reagan, LCSW-C on Therapy Chat

And with Guy McPherson on the Trauma Therapist Podcast

Welcome ISSTD’s New Members in October!

PROFESSIONAL MEMBERS
Margaret Bellows
Jennie Beltz
Dianne Blayney
Amanda Faulkner
Karen Gennaro
Diane Gottfried
Lou Himes
Marcia Holland
Jennifer Kiszely Bressler
Kelly McDaniel
Simona Noaghiul-Yland
Tarz Palomba
Lauren Picciano
Peter Stathakos
Sharon Steckler
Lindsey Steffen
Lisa Tracy
Mary Beth Wiggins
Cheri Yadon
EMERGING PROFESSIONAL MEMBERS
Elizabeth Chalenburg
Laura Michaels
Belinda Rooks
STUDENT MEMBERS
Eric Bottino
Robert Considine
Yekaterina Nikiforova
Megan Williams

Do You Have News ISSTD Members Can Use?
We need your help to make NYCU a great feature, full of news and connecting us all!

Do you have a book or journal article coming out that you wish to share? Have you received an award for your work in the field? Have you been part of developing a new website or training course? If so, we want to hear from you! Don’t be shy, submit your news to us so that we can share with other members. (Please be aware: we do not offer book reviews, but a chance to share with others that your book has been published.)

Submission Deadline: 20th of the month
Send to ISSTD Editor, Kate McMaugh: katemcmaughpsychology@gmail.com

Clinical E-Journal

JTD and Frontiers Table of Contents (October 2018)

Journal of Trauma & Dissociation

Check out the entire library online of the Journal of Trauma & Dissociation – your member benefit – now!

Table of Contents
Volume 19, Issue 1
Volume 19, Issue 2
Volume 19, Issue 3
Volume 19, Issue 4
Volume 19, Issue 5

Are you interested in auto publication alerts?
To set up a quick and each way to get a ‘new content alerts’ for JTD, go to the JTD page at Taylor & Francis and click the ‘Alert me’ button under the graphic of the JTD.

For full access to the entire library of the Journal of Trauma & Dissociation (your member benefit) visit the Member’s Only section of the ISSTD website and log in with your member username & password. Need help to access? Call ISSTD Headquarters at 703-610-9037, or email info@isst-d.org for assistance.

Frontiers in the Psychotherapy of Trauma & Dissociation

Table of Contents

2018

  • A Simple Algorithm for Medication of Patients with Complex Trauma-Related Disorder (Andreas Laddis, MD)
  • Healing Emotional Affective Responses to Trauma (HEART): A Christian Model of Working with Trauma (Benjamin B Keyes, PhD, EdD)
  • Eye Movement Desensitization and Reprocessing (EMDR) in Complex Trauma and Dissociation: Reflections on Safety, Efficacy and the Need for Adapting Procedures (Anabel González, MD, PhD)
  • Cross-Cultural Trauma Work With a Tribal Missionary: A Case Study (Heather Davediuk Gingrich, PhD)
  • The Potential Relevance of Maladaptive Daydreaming in the Treatment of Dissociative Disorder in Persons with Ritual Abuse and Complex Inner Worlds (Colin A. Ross, M.D.)
  • Neuroaffective Embodied Self Therapy (NEST): An Integrative Approach to Case Formulation and EMDR Treatment Planning for Complex Cases (Sandra L. Paulsen, Ph.D.)
  • The Case of the Shaking Legs: Somatoform Dissociation and Spiritual Struggles (Alfonso Martinez-Taboas, Ph.D.)
  • Treatment Outcomes Across Ten Months of Combined Inpatient and Outpatient Treatment In a Traumatized and Dissociative Patient Group (Colin A. Ross, M.D., Caitlin Goode, M.S., and Elizabeth Schroeder, B.A.)
  • Maladaptive Daydreaming: Ontological Analysis, Treatment Rationale; a Pilot Case Report (Eli Somer, Ph.D.)

