Trauma & Dissociation in the News

Fire is the Greatest Purifier: A Therapist Reflects on Surviving the California Wildfires

Ericha Scott, PhD

One block from Ericha’s home as she evacuated

I have wondered, before now, if the dystopian stories embedded in our lives and creative culture prepared us or numbed us for disaster. Now, I can say, they do not do either.

The day before the fire, I noticed and commented on an odd vacuous energy in the air – as if the oxygen had been removed. My colleague noticed it as well. We both knew about the fires in Thousand Oaks, but neither of us imagined the fires were coming our way with a wall of flames – sometimes 100 feet high – in less than 24 hours. There is a whole mountain range in between us.

Fire is the greatest purifier. The fear of fire acts as an accelerant for the psyche, touching the deepest recesses of the primal mind.

In the end I had less than two hours to pack and load my car. For some reason, I had not received any disaster alert notifications, neither did my housemate. My city of Malibu text notice did not arrive until I was already on the highway. The firestorm arrived just a few hours after that. The thick wall of toxic smoke arrived before I left.

Early Friday morning, I heard loud pounding on my bedroom door, “Wake up, mandatory evacuation. NOW!”

My first thought was one of denial, the logic did not make sense. I was not alone in this, it seemed that even the local and experienced firemen were surprised.

It took me a few minutes to wake up fully, watch a bit of news, digest the information, and move into action.

The View from Ericha’s Driveway – car packed and ready to leave

Lara and her husband Michael live on the property and help take care of it. Lara shouted down to me from the floor above and said, “Ericha you need to hurry and get in your car; I can see that the fire just crested the ridge”. I said, “Lara, you need to do the same, you’re a mother with two little girls!” Later, Lara reminded me of my words as she recounted her escape from the fires, after the smoke was so black she could no longer see.

I tried to pack as if I might lose everything, with attention to my most immediate needs. My housemate, who had been through more evacuations than I said, “You do not need to pack much, we’ll be back in two days”. Intuitively, I knew this was not accurate. Ultimately, it was twelve days or more before I returned home.

Therefore, I packed all of my vitamins and supplements, food from my refrigerator to share, comfort clothes such as my favorite sweats, a few books, my computer and powerpoint lectures duplicated on thumb droves, plus lecture outfits for presentations scheduled for the near future. I threw in a few of my recent paintings that have no monetary value whatsoever. I forgot to include items that I could have sold to get back on my feet in case I lost everything. This was one of my biggest concerns during the evacuation.

Scorched

Saturday was the most difficult day. On Saturday I thought I had lost everything, my home and my office. Both my home and my office were located in the firestorm corridor as it blew into Malibu. Saturday, I thought erroneously that the newscasters and film crew were on my street, listening to their commentary and with one look at their videos, I assumed that all I owned was ash and cinder. I also heard incorrect rumors that my office building burned to the ground.

The thought that you have lost everything, even if only for one minute, clarifies what you value. Of course, always people and loved ones are first, after that, survivorship. The two items that I knew I needed in order to rebuild my life included my computer and my powerpoint lectures. My fear of survival showed up in a rather amusing way, I took my computer everywhere and did not leave it out of my sight for 12 days. I joked at one dinner gathering with colleagues, “If I could handcuff it to my wrist I would”. Fortunately, they were very tolerant of my trauma related idiosyncrasies.

I found that I could not pray, at least not in a traditional manner.

I have built almost everything I have from nothing. At age thirty, I quietly left a relationship that frightened me. Without much evidence at all, but trusting my intuition, I walked out of a relationship with a weekend’s worth of clothes. I started over in another city, in another state, with four hundred dollars and my bank accounts suddenly empty.

In hindsight, I made the right decision but at the time I felt as if I was flying blind. I now know that I saved my life.

After the Fire

The scars of 34 years ago, scars that have been largely but not completely healed, seemed to rise up with the flames and remind me of how difficult it can be to have absolutely nothing.

My prayer was more of a conversation, “God, I cannot do this twice in one lifetime.” Six hundred homes were destroyed in Malibu, a very small town, and many of those homes were close to my office and residence.

Too many of my friends and neighbors have lost everything. Many of them are not wealthy, instead, like most of us, they live paycheck to paycheck. Local artist and actor Leigh McCloskey said it so well, “We may not be friends, but we are neighbors,” after some neighbors (with polarized politics) surprised him with heartfelt gifts and support.

Twelve days later was my first visit back to Malibu since the fires. A colleague graciously offered to join me for the first visit back. When I entered my office, I made a mandala (circles of healing and community) in the sand tray. My colleague held up her phone for light, while I worked arranging stones and shells.

Sandtray Mandala by Ericha

It was my visual prayer of gratitude. Against all odds, my house and my office survived. I am used to seeing miracles in the eyes of my clients, but this one was beyond my expectation. I have not often thought of myself as lucky or blessed.

As I was making the tray, my colleague exclaimed, “Ericha, the lights came on!”. For twelve days the power had been turned off, and it was turned back on Tuesday night around 7PM, as I was rejoicing in gratitude.

There is much to do. So much of my life and the lives of others have been disrupted. The cell phone service, texts and emails have been interrupted and delayed, clients cannot make it to sessions due to mudslide risks or understandable and new financial concerns. The main post office burned and has been shut down so I don’t have access to most of my mail. My home, and especially my office, still smell like smoke and may hold that lingering reminder for a very long time. Cleaning up ash, while also preparing for a second evacuation for mudslides, is an odd paradox. I am claiming all paradoxes as much as humanly possible.

I have been gifted a week long intensive with a talented therapist to process these weeks of trauma and stress in order to help prepare me to help others.

Today, my greatest joy is a plan to offer a free art therapy workshop for fire survivors, with two of my colleagues. For now, we plan a mosaic workshop, with found items burned in the fire. It is exactly that isn’t it? If you think about it, we are taking the charred pieces of our lives and fitting them back together in a mosaic, not the same as before, but into another whole.

Publications of Interest

Animal Assisted Therapy for Trauma

Lynn Hazard, LCSW, Coordinator, POI

Lynn Hazard, POI Editor

This quarter we are taking a look at the recent information regarding animal-assisted therapy. You may have read Michelle M. Yarberry’s article in ISSTD News’s Kid’s Korner July 2018: Squeaks, nuzzles, tail wags, woofs, and whinnies: An experiential glimpse into animal/equine-assisted psychotherapy/play therapy.

Our trauma and dissociative clients have many unique challenges that often include difficulty with self-regulation, grounding, social interaction, bonding, and self-confidence. Animals are increasingly recognized as a valuable support system for social and emotional growth and healing for these clients. As such, this quarter we choose to highlight a few recent articles on this topic.

