Letter From The President

Acknowledging the Hard Work of our Society Members

Kevin Connors, MS, MFT

John Kennedy stirred millions with; “Ask not what America can do for you, but what you can do for America.” I invite you to consider what you can do for ISSTD and for the field of trauma treatment.

ISSTD is, at our heart, a volunteer-based organization. While we enjoy working with some of the finest association management executives and staff (Mary Pat Hanlin, Bethany Bjur, Therese Clemens in recent memory), we need to stay mindful of the breadth and range of our endeavors. These take us far beyond the “scope of services” we contract with our management company to provide.

We have many exciting and innovative projects in the works. To get these accomplished takes time, energy, and commitment. I’d like to take this opportunity to acknowledge and appreciate the valuable members of our Society who are contributing so much.

As this President’s Message appears as part of the ongoing and evolving ISSTD News, it seems only fair to start with thanking Kate McMaugh for all she does (including her gentle nagging…err… reminders to some writers who shall go unnamed) to solicit, edit and coordinate the production and publication of a number of valuable news features every month. Her role is indispensable in keeping us informed of what’s happening across our Society.

Another new publication that is pushing the edges of our clinical envelope is Frontiers in the Psychotherapy of Trauma & Dissociation, our clinical e-journal. While Jennifer Freyd continues to edit and guide our stellar Journal of Trauma & Dissociation with world class articles, there has been a growing need for material that focuses more directly on aspects of treatment and therapeutic practices. Enter Andreas Laddis and Steve Frankel as co-editors of our new online publication. The tasks of running down articles, chasing after authors for revisions, and everything else in issuing Frontiers cannot be over appreciated. To access Frontiers and the JTD, log into the ISSTD Member’s Corner and click on the icon for each publication to view articles.

Another growing forum for clinical education is our webinar series. As ISSTD progresses into the 21st century, we recognize the need for alternative means of reaching and teaching our members and other trauma therapists. While our flagship Annual Conference is an amazing, not-to-be-missed, event, it only happens once a year. The need for ongoing training is great. Fortunately, Marilyn Korzekwa has assumed the role as Webinar Chair. Marilyn has succeeded in pulling together an all-star line-up of seven different webinars for 2018 featuring some of ISSTD’s most senior faculty addressing key topics in the diagnosis and treatment of complex trauma and dissociative disorders. To view upcoming webinars, as well as to purchase recordings of past webinars, visit this page!

We know that ISSTD is the premier place to go for clinical and academic understanding of complex trauma and dissociative disorders. Extending our reach, we seek to educate and inform policy makers on a global level. Hopefully we can contribute to a more trauma-informed dialogue influencing decisions that affect future generations and contribute to lessening or preventing interpersonal violence. To that end, ISSTD was granted special consultant status to the United Nations Economic and Social Council. Karen Hopenwasser is the local liaison for our United Nation Task Force and has also been identified as a Member-at-Large of the Executive Committee of the NGO Committee on Mental Health. For more information on this fantastic endeavor, please see the update from the UN Taskforce in this month’s ISSTD News.

Looking to explore additional opportunities to share our knowledge and expertise with other organizations addressing trauma and interpersonal violence, we commissioned a task force to explore Trauma and Dissociation as a Public Health Issue. Heather Hall and Michael Salter have begun work and are planning a pre-conference workshop on this topic for our 2019 Annual Conference in New York City next March.

Also scheduled as a pre-conference workshop for 2019 is a presentation and discussion amongst members of our EMDR Therapy Training Task Group. Co-chaired by D. Michael Coy and Christine Forner, the group includes Lynette Danylchuk, Martin Dorahy, Marilyn Korzekwa, Jennifer Madere, Gary Peterson, and Rochelle Sharpe-Lohrasbe. The task group is in the midst of developing the first, fully dissociation-informed EMDR therapy ‘basic’ training. Although the multi-module training for clinicians seeking initial training in EMDR therapy is presently scheduled to go live in 2020, with the group in the content development phase of the project, here they will discuss the historical, cloven nature of EMDR therapy and the dissociation field; dissociation-informed influences—and persistent gaps—from the early days of EMDR therapy up to the present; and, the particular route this task group is taking to ensure that ISSTD’s version of the EMDR basic training results in newly-trained clinicians employing a more nuanced, dissociation-savvy approach to this powerful therapy right out of the gate.

The central nexus for finding all of this information as well as our online face to the world is of course our ISSTD website. As mentioned in many previous announcements, our website is undergoing revisions to make us more visible and user-friendly. Michael Coy is also directing this process. He reports plans to develop new content for the site that will address not only clinicians and researchers’ needs for information about complex trauma and dissociative disorders but will also help answer questions for lay people and affiliated disciplines seeking fundamental facts and an introduction to the field.