2017

  • Editorial: How Close Encounters of the Completely Unanticipated Kind Led Me to Becoming Co-Editor of Frontiers (A. Steven Frankel, Ph.D., J.D.)
  • Editorial: Sources for Psychotherapy’s Improvement and Criteria for Psychotherapy’s Efficacy (Andreas Laddis, M.D.)
  • Trying to Keep It Real: My Experience in Developing Clinical Approaches to the Treatment of DID (Richard P. Kluft, M.D., Ph.D.)
  • Expanding our Toolkit through Collaboration: DIR/Floortime and Dissociation-Informed Trauma Therapy for Children (Joyanna Silberg, Ph.D. and Chevy Schwartz Lapin, MA)
  • From Passion to Action: A Synopsis of the Theory and Practice of Enactive Trauma Therapy (Ellert R.S. Nijenhuis, Ph.D.)

To access articles, log into the Member’s Corner area of the website and click on the Frontiers link in the upper right corner. New articles will be posted monthly on the fourth Tuesday of the month as they become available. Frontiers is a member-only benefit.

Donate to ISSTD

The Gift that Keeps on Giving

ISSTD is in the midst of some major changes, as many have noticed with the launch of ISSTDWorld, the new online community for ISSTD members. These changes are designed to benefit our membership in new and exciting ways by increasing training opportunities, improving technology and the resources it provides, and better representing the mission of the Society to the public.

As many of you know, ISSTD is celebrating it’s 35th Anniversary in 2018. To help commemorate 35 years of expertise in the field of trauma and dissociation, and to support a successful future, we are working to raise $35,000 by December 31, 2018.

The proceeds from the 35 for the 35th Campaign will focus on three major projects:

  • Updating the ISSTD website to create a place for both the public and mental health professionals to find valuable resources on complex trauma and dissociation, as well as a virtual environment that can foster closer connections amongst our members. (Click here for more details on this project)
  • Expanding our virtual training offerings, including half-day and full-day webinars and teleseminar-format Professional Training Program (PTP) courses. These courses allow participants from anywhere in the world to engage in training with leaders in the field from the comfort of their own home or office.
  • Expanding engagement opportunities and content for our student and emerging professional members.

As of October 31, 2018, we are only a little more than halfway towards our goal. If we are to meet our target and improve member benefits we really need everyone’s involvement. Donations support all of us in delivering the best services possible and, ultimately, help us help our clients.

As the holiday season approaches we encourage all of you to think about giving a small gift, a gift that will keep giving for years to come! If each member gave just $12 before December 31, we would meet our target.

Come on everybody, let’s rally around and give this gift to ourselves and our clients. We are worth it!

There are two ways to donate to the campaign, with a one time gift or a recurring donation. For more information or to make a donation, visit the 35 for the 35th page of the ISSTD Website.

Finally, we must not forget another major achievement. In 2017, ISSTD launched its Clinical E-Journal, Frontiers in the Psychotherapy of Trauma and Dissociation.  Since its launch, the e-journal has become a valued member benefit and offers a new outlet for the latest in clinical perspectives on the field. This publication would not have been possible if not for the generous donations of members and the tireless work of the volunteers who edit and produce the articles. To donate to Frontiers visit this page.

Thank you for your continued support of ISSTD.

For any questions about donating to ISSTD, please contact ISSTD Headquarters at info@isst-d.org.

2019 Annual Conference

2019 Annual Awards Nominations Now Open!

The Annual Awards Committee is now accepting nominations for the 2019 ISSTD Annual Awards and for ISSTD Fellow status to deserving recipients.

For more information on the all of the ISSTD award categories including a list of past recipients, please visit the Annual Awards page.

Award nominations will be accepted until December 17, 2018 at 11:59pm EST.

Please link to the following forms for your nominations:
Annual Awards Nomination Form
Fellow Endorsement Form

Trauma & Dissociation in the News

A Nation Apologises to Institutional Sexual Assault Survivors

Kate McMaugh, Editor, ISSTD News

The six Commissioners with the Message to Australia book, (Photo courtesy of The Royal Commission.)

In a world where children (or adult survivors) reporting sexual abuse are frequently ignored, accused of lying, or of having over-active imaginations, Australia’s Royal Commission into Institutional Response to Child Sexual Abuse has been a beacon of hope.