Emmy A. E. van Houtert, Nienke Endenburg, Joris J. Wijnker, Bas Rodenburg & Eric Vermetten (2018) The study of service dogs for veterans with Post-Traumatic Stress Disorder: a scoping literature review, European Journal of Psychotraumatology, 9:sup3,

DOI: 10.1080/20008198.2018.1518199
To link to this article: https://doi.org/10.1080/20008198.2018.1518199

Abstract:
The therapeutic application of human–animal interaction has gained interest recently. One form this interest takes is the use of service dogs as complementary treatment for veterans with Post Traumatic Stress Disorder (PTSD). Many reports on the positive effect of PTSD Service Dogs (PSDs) on veterans exist, though most are indirect, anecdotal, or based on self-perceived welfare by veterans. They therefore only give a partial insight into PSD effect. To gain a more complete understanding of whether PSDs can be considered an effective complementary treatment for PTSD, a scoping literature review was performed on available studies of PSDs. The key search words were ‘dog’, ’canine’, ‘veteran’, and ‘PTSD’. This yielded 126 articles, of which 19 matched the inclusion criteria (six empirical studies). Recurrent themes in included articles were identified for discussion of methodology and/or results. It was found that results from most included studies were either applicable to human–animal interaction in general or other types of service animals. They therefore did not represent PSDs specifically. Studies which did discuss PSDs specifically only studied welfare experience in veterans, but used different methodologies. This lead us to conclude there is currently no undisputed empirical evidence that PSDs are an effective complementary treatment for veterans with PTSD other than reports on positive welfare experience. Additionally, the lack of development standardization and knowledge regarding welfare of PSDs creates risks for both human and animal welfare. It is therefore recommended that a study on the effect of PSDs be expanded to include evaluation methods besides self-perceived welfare of assisted humans. Future studies could include evaluations regarding human stress response and functioning, ideally conducted according to validated scientific methodologies using objective measurement techniques to identify the added value and mechanisms of using PSDs to assist treatment of PTSD in humans.

Lass-Hennemann, J., Schäfer, S.K., Römer, S., et. al. (2018). Therapy dogs as a crisis intervention after traumatic events? – An experimental study. Frontiers in Psychology (August 2018).
DOI: 10.3389/fpsyg.2018.01627

Abstract:
Animal-assisted therapy has been proposed as a treatment adjunct for traumatized patients. In animal-assisted crisis response, dogs are used directly after a traumatic event to reduce stress and anxiety. However, to date there as few controlled studies investigating the effects of therapy dogs on PTSD symptoms and to our knowledge there is no study investigating the effects of a therapy dog intervention directly after a traumatic event. In this study, 60 healthy female participants were randomly assigned to one of three groups. After exposure to a “traumatic” film clip (trauma-film paradigm), one group of participants interacted with a friendly dog for 15 minutes, another group of participants watch a film clip showing a person interacting with a friendly dog, and the last group was instructed to relax. Participants who had interacted with the dog after the film reported lower anxiety levels, less negative affect, and more positive affect after the intervention as compared to the other two groups. However, participants who interacted with the dog showed less decrease in physiological arousal after the traumatic film clip compared to both other groups. There were no differences in intrusion symptoms between the three groups. Our results show that dogs are able to lessen subjectively experienced stress and anxiety after a “traumatic” stress situation.

Hayden-Evans, M., Milbourn, B., & Netto, J. (2018). Pets provide meaning and purpose: A qualitative study of pet ownership from the perspective of people diagnosed with borderline personality disorder. Advances in Mental Health, Volume 16, Issue 2.
DOI: 10.1080/18387357.2018.1485508

Abstract:
Objective: This qualitative study aimed to explore the experiences of pet ownership for adults with borderline personality disorder (BPD) and understand the impacts of pets on their attachments, social connections, and activity participation.
Method: Semi-structured interviews were conducted with eight individuals with BPD and analyzed using interpretive phenomenological analysis.
Results: Five dominant themes emerged: Pets (1) provide meaning and purpose; (2) influence positive emotional attachments; (3) influence positive social connections; (4) promote participation and engagement in meaningful activities; and (5) have therapeutic value. Discussion: Pets provided opportunities for community engagement, social interaction, and participation in meaningful activities, and may aid development of coping skills and secure attachments, inviting further research to confirm the role of pets personally and therapeutically for this population.

Burgon, H., Gammage, D., & Hebden, J. (2018). Hoofbeats and heartbeats: equine-assisted therapy and learning with young people with psychosocial issues – theory and practice. Journal of Social Work Practice, Volume 32, Issue 1.
DOI: 10.1080/02650533.2017.1300878

Abstract:
The practice of equine-assisted therapy and learning (EAT/L) to deliver psychosocial interventions to young people is a rapidly growing field. However, recent reviews have cited a need for further documentation of a theoretical foundation and evidence of outcomes of these programmes. This paper is a theoretical discussion on psychotherapeutic theories and models that the authors understood and being relevant and giving substance to the application of EAT/L at a Therapeutic Horsemanship centre in the UK. It also describes and defines the practice of EAT/L at the centre. Philosophical and psychological theories/models of Non-Violent Communication, Object Relations, Play and Dramatherapy, Mindfulness practice, and Attachment theory, all set within a person-centered and relationship-based approach employed at the centre were examined and illustrated in the form of client case material. The authors report the central role relationship plays between client-horse-therapist and horse-handler in the building of trust and resolution of the impact of trauma. The paper highlights a need to carry out well-designed empirical studies with different client groups in the field of EAT/L in order to gain more insight into this growing field.

Germain, S.M., Wilkie, K.D., Milbourne, V.M.K, & Theule, J. (2018). Animal-assisted psychotherapy and trauma: A meta-analysis. Anthrozoös, Vol. 31, Issue 2.
DOI: 10.1080/08927936.2018.1434044

Abstract:
The present meta-analysis examined the efficacy of animal-assisted psychotherapy for individuals who have experienced trauma. Eight studies quantitatively assessed the treatment effects of involvement in animal-assisted psychotherapy. A random effects model was used to aggregate each study into an overall effect size. Eight effect sizes were included in the pre-versus post-comparison analysis. The results indicate a large effect size (Hedge’s g = 0.86, p < 0.001, 95% CI [.53, 1.18]. Two effect sizes were included in the treatment versus control comparison analysis. The results indicated a small to moderate effect size (g = 0.46, p = 0.03, 95% CI [0.04, 0.06]. Limited moderator analyses were able to be conducted due to lack of consistent reporting across studies. Place of study and percentage of female participants in the treatment group were found to statistically moderate the effect of animal-assisted psychotherapy. The results indicate that animal-assisted therapy is an efficacious treatment for trauma.