As you can see, there’s a lot going on around ISSTD. This is in addition to our excellent Professional Training Program classes through the Center for Advanced Studies, four upcoming regional Seminars in Hobart, Australia, New York City, and San Francisco in 2018, and Christchurch, New Zealand, in 2019. Planning is also well underway for our 36th Annual International Conference in March of 2019 also to be held in New York City. The Call for Proposals for the Annual Conference will open August 1st and close September 17th. More information coming soon!

All of this takes the time energy and commitment of wonderful volunteers. As you can see, some serve on committees, others play a role by working on time limited projects. If you would like to help out – and trust me, we can sure use the help – start by filling out the ISSTD Member Engagement Survey to let us know how you would like to contribute.

LAST MINUTE SHAMELESS PLUG: If you aren’t able to give through time and energy, you can help by making a donation of any size to our 35 for the 35th campaign. This campaign focuses on raising funds for our website updates as well as supporting student member opportunities and activities. You can make a donation here.

Thanks for all you do to support ISSTD and to support our mission of promote greater understanding and improving the treatment of people impacted by complex trauma and dissociative disorders.

With great appreciation,

Kevin

Clinical E-Journal

JTD and Frontiers Table of Contents (June 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 18, 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

  • 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.

News You Can Use

News You Can Use

Kate McMaugh, Editor, ISSTD News

New Book Explores the Critical Role of Relationships in Trauma Recovery.

ISSTD Fellow Robert T. Muller PhD, CPsych, has just published his second book on trauma and relationships: Trauma and the Struggle to Open Up. Like his first very popular book Trauma and the Avoidant Client, this latest book particularly focuses on the challenges for a trauma survivor in fully participating in intimate and healing relationships.

As therapists we understand that relationships are often central to traumatic experiences, but relationships are also critical to trauma recovery. Grounded firmly in attachment and trauma theory, this book shows how to navigate the ups and downs of the psychotherapy relationship to help clients find self-understanding and recover from trauma.
In the introduction Muller explains:

“This book is about trauma. It’s about the relationships in our lives that hurt and harm. It’s about the ones that help and heal. Indeed, when we study trauma, we see what a double-edged sword relationships are: Trauma stems from them. Recovery depends on them. The most harrowing trauma happens in close relationships, but recovery can’t happen in isolation. Relationships are both poison and antidote. This, in part, is why we see the avoidance of closeness in many trauma survivors. A certain safety comes with avoidance, but the price is high.”

Described as “a gem of a book” by James Chu and “a joy to read” by Kathy Steele in reviews, this book explores relational psychodynamic therapy for the trauma survivor and outlines ways for the clinician to use the relationship to facilitate healing. Full of practical tips and protocols, this book guides therapists through pacing therapy, dealing with relational rupture and repair, while facilitating healing and post traumatic growth. Using candid clinical vignettes and case studies the book is a must-read for trauma clinicians.

The book is available here.
Artwork from DID case study features on the Cover of the American Journal of Psychiatry

ISSTD Fellow Vedat Sar, MD, and his colleagues have written a brief, but fascinating case study of a young artist with DID. This interesting case presentation explores the role of DID in this client’s creative process. The article begins:

“This report describes a 19-year-old male patient with dissociative identity disorder who has an extraordinary skill in drawing. After carefully observing people, objects, or their photograph, he later creates hyper-realistic charcoal drawings of them entirely from memory. Remaining partly amnestic, he produces these pictures during a trance, that is, in control of an alternate personality state. He daydreams about unrelated themes while “his hand” keeps drawing. Such episodes follow an “appetite-like” urge to draw. Withdrawing to his studio, he suspends daily activities (e.g., skipping meals), enters an apparent stupor, and the “child inside” takes control. He does not experience these drawings as produced by himself.”

The rather incredible artwork graces this month’s cover of the journal and is well worth a look. The article itself is also accessible here.

 

Welcome ISSTD’s New Members in June!

PROFESSIONAL MEMBERS
Elana Christiansen
Melissa Connell
Andrea Dougherty
Annabelle Gagne
Laurey Gronemeier
Melinda Hawley
Margaret Jordan
Ellen Nasper
Laura Romine
Heather Scarboro
Rennie Schmid
Kathryn Cox
Megan Franklin
Regina Hund
Meghan Lederman
Andrea Price
Marina Sokolenko
Melody Stiles
Jennifer Trainor
EMERGING PROFESSIONAL MEMBERS
Susan Elliott
Kathryn Gelinas
Rebecca Pancoast

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! Submit your news to us so that we can share with other members.

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

Donate to ISSTD

35 for 35th Donation Campaign Update & Donor List (June 2018)

The 35 for the 35th Donation Campaign in now in full swing! Our goal is to raise $35,000 by December 31, 2018. The funds raised from the campaign will help with a full redesign of the the ISSTD website including the introduction of a new member community, expansion of our virtual training program including webinars and teleseminar training courses, and the expansion of opportunities for students and emerging professionals.

As of June 30, we have raised $8,390.70 from 70 donors. We ask all members to consider making a donation, big or small, to help support this campaign. Members now have the option to make a one time donation or elect month recurring donations. For more information on the campaign or to make a donation, visit the 35 for the 35th page on the ISSTD website.