The Royal Commission was announced in 2012 and the scope of the 6-year process was enormous, with over 42, 000 calls taken, over 25, 000 letters and emails received, and over 8000 private sessions held for survivors to tell their story. The Commission referred almost 2, 600 cases to authorities, (including the police) and many organisational processes were investigated and will continue to be.

The Royal Commission produced a huge body of work with 11 issues papers published, strengthening all types of institutional responses to reports of child abuse. Of the 122 recommendations made by the Commission, the Commonwealth government has adopted 104 of them, with the remaining recommendations still being considered. A redress scheme is being developed.

Bit by bit this enquiry delved into the way in which society has responded to children reporting abuse. The Commission has sat through harrowing stories and painstakingly pieced together a bigger story, a picture of organisational child abuse that is of relevance not only to Australia, but to all societies.

International organisations such as the Catholic Church, the Boy Scouts Association, the Jehovah’s Witnesses, the Salvation Army as well as other institutions such as sporting bodies and schools were all exposed as having harboured, enabled and covered up the sexual abuse of children. In a culture where many deny that child sexual abuse occurs in an organised and repeated manner, the stories and details were so overwhelming, so consistent, that they drowned out many deniers.

Justice Peter McClellan, ISSTD Regional Conference, Sydney, November 2015 (Photo: Warwick Middleton)

The Royal Commission took the evidence, the stories, deep into the Australian community. For years the stories of survivors and the cover ups by our most respected organisations were front page news. Importantly, the Royal Commission was generally well-supported by the public. There was no widespread backlash or punitive attempts to silence or disbelieve survivors. Overall, the media was supportive and affirming of the fact that terrible abuse occurred, and was indeed covered up. Tellingly, all six commissioners who began this lengthy process stayed until the end, which was an heroic feat, given the depth and breadth of trauma they were repeatedly exposed to.

The ISSTD awarded the 2018 Media (Written) Award to the six Royal Commissioners and the Senior Counsel Assisting. When writing in ISSTD News (April 2018) about this award, Former ISSTD President Professor Warwick Middleton wrote:

“This enquiry represents mankind’s most comprehensive attempt to examine very closely the network of society’s institutions involved in the sexual abuse of children and the manner in which such institutions protect abusers. It was unprecedented in scale and scope. The Australian findings are of direct relevance to all comparable societies.”

On the 22nd October, 2018 the work of the Royal Commission reached an important stage of completion when the Australian government issued a public apology to the survivors of institutional sexual abuse.

The apology came after a three-month consultation process was held around the nation. Fifty eight face-to-face consultation sessions were organised and over 400 written submissions were examined.

The Prime Minister Scott Morrison’s speech included:
“Mr Speaker, today, as a nation, we confront our failure to listen, to believe, and to provide justice,”
“And, again, today, we say sorry. To the children we failed, sorry. To the parents whose trust was betrayed and who have struggled to pick up the pieces, sorry.
“To the whistle-blowers, who we did not listen to, sorry. To the spouses, partners, wives, husbands, children, who have dealt with the consequences of the abuse, cover-ups and obstruction, sorry.
“To generations past and present, sorry.”

However, this would not be a story involving politicians, and it would not be a story of child abuse, if it wasn’t complex and full of mixed emotions and conflicting opinions.
ISSTD Member and President of the Blue Knot Foundation, Dr Cathy Kezelman was at the Apology. She reports:

“It was somewhat overwhelming to be present with such a large group of people who had been so profoundly hurt … and then hurt all over again when seeking help. Emotions ran high – from grief, to rage, and a sense of deep isolation. It was incredibly challenging for some to be in Parliament House, such a symbol of power, with so many other people, and to have travelled so far when safety and trust are such issues. …To hear from their leaders that they had been heard, were believed and that their harm was acknowledged, was very powerful for many. To hear that it was not their fault and that the country is with them was very moving, although not everyone was convinced. Some people walked out. Other heckled. It was not a settled crowd, with much raw distress for many whose lives were so shattered. A moment’s silence was held for those who didn’t make it. “

Ex-Prime Minister, Julia Gillard, speaking to supporters at the National Apology. Photo supplied by a survivor.