Krause-Parello, C.A., Thames, M., Ray, C.M., & Kolassa, J. (2018). Examining the effects of a service-trained facility dog on stress in children undergoing forensic interview for allegations of child sexual abuse. Journal of Child Sexual Abuse, Volume 27, Issue 3.
DOI: 10.1080/10538712.2018.1443303

Abstract:
Disclosure of child sexual abuse can be a stressful experience for the child. Gaining a better understanding of how best to serve the child, while preserving the quality of their disclosure, is an ever-evolving process. The data to answer this question come from 51 children aged 4-16 (M = 9.1, SD = 3.5), who were referred to a child advocacy center in Virginia for a forensic interview (FI) following allegations of sexual abuse. A repeated measures design was conducted to examine how the presence of a service trained facility dog (e.g. animal-assisted intervention (AAI) may serve as a mode of lowering stress levels in children during their FIs. Children were randomized to one of the two FI conditions: experimental condition (service-trained facility dog present-AAI) or control condition (service-trained facility dog not present – standard forensic interview). Stress biomarkers salivary cortisol, alpha-amylase, immunoglobulin A (IgA), heart rate, and blood pressure, and immunoglobulin A were collected before and after the FI. Self-report data were also collected. Results supported a significant decrease in heart rate for those in the experimental condition (p = .0086) vs the control condition (p = .4986). Regression models revealed a significant decrease in systolic and diastolic respectively. Statistically significant changes in alpha-amylase and IgA were also found in relation to disclosure and type of offense. The results of this study support the stress reducing effects of a service-trained facility dog for children undergoing FI for allegations of a child sexual abuse.

Spattini, L., Mattei, G., Raisi, F., et. al. (2018). Efficacy of animal assisted therapy on people with mental disorders: an update on the evidence. Minerva Psichiatrica, 59(1), 54-66.
DOI: 10.23736/S0391-1772.17.01958-6

Abstract:
Introduction: Animal assisted therapy (AAT) is a structured form of animal assisted intervention (AAI), which specifically adopts animals in healthcare services and education facilities, to achieve therapeutic goals. Although such interventions are widely used nowadays, evidence supporting them is still largely lacking. A previously published review of the literature highlighted some promising effects of AAT on people presenting with psychiatric disorders, though quality of the studies included was generally low. In order to provide an update of recent evidence, the aim of this study was to systematically review randomized control trials (RCTs) published since 2000, involving people affected by mental disorders and receiving AAT.
Evidence Acquisition: The following databases were searched: CINHAI, EBSCO Psychology and Behavioral Science Collection, PubMed and Web of Science. 115 papers were obtained and screened. 28 were from CINHAI, Psyc-INFO and Psychology and Behavioral Science Collection together. 15 from PubMed and 72 from Web of Science. In addition to this, grey literature and references of already published reviews and meta-analyses on the topic were searched, resulting in the addition of 6 further articles. After screening, 10 RCTs were included in this review.
Evidence synthesis: Studies involving outpatients were more frequent than those involving inpatients, sample size was generally low. The majority of studies adopted scales routinely used in clinical trials, with a good level of validity and reliability. Five out of ten studies reported significant differences in the main outcomes favoring AAT. Most of the studies did not include any follow-up, yet where prospective data were available, the benefits of AAT appeared long lasting. Dropout rates were higher in studies involving outpatients. However, the only trial which enrolled both inpatients and outpatients showed a higher drop-out rate among the inpatients group, possibly due to their more severe psychopathology.
Conclusions: Though a paucity of available studies partly limits our findings, AAT seems to improve empathy, socialization and communication, and to favor therapeutic alliance among patients who have difficulties with therapeutic programs adherence. AAT appears to be a feasible and well-received intervention, potentially with few or no side effects reported. However, there is a need for further studies with larger sample sizes and high-quality research standards.

Jones, M.G., Rice, S.M., & Cotton, S.M. (2018). Who let the dogs out? Therapy dogs in clinical practice. Australasian Psychiatry, February 2018.
DOI: 10.1177/1039856217749056

Abstract:
Objectives: Animal-assisted therapy (AAT) is a growing field in Australia, and therapy dogs are becoming increasingly common in clinical settings. This paper aims to highlight the current issues facing AAT in Australia and to make recommendations on how to progress the field. We acknowledge that there are several ways that therapy dogs may enhance treatment outcomes for clients, such as reductions in stress and acute anxious arousal, and improvements in engagement and rapport. These psychological and physiological advantages, however, may not be sustained once interaction with the dog ceases. Clinicians require adequate training and support to develop and implement interventions that are based on sound theoretical foundations, and take advantage of the adjunctive benefits of animal presence.
Conclusions: A series of recommendations are made for the professionalism of AAT, including the development of consensus definitions, clinical governance, accreditation, research and evaluation.

The Future of Publications of Interest

This is the last Publications of Interest which will be coordinated by Lynn as she moves into retirement. I cannot thank Lynn enough for her work on this feature. She has been a pleasure to work with: full of ideas for future columns and always interested in suggestions and comment from others. Thank you, Lynn, for the time and effort you have put into each POI. We will miss you, but we know that you are off to enjoy more time with family.

Publications of Interest is a quarterly feature which highlights key articles within a theme that may be of interest to members. We are seeking a new Coordinator. For this role you only need a love of reading and collating research. No literature reviews, analysis or comment are required. It would help if you had access to a research publications database (eg through a university), but this is not essential as I can help access articles.

Publications of Interest is a low-demand way, but an important way, to contribute to ISSTD. If interested contact Kate on katemcmaughpsychology@gmail.com

Trauma & Dissociation in the News

Bringing Trauma Sensitive Art Therapy to Croatia

Tally Tripp, MA, MSW, ATR-BC

The author, Tally Tripp (2nd from right) pictured with Croatian students, having worked together on a mural

This past September, I spent several weeks in Croatia teaching in a first-of-its-kind art therapy postgraduate program at the J.J. Strossmayer University of Osijek, Academy of Arts and Culture. This new art therapy training program was created in collaboration with faculty from the Art Therapy Program at the George Washington University in Washington, DC.

Located in the far northeastern corner of country, and far from the scenic coastal cities that beckon hordes of tourists, Osijek and the surrounding region share a rich history, but one that is also marred by cultural upheaval and violent warfare.