The person who was the focus of the most enthusiastic spontaneous applause on the part of victims of institutional sexual abuse was an ex-politician, former Prime Minister Julia Gillard, who in late-2012, perhaps aware that she would not be in that role for much longer, went out on a proverbial wing, to announce that her government was establishing the Royal Commission (Gillard was deposed as Prime Minister in June 2013.)

During the week of the National Apology reaction from my clients, colleagues and friends has been very mixed. One client, abused in multiple children’s homes and the juvenile justice system, expressed anger that the Prime Minister cried, stating: ‘Those are crocodile tears. He doesn’t care about us. All the politicians want to use us to (make themselves) look good.’

But another, abused by paedophile priests at her local catholic church said it made a big difference to her. Although unable to watch it all as she became too distressed, she said, ‘Normally I feel so alone. Like I am the only one this happened to, but the Apology helped me see I’m not alone. This happened to lots of people.’ She looked up at me and said, ‘I feel less ashamed.’

A third client abused in children’s homes and as a street kid, still feels angry at the lack of help he got from the government and the police. When I asked him how he felt, he laughed and said, ‘It’ll feel a hell of a lot better when they put their money where their mouth is.’

There has been outrage that the Government will express an apology for historic abuse, but at the same time lock up child asylum-seekers in long term detention, under appalling conditions (as is current practice in Australia). Others are angry that physical and emotional abuse was not included in the remit of the Royal Commission. Still others point out that the Royal Commission and the National Apology only addressed sexual abuse in institutions and organisations, meaning that familial sexual abuse was also not addressed.

Such diverse reactions led me to reflect deeply on the process for Australia, for all of us as clinicians, wherever we work, and for survivors.

For me this is both a personal and a professional story. My experience of growing up Catholic in Australia just meant that abuse was ubiquitous. Teachers, nuns, priests and brothers were well known for harsh physical abuse, emotional abuse, and even sexual abuse. For many of us, our parents, aunties and uncles told stories of terrible abuse (usually physical), meted out in the name of education, training or discipline. (And we would all be naive if we felt this only happened in Catholic organisations. The Royal Commission certainly showed it did not, though 40% of victims who gave evidence to the Royal Commission in private sessions were abused in Catholic institutions.)

Living in a Catholic educational facility for a third of my childhood, with limited family contact, I witnessed much abuse. When I first told an adult that a member of a Catholic religious order was sexually abusing a friend of mine, I was hit and told, ‘not to talk like that about people who have taken the cloth’.

In high school, over the years, several of us spoke out about male teachers who were sexually abusing girls as young as 11 or 12. The most frequent responses were to blame the child or ignore the situation. Sadly, a number of those victims never got to hear the Apology as they have taken their lives in the years since.

Fast forward a few years. When at university I accompanied a friend to a sexual assault service for counselling. In the waiting room was a large poster of rows of people, all standing with their backs turned to the camera. It was quite eye-catching as normally posters show people front-on. I went closer to read the writing at the bottom. It said, ‘This is what most people do when a child tells them they have been sexually abused.’ It had an enormous impact on me and I vowed never to be one of those adults. I hope I have lived up to this. For me, personally, the Royal Commission and the National Apology meant a lot, not because of who said it, but because it was an acknowledgment.

I also believe our Australian experience is meaningful to all of us in ISSTD. Therapists, particularly those working with organised and extreme abuse, often hear that clients ‘make things up’. The False Memory Wars have not really gone away. Research into the creation of false memories is still mis-understood, mis-interpreted and taken as proof that children are unreliable and prone to ‘making things up.’ Adult survivors speaking out are still routinely doubted and even criticised.

The truth is, for almost 200 years in Australia, those who claimed that ‘trusted’ people in power were abusing children, and that institutional sexual abuse of children was real, organised and covered up, were also, often rather automatically, discredited or ignored. The Royal Commission proved the nay-sayers were wrong. This should have implications for how we treat whistle-blowers and victims on a global scale.

For me, the National Apology was not really a day for politicians, many of whom have lost the respect of survivors. It should ideally be a day for us as a community, citizens of this Nation, to publicly and formally say to people who have waited decades to be heard and believed: “We hear you. We know this stuff happens and you have not spoken out in vain. We will be with you.” Only then is a National Apology really taken out of politics and embraced into our shared humanity.

To spend just one day supporting these silenced survivors does not mean we ignore those who still suffer. Our Nation, and the world at large, has much work to do in protecting children and enhancing their lives. We need to focus on sexual abuse within the world’s biggest institution: the family. We need to include those who have experienced physical and emotional abuse, both within the family and within organisations. We need to not turn a blind eye when our most powerful organisations continue to abuse children, be that in detention centres, border crossings or churches. Most of all we need to look back at how entire generations cast doubts on the stories of child survivors… and how wrong they got that.

Membership

Strengthening the ISSTD International Community

On Monday, October 5 ISSTD officially launched its new membership community platform, ISSTDWorld. This new platform is designed for members to engage with each other through discussions, resource sharing, committee involvement, and learning opportunities such as the member-only virtual book club.

We are thrilled to report that in just the first three weeks, nearly a third of members have logged into the new system, updated their profile, participated in a discussion, shared a resource or visited the new Member Resources area. If you have not logged into the system, we encourage you to spend a few minutes checking it out. We have put together a User Guide with instructions on how to use the system and additional assistance is available in the FAQ section under the ‘Participate’ tab.

We especially encourage all members to spend a few minutes updating their profile and privacy settings ahead of the launch of the new ‘Find A Therapist’ Directory which will be rolled out as part of the new website in early 2019.

Thank you to our Trail Blazers who helped with the beta testing of the new platform and to all of the committee chairs who have assisted with making this a smooth transition. We are excited to continue to add additional content to the platform over the next several month.

If you are encountering problems logging into the system or need additional assistance, please email membership@isst-d.org and a staff member will be happy to assist.

Spreading the Word

The Blue Knot Foundation, Australia

Shelley Hua

Dr. Cathy Kezelman AM with The Hon. Justice Peter McClellan AM

Welcome back. October brings us to the great work of the Blue Knot Foundation, Australia’s National Centre of Excellence for Complex Trauma, with a focus on those who have experienced childhood trauma. Blue Knot Foundation was founded in 1995, as a self-help organisation called ASCA (Advocated for Survivors of Child Abuse). It was developed by survivors for survivors but over its 23 year history has combined the composite voice and passion of survivors with that of academics, clinicians and researchers. It has driven socio-political change advocating for recognition of the needs of complex trauma survivors, primarily as a result of adverse childhood experiences and a trauma-informed world.

It has educated the community, and other sectors, around the differences between complex and single incident trauma, in underpinnings, dynamics, impacts and treatment. This includes its leading role in demystifying an understanding of dissociation and dissociative disorders within the mental health, legal and other sectors, led by its Head of Research, Pam Stavropoulos PhD, a member of the Advisory Board of the ISSTD Scientific Committee.

The Foundation is strikingly holistic in its reach, with direct services, training and resources for all areas of society touched by trauma, particularly complex trauma and its recovery. Its 2012 Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery were a global first, and have been followed regularly by other accessible evidence and practice-based publications. This includes its 2017 document The Truth of Memory and the Memory of Truth – Different Types of Memory and the Significance of Trauma  and multiple factsheets.

Whether it be guidance for supporters on how to talk about trauma, training for health professionals and organisations, or direct support for survivors, they’ve got it covered.

Sitting down with its President, Dr Cathy Kezelman AM, we explore the theme of ‘spreading the word’ and what it means for the Blue Knot Foundation. “It’s a big part of what this organisation is,” Cathy tells me. “To move forward we need to understand what trauma is and what complex trauma is. There is not a shared understanding, even within the sector.” Cathy elaborates on the importance of understanding complex trauma, as opposed to single-incident trauma, and how it’s not sufficiently reflected in DSM-5. Encouragingly, Complex-PTSD is recognised in the upcoming ICD-11 . Blue Knot Foundation’s mission then, becomes one of education around the complexities and nuances of childhood trauma. For example, developmental and attachment trauma, understood so much better due to advances in neuroscience, can make it hard to seek help and support and build a recovery pathway. Or for many, to know that living freely is an option within reach at all. Cathy comments that a lack of understanding and empathy translates to impatience and judgment, limiting crucial support.