The Croatian War of Independence (1991-1995) was a protracted conflict between the country’s Croat and Serbian population, making bitter enemies of neighbors and taking the lives of thousands in its wake. This conflict, referred to as the “Homeland War” was fought between citizens of Croatia who declared independence from Yugoslavia and the Serb-controlled Yugoslavian Army.

The Osijek Museum of Art which sustained damage during the war. The red paint highlights where the damage occurred and remains a reminder for all.

Perhaps no battle in this war was as brutal as the 87-day siege of Vukovar, a city less than an hour’s drive south-east of the town where I was teaching. Terrified Croatian residents sought refuge for months on end in cellars and communal bomb shelters, desperately trying to avoid the 12,000 shells and rockets fired by Serbian led Yugoslavian Army that fell daily on the city center. The small Croatian resistance army was a rag tag group lacking official uniforms or even basic supplies and ammunition. When the Serb forces took the city in November of 1991, they further punished the Croats by massacring large numbers of civilians and expelling more than 20,000 residents as part of a brutal ethnic cleansing campaign.

Given Croatia’s extensive history of upheaval, it is not a surprise that a significant percentage of the population bears both visible and invisible wounds related to war trauma. Although Croatia did achieve its independence in 1995, deep divisions remain in the community. Most of the population have a direct or indirect link to the past traumatic events, and many are dealing with the effects of intergenerational trauma, PTSD and related mental health issues (anxiety, depression, substance abuse etc.)

It was to gain a better understanding of this legacy of trauma that my students insisted from the outset of my time in Croatia that I visit the town of Vukovar and experience firsthand the somber memorials, historical sites, and museums that pay homage to this devastating period of conflict. The weight of the cultural and human tragedy was felt most directly when I stood with them at the site of a mass grave where hundreds of civilians had been brutally tortured and were then executed by Serbian forces. The visit to Vukovar was the perhaps the most impactful part of my trip, allowing me to deal directly with the scenes of war and manifestations of trauma visited upon the Croatian people.

The site of a mass grave at Vukovar, Croatia

Even today, in the surrounding villages and cities, devastating reminders of war can be seen in many of the otherwise elegant European style buildings. In some cases bullet holes and large shrapnel damage have been deliberately left unrepaired as both a memorial to the conflict and tragically as a reminder that deep divisions and distrust still exist between the city’s residents.

I took what I felt and learned during my visit to Vukovar back to the classroom in Osijek and tried to integrate this impactful experience into our intensive course of study. The course work revolved around teaching an introduction to trauma theory (including basic interpersonal neurobiology and neuroscience, polyvagal theory, attachment theory etc.) and, through lecture, discussion and experiential learning, demonstrating the value of a non- verbal approach (art therapy) for managing and resolving trauma responses.

Since I teach a similar yearlong course at George Washington University, I came prepared with dozens of slides and handouts that demonstrated these concepts. While the Croatian students were interested in the theories and cases I presented, it became increasingly clear that reminders of war trauma were ever present in this culture and many of these students and their loved ones were still dealing with the lingering effects. They feared confronting the subject of trauma, doubted their ability to work with the affected veterans and their families, and felt vulnerable and unprepared for the inevitable flooding of feelings and grief that might arise if the right (or wrong) question were posed.

The military cemetery at Vukovar, Croatia.

They asked me: “How do I manage a spouse or significant other with PTSD who will have nothing to do with therapy?” “What happens when their trauma is exposed?” “Where can I begin?” and “We have no time to develop a therapeutic relationship. They (the veteran) will just walk away when we start a conversation.” There was a quality of desperation and possibly futility in some of these questions, and yet I detected curiosity and even hopefulness as well. As a trauma therapist I knew I needed to hear the unique perspective of each student and listen for ways to offer a sensitive response.

I provided the students a range of art therapy tools and techniques to facilitate self-awareness and self-expression. Through various forms of art making and metaphor, we created a “safe space” in the classroom which was our laboratory for learning and processing traumatic experiences. In order to deal with the feared subject (how to actually “deal” with trauma) I invited the students to creatively paint, draw, sew and sculpt in response to their own traumas, starting with smaller (less devastating) ones and ultimately moving to the more complex, emotional memories. Working together in this way, much work was done and many feelings could be expressed. Our classroom became a container for shared experiences.

Making art was the perfect medium to bring these feelings to the surface in that that they could be created, managed, and contained without a reliance on words. This creative expression is the basis for art therapy practice and something humans have done naturally for millennia. The students soon warmed to the experiential activities of an art therapy studio approach and began to open up and share more deeply. We practiced grounding and containment skills, worked with the body and regulation of the nervous system, and created graphic narratives for the consolidation of traumatic memories.

The Students undertaking an experiential exercise using art therapy for a relational attunement

As my time in Osijek came to an end, there were inevitably many difficult questions lingering, and of course many remain unanswered. But I am continuing to provide weekly group supervision via an online collaborative tool (Zoom) and am listening to students present their cases with increasing confidence and competence.

I can see the integration of trauma sensitive art therapy happening in their clinical practice. And, in our last supervision session, I was delighted to learn that one student will soon begin working in a psychiatric setting with veterans who are dealing with PTSD, which was an inconceivable idea only several months prior.

Tally Tripp is a Licensed Clinical Social Worker, Board Certified, Registered Art Therapist, and Assistant Professor at the George Washington University. She is also a Fellow of the ISSTD, a Board Member of ISSTD, and the Chair of the Creative Arts Therapy Special Interest Group

Volunteer Spotlight

Volunteers Build Resilient Communities

Kate McMaugh, Editor, ISSTD News

“Volunteers build Resilient Communities”. This is the slogan for the UN International Volunteer Day in 2018. It certainly is true. Communities with a strong volunteer culture are happier, stronger, more connected, more resilient.

A few of our wonderful antipodean volunteers who have been known to attend meetings at strange weekend hours! From Left to Right: Martin Dorahy, Warwick Middleton and Joan Haliburn.

This is why December the 5th is International Volunteer Day. This international day, developed by the United Nations, celebrates volunteers who strengthen communities. To quote the UN on International Volunteer Day:

“It is viewed as a unique chance for volunteers and organizations to celebrate their efforts, to share their values, and to promote their work among their communities, non-governmental organizations (NGOs), United Nations agencies, government authorities and the private sector” (http://www.un.org/en/events/volunteerday).

Closer to home, volunteers make ISSTD more resilient as well. It is fair to say that many people around the world do not know that ISSTD, the world’s oldest and most awesome (IMHO!) trauma and dissociation society, is largely run by volunteers. In fact, we have just two paid staff: The wonderful Mary Pat and Bethany, who also often go way beyond the call of duty to assist members.

ISSTD has so much going on that our work is beyond what’s possible with two staff. Without our volunteers – which include our entire Board, our Presidents, all our Committee Chairs and all our Committee Members – ISSTD simply would not function.

What this means – in real life terms- is that people like me, ordinary clinicians, would not be supported to provide the very best, evidence based and effective services to our clients. ISSTD exists for us, the therapists, teachers and researchers, but really it exists so we can do a better job for those most vulnerable and important people: our clients.

Four years of volunteer Presidents (and President elect): Kevin O’Connor, Christine Forner, Martin Dorahy and Warwick Middleton

I recall how I felt when I first joined ISSTD, not that many years ago. I had a few clients who ‘looked like DID’. One was raised in a polygamist cult which practiced paedophilia and enforced separation of children from their biological mothers. Another, sexually abused since three years old, told me of a crying child inside, experienced loss of time, including writing emails she did not remember writing.

My well-meaning supervisor at the time stated that, in her 30 years of trauma work, she ‘had never seen a case of DID’ and suggested to me that my clients’ descriptions of their inner worlds was ‘just their imaginative way of describing themselves’, but not an indication of this rare and perhaps non-existent disorder.

Needless to say, things went pear-shaped pretty quickly.

Luckily, I found ISSTD and immersed myself into this organisation where experts rub shoulders with beginners, discuss, debate, and collaborate, at a level most of us never experience anywhere else.

I still remember my first book-club and innocently posting a few questions that had been on my mind for some time. Onno van de Hart answered… then Rich Chefetz… then Onno, then Rick Hohfeler. Elizabeth Howell and Shelley Itzkowitz were involved as well.

What a privileged, relatively junior psychologist I was! Truly, all these famous names were volunteering their time to assist me, a complete unknown from Australia. I can never repay them for their wisdom, their welcome, their generosity.

I sought out more dissociation-informed supervision, joined a couple of SIGs and bookclubs, did webinars and online training and read everything I could in JTD and Dissociation. Within ISSTD I found people who have supported me far more than dollars and cents could ever account for, generous and kind people, who encourage the ‘newbies’ to the field.

I felt so supported by ISSTD that I wanted to give back. Warwick Middleton and Martin Dorahy encouraged me to volunteer. At first, I felt intimidated as I joined the Communications Committee and the Membership Committee. I doubted I had much to offer, compared to other members, but as time went by I felt more at home.

Outside of dissociation-world, I have edited before, and written articles. So, in one of those spontaneous “ADHD moments” I sometimes have, I volunteered to edit ISSTD News. Through this I have been privileged to meet and ‘talk to’ (mostly via email or Zoom) people from all over the world, who were also often volunteers, even if some of those volunteers are also famous names on my bookshelf.

I recall the anxiety I felt when starting out as Editor, and my first draft ‘President’s letter’ arrived in my email. I have to edit this? Didn’t Martin Dorahy write those articles I have studied, edit those books on my bookshelf? Do I dare to comment? I recall having my first contact with Colin Ross. A book written by Colin and Naomi Halpern kept me surviving those dark, early days when I had no adequate supervision. Do I have to edit him too? It felt overwhelming. But, needless to say, Martin and Colin were kind, generous and open to suggestion and editing, way above and beyond what is seen in most fields. This has been typical of most of my experiences in ISSTD.

These days, back in my clinical role, not that many years on from my early ‘disaster days’ of DID therapy, I see people stabilise and process their trauma. These are often people written off by services as ‘impossible’ or ‘too difficult to treat’, people with multiple diagnoses and long histories of institutionalisation or incarceration. None of these clients get better because I am an amazing therapist. They get better because of their own personal bravery and because of volunteer-led organisations like ISSTD, who trained me, encouraged me… and sheltered me.

To recognise and honour our volunteers, each quarter in ISSTD News we have a segment called Volunteer Spotlight. This feature highlights the work of specific volunteers and illustrates the value of volunteering to members. In Volunteer Spotlight, over the last year, we have highlighted the work of:

  • Tally Tripp – who founded our Creative Arts Therapy SIG, provides training and workshops to members, as well as occasionally writing an amazing article for ISSTD News;
  • Rochelle Sharpe Lohrasbe – Chair of the Social Media Sub-Committee, a sub-committee that is of obvious growing importance to how we operate;
  • Susan Hykes – who generously volunteered to be the Moderator of the RAMCOA SIG, not just one year, but two years in a row. The RAMCOA SIG is by far the largest of the ISSTD SIGs and we have greatly valued Susan’s massive contribution, as well as her gentle wisdom; and
  • Abigail Percifield – who volunteers for lots of things and is currently Co-Chair of our Membership Committee.

Andreas Laddis, Editor of Frontiers, enjoying our Annual Conference, 2018

But there are so many more volunteers whom we have not focussed on in ISSTD News. This month, to commemorate International Day of Volunteers, we use this segment to thank everyone in ISSTD: those who Chair our Committees, SIGs and Taskforces; our board members; and all those committee members who front up to meetings, often at strange hours of the day (or night, depending where on this planet you happen to live!). As the annual conference draws near, we thank those who volunteer their time to develop and present a paper, lead a workshop, or assist behind the scenes to make the conference go smoothly. We all love to read Frontiers and JTD, but many volunteer hours go into writing, reviewing and editing the papers we read and learn from.

In addition to those featured in Volunteer Spotlight, many others also contribute in multiple areas:

  • We all appreciate the boundless energy and endless generosity of our most recent past Presidents Martin Dorahy and Warwick Middleton, who chair committees, edit documents, assist in the development of policies, and provide support to many other projects;
  • The wonderful Michael Coy who, in addition to serving as ISSTD’s Treasurer, continues to volunteer endless hours into our website re-development, as well as other projects;
  • Michael Salter, who contributes in many areas, including working with another valued volunteer, Heather Hall, to spear-head our Public Health Taskforce; and
  • Andreas Laddis who continues to work tirelessly developing and shaping our new clinical e-journal: Frontiers in the Psychotherapy of Trauma & Dissociation.

The truth is, the numbers of people who help out in ISSTD are too many to mention all by name. And every single one of our volunteers already has a demanding professional role. They go to work each day to be therapists, teachers or researchers in one of the most

Michael Salter, presenting at ISSTD Regional Conference, Sydney 2015. (Michael also loves weekend meetings!)

difficult fields imaginable – the study and treatment of complex trauma and dissociation. Yet, somehow, they each find the time and energy to give even more!

Finally, we are fortunate that another volunteer has stepped forward to encourage and support the volunteering spirit of ISSTD. Christianna Flynn-Christianson has joined ISSTD News as Coordinator of Volunteer Spotlight.