“We all want to be treated as human beings – to be and to feel safe, to trust other people, to be believed, to have choices, to work with others, to feel empowered, have a sense of agency, to be understood.

“Often society and its members are reluctant to hear the reality of interpersonal events that offend our sense of humanity our expectation of ‘civilised’ societies. However, abuse, violence and neglect are pervasive realities. As a society we have tried to pretend that abuse doesn’t happen, or that it isn’t so bad – that it is only occasionally perpetuated, and by those who are ‘unbalanced’. But it’s common, and it’s an established social practice. It is time we recognised not just abuse but other traumas which impact our children, adolescents and the adults they become.”

Blue Knot’s mission is to educate and promote understanding and cultural change so that our systems of care and justice no longer replicate abusive systems of power, but provide safe respectful spaces in which people can and do recover from diverse traumas.

Blue Knot Day – Monday 29 October 2018

Blue Knot Day is Blue Knot Foundation’s national awareness day celebrated in October every year. On 29th October this year, Australians unite in support of the 1 in 4 Australian adult survivors of childhood trauma. The 2018 Blue Knot Day theme ‘REAL LIVES. REAL CHANGE’ recognises the urgent need for support services for adult survivors of childhood trauma. Coming a week after the national apology to victims of institutional child sexual abuse and within Australia’s mental health month, the timing is opportune.

Blue Knot Day brings the conversation home, between friends and with strangers – it makes the topic approachable and visible in our everyday life. We invite you to start the conversation around the world. Here’s how. Download Blue Knot Day social media images from www.blueknot.org.au/BlueKnotDay and share with the hashtag: #unitebkd

The tangled blue knot symbolises the complexity of childhood trauma, with blue representing the colour of the sky and a clear sky providing the space for new possibilities. Disseminating Blue Knot’s social media images throughout the month of October using the hashtag: #unitebkd will help spread the critical message.

An example of a Blue Knot Day Campaign Poster (Courtesy of Blue Knot Foundation)

Do you have something to share?
If you’re spreading the word about trauma and dissociation into the wider community, or to other professional groups, then we want to hear from you!
Tell us about your work by emailing shua@myune.edu.au
Until next time: adios, do good, fly high.

Creative Space

Creative Space

Noula Diamantopoulos, Curator

The issues that we delve into as clinicians seep through our being and an alchemical process takes place, with the issues expressed again in a process we call Art.

Ruined and Improved

In this first piece, Ericha shares with us an expression of that mystical process – symbolic brush marks and colours that invite us to pause and mindfully reflect. We are able to experience with our own senses and are gifted the opportunity to narrate our own meaning from it.

Title: Diptych: Ruined and Improved I & II
by E. Hitchcock Scott

“This painting is dedicated to those who hurt themselves and struggle to recover, those who cut, burn, scald, scratch and break their bones.
I select this painting because I thought I had ruined it and then – upon reflection – I realized that this painting is better now than it was. This awareness, that the painting was improved instead of ruined, is a golden shadow of the expression I see in the face of clients as they realize they have made progress.”

Un Divided

When I first received this poem, by Jan Ewing, I was drawn into a place I cannot properly describe but wanted to create something visual as a response. Jan allowed me to do this, so here you have her Un Divided poem and my ink painting. Together we are sharing a call and response moment.