Christianna has been studying at Adler University in the Clinical Psychology, Psy.D. program, after having already obtained a Master’s degree in Psychology and a Master’s degree in Counseling Psychology. She is completing her therapy practicum at DePaul University Counseling Services in Chicago and was recently selected for Advanced Therapy practicum at Captain James A. Lovell Federal Health Care Center’s Stress Disorders Treatment Unit. Within ISSTD, she is now co-chair of the Students and Emerging Professionals Committee. To learn more about Christianna check out this article about her work and research.

Christianna Flynn-Christianson, who will be coordinating the Volunteer Spotlight column in 2019.

If you know of a volunteer for ISSTD who you think deserves recognition, please contact Christianna at: cflynn-christianson@adler.edu 

Sometimes, as a global organisation, with much work online, we can not realise the impact of our voluntary roles. As this holiday season approaches, my wish for all our volunteers, is that you are able to feel the appreciation and the tremendous benefit we all get from your contributions. Every volunteer has made our professional lives just that little bit easier. Therefore, by a ‘ripple effect’, every volunteer has, perhaps, made the lives of some trauma survivors just that little bit easier.

And (Hint! Hint!), if you ever feel inspired to help out in ISSTD, complete a Member Engagement Form and the Member Engagement Committee will be in touch to match you with a role that suits. Current Volunteer Opportunities can be found here!

Trauma & Dissociation in the News

Trauma, Dissociation and Disability: A double-dose of complexity

Valerie Sinason, PhD MACP MInstPsychoanal FIPD

The Author Valerie Sinason, in Cape Town

Today, December 3, is International Day for People with Disabilities. What does it mean to have an international disability day?

For those I have spoken to in the U.K., Europe, Australia and South Africa – being named means being seen, valued, represented. We know the impact on black citizens in the U.K. before black actors appeared on television. What does it mean to see no one like you in magazines, comics and films? For your name or your condition only to be known in hospitals? To have therapy and not play?

In America, one disability rights groups called “ordinary” people the “temporarily unimpaired” which I find extremely helpful- it has the deep truth that humour provides.

Joanna, aged 15, when asked about this day, said “It is my day. You have Mother’s Day and Father’s Day and my birthday but disability is all of us – people in wheelchairs with good brains and me who can walk with half a brain”.

And what of our language for this International Day? The word “Disability” has not caused furore in the way “handicap”, or even more stigmatising language such as ‘retarded’ and ‘subnormal’ has done. It is worth reflecting that when a label changes every few years we know, psycho-linguistically, that something is not bearable. Subnormal to handicap to special needs to learning difficulty to intellectual disability. . .

Tuki, religious leader of the Bushmen in Nieu Bethesda ready to bless the Bushman Heritage Center where Valerie and her husband, and Professors Joan and Julian Leff are the Trustees.

As we celebrate this International Day for People with Disabilities, I am in South Africa, where the population deal with mass illiteracy and a significant number, through social-political trauma, develop mild intellectual disability.

When I was first invited in 1994 to help address this process, painful issues emerged. Many township mothers had refused to let their children become literate, fearing they would be made to sign false confessions by apartheid police.

Slowly, as a result of Mandela’s influence when he was freed, this lessened. However, the system of making a child who was educationally “behind” repeat a year in school continues to shame and damage progress. Additionally, although Mandela banned the beating of children, and that is enshrined in law, schools continue to do this illegally. Outside of major centres of excellence there are little resources for disability services.

However, Cape Town is blessed with a fine psychology training at UCT and projects to help children and adults with intellectual disability are world class, despite the lack of resources and the enormity of the problem. Brian Watermeyer, a lecturer there, is visually impaired and uses his experience of his own disability to aid his clients. Professor Leslie Swartz of Stellenbosch University, together with his Cape Town and Lenteheur hospital colleagues, created a joint disability International Day on December 1st, where I had the privilege to present a half-day workshop and provide supervision.

How does all this relate to our field? Tragically, people with disability are much more likely to experience abuse, with the highest rates being among those with intellectual disability. In addition, the impingement on attachment, due to depression in parents, and the bodily and mental discomfort in the child leads to an extra vulnerability.

In a world where there is impatience and fear over non-comprehension, slowness and deformity, it is not surprising that behaviours that come from trauma such as self-injury and rocking are seen as an innate part of disability and therefore ignored.

In fact, these groups have high rates of unacknowledged and untreated trauma and dissociation. Kate McMaugh, an ISSTD Member, who has worked within both disability and trauma services in Australia, said to me, when talking of her experience in disability services:

“I was amazed by the amount of complex trauma amongst this group of people. People often lack the ability to speak out, yet they have certainly had a lot of abuse. Often it is the carers or group home staff, who know the clients really well, who get told of the abuse – sometimes decades later and often only in ways that people close to them can understand.

One of my clients had such idiosyncratic sign language and severe speech problems that only those who knew her really well would understand her story. When I got to know her she was able to say (actually ‘sign’) that her father touched her in the shower, that he was bad, that he showed her his penis and even more detail. Yet 99% of people on the planet could not understand her communicate.

I felt so sad that so many of these clients never got the care they needed, or the therapy they needed. But I know they do respond to counselling – it might be slower or we might need to use creative methods, but it can work.”

Professor Leslie Swartz of Stellenbosch University (in blue shirt) who organises Disability Day with two of his PhD students

To illustrate just what is possible I will discuss a case of mine, Eve, aged 19, who had profound multiple disability and was paralysed from her waist down. She was blind in one eye from eye poking and had a collapsed bowel from anal poking. She had no verbal or sign language and yet she was able to communicate the deepest issues. Abandoned at birth and moved from home to home where no records were left, she was referred from a community home who noted she screamed most at Christmas, which was when she was abandoned. Every night the staff put her to bed and, with no 24 hour shift, they would find her the next morning, covered in feaces, with the walls all smeared. Smearing of menstrual blood occurred each month.

After two years of therapy, where I would wonder aloud about what I was observing, her self injury lessened, yet there was a wish to sterilise her to avoid the moods that came with her period, as well as the menstrual smearing.

In one session, sitting on her wheelchair, she pulled down her tights and a little drop of menstrual blood fell on the floor. I felt enormous sadness. I said: “Why Eve- all this time we have worked together you didn’t want me to know you were a woman with a period, which means you are not pregnant.”

She pointed to a baby doll and I passed it to her. She threw the doll on the floor and a tear ran down her cheek. I said she had been thrown away by her mother as a baby and here she was in the room, a woman without a baby. But also – here we were two women in the room and she was my therapy baby, as well as a woman without a baby. She pointed for the doll and hugged it and then drew the tree from the front garden. I said the tree would be there after we had died and how comforting she found it.

That night there was no smearing and all calls for an operation stopped. Later she was able to reveal anal rape.

In other words, this case shows that psychoanalytically informed therapy can be applied to extreme disability. The only difference in application was to show more affect in face and voice rather than “neutrality”.

When I discussed this with Kate, she mentioned how important it was for her, working with people with intellectual disability and brain injury, to be trained in augmentive and alternative communication strategies, such as key word signing or Boardmaker. When needed, these extra communication tools are typically not that difficult to learn. Kate said:

Zulu dancers in Cape Town

“Since many people with disability need an individual communication approach, a therapist can actually learn this communication as part of getting to know the client. I believe specialist trauma and dissociation therapists would be complete naturals at working with traumatised individuals who have a disability, as they are already used to individual and creative approaches.”

Where someone has intellectual disability and DID, the process of treatment is harder. Judy Williams from the U.K., Aafke Scharloo from The

Netherlands and I have presented on this dilemma at past ISSTD conferences. Again, access to treatment is crucial and people with this double disability can be helped. Extra time is needed to help process the complexity of this double situation.

For example, Jon, the male alter in a 30 year old woman, found “inside” and “outside” even more intellectually difficult to grasp. He wept for his “lost” penis when he came out and his level of intellectual capacity made the predicament of DID unbearably complex. He felt his carer or therapist must have magically removed it. This led to violence until turning the light switch on and off created a clue for him as to how different states co-existed. Once this was identified he was able to make progress.

The good news is that therapy and meaning work for people with all levels of disability, whether with or without DID.

Valerie Sinason PhD, is a child and adolescent Psychotherapist and an adult psychoanalyst. She is chair-elect of ISSTD’s RAMCOA Special Interest Group. She was recipient of the ISSTD lifetime achievement award in 2016. In the U.K. she was Founder of the Clinic for Dissociative Studies and Founder President of the Institute for Psychotherapy and Disability. She is the first recipient of the IPD Valerie Sinason award.

Books
Intellectual Disability and Psychotherapy: The Theories, Practice and Influence of Valerie Sinason, Ed Alan Corbett (2018) has just been published by Routledge. See NYCU this month for more information.

Sinason,V (2012) Mental Handicap and the Human Condition; an analytic approach to intellectual disability, Free Association Books

Letter From The President

I Touch the Earth, the Earth Touches Me

Kevin Connors, MS, MFT

“When I paint I am influenced by the texture of the paper, the viscosity of the paint, the condition of the brush. I reach down to make a thin line and it comes out plump. Then the picture takes a new direction – I influencing it; it influencing me.”

Hugh Prather
I Touch the Earth, the Earth Touches Me

I find it funny how the projects I take on; take on a life of their own. I am not talking about household repairs, although my wife will attest to most projects growing beyond the original 2 or 3 hour estimate.

I am thinking about the nature of collaborative process and the evolution of ideas that comes about when creative people come together. I am certain the clinicians among us see this process unfold everyday as we meet with our clients. Treatment plans to address specific issues grow into larger life lessons, while attempts at psychoeducation shift into dealing with triggered trauma. I imagine researchers find similar shifts as the data reveals new and unconsidered information.

I am also thinking about projects organized at the board level promoting the strategic plan and the mission of our Society. At the all-day, face-to-face Board meeting held last March, we initiated the Public Health Task Force; chaired by Board members, Heather Hall and Michael Salter.

The initial thought was to help ISSTD explore ways to reach outside of our silo and to collaborate with other organizations that also addressed ways of researching, treating, and training people addressing complex trauma. We have a tremendous wealth of knowledge; we are the premiere organization addressing the role of dissociation in complex trauma. Failing to recognize and assess for dissociative phenomena accounts for a significant number of complications compromising treatment success. We have a lot to offer. We need to go beyond preaching to the choir, finding ways to reach new audiences.

Even as this idea was being presented at the March Board meeting, Heather and Michael were running with this idea. They excitedly looked to reframe and reimagine dissociation and complex trauma as a public health issue. Going beyond the original concept they started talking about the differing impact of and responses to trauma among marginalized populations.

In early August, they formalized the Public Health Task Force Mission Statement:

“The mission of the task force is to examine the public health dimensions of complex trauma and dissociation, and to identify opportunities for the ISSTD to contribute to primary prevention and early intervention for those at increased risk of complex trauma and dissociative disorders.”

In discussion with the ISSTD Board of Directors, Heather and Michael were charged with four tasks:

  1. To advance an intersectional public health framework that recognises the contribution of oppression, disadvantage and discrimination to complex trauma and dissociation,
  2. To promote evidence-based strategies for primary prevention and early intervention for those at risk of developing complex trauma and the dissociative disorders,
  3. To champion interagency collaboration between the ISSTD and other organisations to reduce risk factors for complex trauma and dissociation, and
  4. To work with the ISSTD Board and organization as a whole on the long term goal of addressing the public health implications of trauma and dissociation.

One development growing out of their work is a pre-conference workshop on Complex Trauma and Dissociation (CTD) from a public health perspective, focusing on their belief that “the prevalence and burden of CTD in the population can be reduced through the reduction of risk factors, and the promotion of protective factors, at the community, institutional and social level.”

Addressing cyclical factors whereby CTD maintains and exacerbates social inequalities which in turn negatively impact opportunities for treatment and other vital services, this workshop speaks to the need for systemic responses to individuals and communities.

A key element in understanding and informing what underlies the impact of CTD across the lifespan is the concept of dignity. Violation of dignity is seen as a critical risk factor contributing to CTD and developing dignity at personal and systemic levels is an essential part of both treatment and prevention.

This workshop promises to be an exciting and innovative look to the future of ISSTD and the trauma field.

Further, the recommendations coming out of the Public Health Task Force will hopefully guide and inform the ISSTD Strategic Plan; broadening our focus to include the spectrum of complex trauma, to focus on new areas of service delivery including community level services, especially those delivered to marginalized populations, as well as increased training in these areas.

They make another key recommendation: The ISSTD should identify a core list of values to guide ethical decision making and collaboration.

I am excited to see more from this dynamic duo, from this task force, and from ISSTD as we expand our ability to network and influence the study, treatment, and prevention of complex trauma and dissociation.

The Public Health Task Force’s workshop; Dissociation and Public Health, is one of many powerful and dynamic in-depth workshops offered in the two days leading up to our 2019 annual conference – The World Congress on Complex Trauma: Research, Intervention Innovation – to be held in New York City.