Un Divided
By Jan Ewing

I know and yet I do not know
I’m here and yet unseen
I am the person at the front
And the spaces in between

We know that there is more than one
But not all parts agree
Some yearn to come in from the cold
But others wish to flee

My life is filled with missing time
My mind has many files
I hear both rage and weeping sobs
While all you see is smiles

My childhood is a mystery
Both absent and too real
I live there still but know I’m here
I’m numb and yet I feel

You cannot know what life is like
When hiding from your mind
The rules are strict to keep us safe
Some things we mustn’t find

And there is deep within our core
Division with no name
It keeps us hidden from ourselves
We can only whisper ‘shame’

There are many ways of being me
Not just the ones you see
We do not ask for sympathy
Just know that we’re not free

We cannot just forget it all
Despite our memory gaps
We cannot just get over it
Our mind is filled with traps

So judge me not for who I am
Like you in many ways
I had to find a way to live
And live still in this haze

Title: “A Part” By Noula Diamantopoulos

Trauma & Dissociation in the News

The Role of Shame within Domestic Violence Relationships

Christine Forner, BA, BSW, MSW, RSW

October is Domestic Violence (DV) Awareness Month in the USA. Many other countries have similar months at different times of the year. During this time it is very important to bring these situations and circumstances to the forefront of our minds.

We know that interpersonally violent situations are very damaging for everyone involved, and children especially. Brain images show us that the brains of children look very similar to the brains of war vets who have PTSD (McCrory, et al., 2011).

We also know that dissociation is one of the main defensive strategies that many use to cope with these relationships, as depersonalization and derealisation (Simeon, et al., 2001) are needed to live with the constant stress these homes get filled with. Last year Alison Miller wrote an article for ISSTD News which summarised the way this dissociative process plays out in DV relationships.

Similarly, we know that DV is dangerous; yet, we might also hold information, assumptions, and perspectives that make it harder for all to leave violent relationships and heal with dignity.

Domestic Violence is a common experience, yet if you have lived this experience of domestic violence, it is hard not to speak from a place of shame. It is hard to talk about what it is like to be in this situation, to have been a survivor of these events. It is hard to fathom what is, or was, actually happening and it’s even harder to constantly try to educate others that DV is about a lot more than being hit.

Shame is likely one of the most powerful forces in these relationships, perhaps even more powerful than fear (Platt & Freyd, 2015). The emotion of shame is likely playing a key role in perpetuating these relationships. If we look at shame from a mechanical or strictly a physiological perspective, it is a strong emotion whose main purpose seems to be very connected to our defence of staying and being part of a human tribe. When we are not part of the tribe, or feel like we are not part of the tribe, this is when shame kicks in. Why? Why do any of our defences kick in – simply to force us to do what we need to do to be safe, optimally function and stay alive.

Shame is a powerful force, as is hunger. When we are starving, hunger increases, when we are dangerously alone shame increases. Hunger drives us to get food, shame drives us to be with people. It is sensical that the more shame someone has, the more the body is trying, all be it unsuccessfully, to get its needs met. When a person is experiencing toxic shame, which is indicative of the domestic violence relationship, the toxicity of that shame can be evidence that there has been relational starvation. The solution to hunger is food, the solution to shame is connection. Shame seeks out connection and if there is no connection, where neurobiologically there should be one, our bodies and minds will ramp up shame. If we view shame as evidence of someone being dangerously alone, or not bonded enough, we can make the inference that the person is needing to feel safety and security in relationship rather than the common understanding that the person is feeling bad or disgusted with themselves.

The end result of shame, the firm belief that one is not a good enough human and all of the words and language that goes along with these beliefs, is painful emotions. Humans will seek out ways to manage the shame, and this can lead to pandemonium. This can now lead to a perpetual unsolvable problem. The dance of “I need people – people are not here or people are hurting me – I feel awful – I am awful – I need people – people are not there”. In an attempt to meet the need of human connection and then being betrayed or hurt by this connection, one can see the relational cyclical cluster of “come here”, “go away”, “I’m bad”, “you’re bad” which really is a defining hall mark of many interpersonal violent relationships.

Kaufman, in his book The Psychology of Shame states that shame is always an affront to human dignity (1996). Dignity can be viewed as our inborn “basic standard of care” that we all require for optimal growth and health. Dignity and pride suggests that inside of us all is a natural knowledge of how we should be cared for. If that standard is not met, shame is the result.