A full list of the pre & post conference workshops is available on our conference website. The full conference schedule will be available in mid December.

I look forward to seeing you in New York.

Kevin

PS: If you are excited as I am about the direction that ISSTD is going; with our growing library of webinars, our ever-developing PTP classes, the new SIGs; please consider doing as I do and making a donation to our $35 for the 35th Campaign. The money supports so many important ISSTD projects and helps keep our Society functioning. You can donate easily by clicking here!

News You Can Use

News You Can Use

Kate McMaugh, Editor, ISSTD News

Paul Dell article wins Important Award

An article by ISSTD Fellow, Paul Dell, PhD, recently won the Society for Clinical and Experimental Hypnosis’ Ernest R. & Josephine R. Hilgard Award for Best Theoretical Paper on Hypnosis: “Reconsidering the autohypnotic model of the dissociative disorders [Journal of Trauma & Dissociation, 19(5)].

The article challenges the hypnosis field and the dissociation field to re-think (1) the link between autohypnosis and dissociation, and (2) the nature of the dissociative disorders. The article contends that the dissociative disorders are forms of hypnotic psychopathology.

This is the second year in a row that Dell has won SCEH’s Hilgard Award for the best theoretical paper on hypnosis. Last year, Dell’s article, “Is high hypnotizability a necessary diathesis for pathological dissociation?” [Journal of Trauma & Dissociation, 18:1, 58-87], won the Hilgard Award. That article refutes the longstanding belief that there is no meaningful relationship between high hypnotisability and psychopathology.

To access both of these articles, 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 202-803-6332, or email info@isst-d.org for assistance.

Welcome ISSTD’s New Members in November!

PROFESSIONAL MEMBERS
Christina Mardirossian
Kristen Wold
Maureen O’Connor-Strout
John HOrton-Young
Will Warren
Urszula Kelley
Esther Perez
LaShaun Williams
Amanda Marotz Roemer
Patricia Doherty
Mary Ann Sokolowski
EMERGING PROFESSIONAL MEMBERS
Brittany Edgar
Regina Cantrell-Kinzfogl
Hillary Walker
Lee-Anne Francois-Dornbusch
Stacey Senko
Lana Seiler
Joni Fisher-Canham
STUDENT MEMBERS
Gabriella Black
Tammy Summers
Paul Gibson
Tammy Scaramuzzino
Sheri Waldrop
Morgan McCowan

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 (November 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 202-803-6332, or email info@isst-d.org for assistance.

Frontiers in the Psychotherapy of Trauma & Dissociation

Table of Contents

2018

  • The Relationship of Mental Telepathy to Trauma and Dissociation (Sharon K Farber, PhD)
  • 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

Partner News

7th Biennial ESTD Conference – Rome: October 24-26, 2019

We are delighted to invite you to Rome for our 7th biennial conference, October 24-26, 2019. The theme of this ESTD Conference is “The Legacy of Trauma and Dissociation – Body and Mind in a New Perspective”: a challenging notion for both clinicians and researchers! Throughout the program we will explore these issues from many different perspectives, and across all developmental phases, from childhood to old age. Go to www.estd2019.org to learn more about the conference.

Abstract submission is now OPEN. Click here for Submission Guidelines

Registration is now OPEN with lower ‘early bird’ registration fees dedicated to ISSTD members
Register Online Now!

Keynote speakers

On Thursday evening we will open our conference with two exciting plenary talks: Michela Marzano, a famous Italian philosopher, will introduce us to social aspects of the fragility of the human condition. Then Kathy Steele will present her latest ideas on the treatment of trauma and dissociation. On Friday and Saturday, plenaries will be offered by Benedetto Farina (brain studies on trauma, disintegration and disorganized attachment), Martin Dorahy (on DID, episodic autobiographical memories and the sense of self in different dissociative identities) and Ellert Nijenhuis on his new approach to trauma treatment (“Enactive Trauma Therapy: Bridging mind, brain, body and world”). A few words about the background of the main speakers can be found on the ‘keynote speakers’ page.

Webinars

2019 Webinar Schedule and Full-Year Webinar Pass

ISSTD is pleased to announce the 2019 Webinar Schedule!

Make the most of our training opportunities by taking advantage of our Full-Year Webinar Pass! Participate in a full-year of webinars for a discounted price. Those who purchase the pass have access to all live and recorded webinars in 2019. CE Credits are included for live webinar participation but must be purchased for recorded webinars for an additional charge through our CE Co-Sponsor, CE Learning Systems. Discounted pricing is available for students and emerging professionals! Act now, this offer runs through April 5, 2019 only!.

To learn more about the Full-Year Webinar Pass, click here.

2019 Webinar Schedule

The Progressive Approach of EMDR Through a Case Example
Date: January 25, 2019
Time: 12:00 PM – 1:30 PM Eastern Standard Time
Presenters: Dolores Mosquera
1.5 CE Credits (APA & ASWB) pending

The Disconnected Brain: Understanding Brain- Behaviour Relationships in Complex PTSD and Dissociative Disorders
Date: February 21, 2019
Time: 7:00 PM – 8:30 PM Eastern Standard Time
Presenters: Jan Ewing
1.5 CE Credits (APA & ASWB) pending

Attachment in Children and Adolescents
Date: April 26, 2019
Time: 12:00 PM – 3:00PM Eastern Standard Time
Presenters: Niki Gomez-Perales

3 CE Credits (APA & ASWB) pending

Attachment, Dissociation, and Unresolved Mourning of Trauma or Loss
Date: May 17, 2019
Time: 12:00 PM – 1:30 PM Eastern Daylight Time
Presenters: Paula Thomson
1.5 CE Credits (APA & ASWB) pending

How the Creative Arts are Useful for Working with Trauma and Dissociation
Date: June 7, 2019
Time: 12:00 PM – 1:30 PM Eastern Daylight Time
Presenters: Tally Tripp
1.5 CE Credits (APA & ASWB) pending

Stabilization of DID
Date: September 27, 2019
Time: 12:00 PM – 1:30 PM Eastern Daylight Time
Presenters: Colin Ross
1.5 CE Credits (APA & ASWB) pending

RAMCOA Half Day Workshop
Date: October 2019
Time: TBA
Presenters: TBA
3 CE Credits (APA & ASWB) pending

Phase II of DID Treatment
Date: November 1, 2019
Time: 12:00 PM – 1:30 PM Eastern Standard Time
Presenters: Lynette Danylchuk & Kevin Connors
1.5 CE Credits (APA & ASWB) pending

Note: All dates and times are subject to change. Additional webinars are expected to be added in the coming months.  

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