When you take the perspective that shame is a drive and examine the impact that this drive has on us, it can be seen that shame would be a prevailing force of movement towards other, not to run away. The words in the mind might be ‘I am horrible’, but the emotions and energy of those emotions force us to connect. In this case shame will drive us to be with people, even if those people are not safe. From a biological perspective shame is not the best at discernment, as could be said for all of our other defenses. In the instance of domestic violence, from a logical perspective, you might ask ‘why don’t they leave?’ One answer is that there are mighty neurological influences that are trying to connect to the closest human they love – the dangerous partner.

When you have someone in a partnership that is riddled with dissatisfied shame, one member may become violent as a way to preserve the bond, and the other may over-compensate and soothe to also preserve the bond. In these circumstances you will have a breeding ground for a DV relationship. Shame is searching for care and dignity and in its absence, it will still keep seeking predictability or what is familiar.

Dissociation is one of the few ways humans can endure years of shame-filled chaos and fear. Dissociation is what we do when we have nothing else to do. Dissociation is part of what keeps these dynamics continuing. When you have some of the worst relational pain that can be imagined, the human body will numb out the pain. Inside of the survivour is a human who desperately is seeking comfort and safety from others, but never seems to receive this comfort. As the cycle of goodness, connection and care gets thwarted with pain, anger, fear, control, hitting, rape and degradation, dissociation can become stronger and stronger. As a result, this person or persons will feel further and further away from the human tribe, triggering shame to be used more and more.

These powerful human neurobiological forces of shame and dissociation are often not spoken about in normalizing terms. Shame and dissociation are not behavioural. They are basic human traits and are as behavioural as the need for water. Talking about safety plans are good, but if the conversation about the normal human reaction to being alone and having violent broken bonds is not discussed, little insight and change can occur, especially if there is no therapeutic relationship that can help establish a safe bond. Bonding and attachment is a stronger force than food (Ainsworth & Bowlby, 1991). In these instances, bonding to others is our largest driving force and with a DV relationship the bonding process is perhaps substituted with shame cycles.

What you may hear in your office are the words, or the story of what happened, or the justifications of why there is violence or why there is a need to stay tougher. Or the words of “I hate myself” or “I hate the other person when they do a, b or c”, people get lost in the A. B. or C. We need to have discussions on the power and wisdom of shame, and of the power and wisdom of dissociation. It is in these discussions solutions can be found and dignity can be restored.

Dignity and care is what these toxic situations are seeking. In working with people who are in these relationships it is important to help them gain awareness that it is not about being ‘strong enough to leave’; it is often more about finding an alternative bond to support the internal instructions of shame to be close to other humans. This bond can take many forms, such as the therapeutic relationship, group situations where dissociation and shame are normalized, friendship groups and most importantly inner bonding to oneself where survivors can appease the command of shame to bond and be safe in this world. In essence, the main goal is helping our clients find a home within themselves. When they have this inner agency they tend to leave with dignity instead of shame.

Ainsworth M., & Bowlby, J., (1991). An Ethological Approach to Personality Development. Journal of American Psychologist, 46, (4), pp. 333-341.

Kaufman, G. (1996). The psychology of shame: Theory and treatment of shame-based syndromes (2nd edn). New York, NY, US: Springer Publishing Co.

McCrory, E., De Brito, S., Sebastian, C., Mechelli, A., Bird, G., Kelly, P., Viding, E., (2011). Heightened neural reacting to threat in child victims of family violence. Current Biology, 21 (23), 947-948.

Miller, A. (2017). Intimate Partner Violence: A Dissociative Family Dance. ISSTD News, October 2017. http://news.isst-d.org/intimate-partner-violence-a-dissociative-family-dance

Platt, M. G., & Freyd, J. J. (2015, January 19). Betray My Trust, Shame on Me: Shame, Dissociation, Fear, and Betrayal Trauma. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. http://dx.doi.org/10.1037/tra0000022

Simeon, D., Guralnik, O., Schmeidler, J., Sirof B., Knutelska, M (2001). The Role of Childhood Interpersonal Trauma in Depersonalization Disorder. American Journal of Psychiatry; 158, 1027-1033

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