Thank You to Our 2018 Donors
(as of June 30, 2018)

Linda Alexander
Kathy Barclay
Bethany Bjur
Monica Blum
Elizabeth Bowman
Sandra Buck
Thomas Carlton
Therese Clemens
Juliana Cocola
Adrian Connolly
Kevin Connors
Frank Corrigan
Christine Courtois
D. Michael Coy
Lisa Danylchuk
Paul Darnell
Charme Davidson
Martha Dennen
Martin Dorahy
Marcia Dunn
Nancy Ellis
Janina Fisher
Christine Forner
Julie Friedman
Linda Gantt
Ursula Gast
Richard Greenfield
Edward Groenendal
Joan Haliburn
Heather Hall
Mary Pat Hanlin
Kim Havenner
Stephanie Hawotte
Richard Hohfeler
Heather Hruby
Sheldon Itzkowitz
Terry Kerler
Phyllis Klein
Marilyn Korzekwa
Andreas Laddis
Ulrich Lanius
Johanna Lynch
Peter Maves
Warwick Middleton
Rosalind Monahan
Pamela Morgan
Randall O’Brien
Caroline Onischak
Erdinc Ozturk
Jane Parker
Gary Peterson
Valerie Pronovost
Sheree Riley-Violon
Dana Ross
Adah Sachs
Michael Salter
Ruth Schofield
Stergios Skatharoudis
Linda Skillingstad
Robert Slater
Genine Smith
Kirsten Stach
Paula Thomson
Grace Tomas-Tolentino
Joan Turkus
Onno Van der Hart
Marcia Weiner
Victor Welzant
Frank White
Roxanna Wolfe

 

Focus on ISSTD History

An Interview with Richard Kluft, MD

An Interview with Richard Kluft MD, 
13th December 2017
Selected Excerpts
Warwick Middleton MD, Past-President, ISSTD

WM: Is there anything, when you look back at your formative childhood years…that predisposed you to end up with the career path that you took?

Rick Kluft, San Francisco, 2016

RPK: I have asked myself that only every day. (Laughs) You know I was never pushed to go into medicine, but I experienced the kind of pressure that children of doctors know all too well. Without a word being spoken, you realise that you are free to be any kind of doctor that you want! So, as close to a rebellion as I could make from a benign authority was to become a psychiatrist after my starting in internal medicine.

But I really think it is a little deeper than that. I saw a lot of stuff when I was a kid that was not trauma directed toward me, but which I witnessed. My father came back from WWII in terrible physical shape. He was in the VA Hospital for a couple of years before being released home. My sister was born with some problems that required intensive physical therapy for years. … My grandparents on my mother’s side were taking care of me while my father was in the military, and … I have very clear memories of my grandmother learning yet another one of her siblings had been reported dead in the Holocaust. I think that had a profound impact on me, probably of the sort that I could not even articulate until after my analysis when I started to hang out with second generation Holocaust experts like Ira Brenner and had my eyes opened to what that meant.

WM: Before you became involved in dissociative disorders, what were your career aspirations?

RPK: (Laughs) I thought I would either be an academician, and maybe a director of residency training, or a private practitioner in a small city…

WM: So, what went wrong?

RPK: (Laughs) Towards the end of 1970 I found a multiple. I must admit she was not the first I diagnosed but she was the first I found, and after I saw the second one, I realised what I had in the first one. I started learning that there were people who blocked out a tremendous amount, whose minds were compartmentalised …

… I had my once-in-a-career exposure to these patients early. Unfortunately, I had already talked enough about them to ruin my reputation, so they started getting referred to me (laughs) … there were many people at my university who later became prominent in attacking the whole notion of dissociation, and they were instrumental first figures in the False Memory Syndrome Foundation. I became their target while I was still a resident. So, stigmatization led to specialisation.

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WM: When you became the target and you were obviously getting referrals, what was your strategic plan at that point? One can’t

Colin Ross, MD and Rick Kluft, MD, ISSTD Annual Conference, Chicago 2018

be the sole poster child with a target emblazoned on one’s chest as a career path?

RPK: That’s the way it’s been. I’m one of these people for whom some have said that if it weren’t for bad luck, you’d have no luck at all! When I started, I had a few patients whom I took into private practice after graduating residency. But I was a Kennedy-era idealist. I was a community psychiatrist. That was what I decided to do with my life after just getting out of training, and then a very interesting thing happened to me. The African-American community I served decided they wanted to replace me with an African American. Back then, the idea of reverse discrimination had not really been ever thought of in an open way, and the nature of the Pennsylvania unemployment law was that a physician who stopped making money, even if it was salary, was simply understood to be a very unsuccessful physician..(so) I looked for another job. I couldn’t find one that I could tolerate, and then I had a weird idea. And the weird idea was that at that point in time, if you wanted to curse someone, you called them a “borderline”. So, I figured, I really liked Kernberg. I read everything he had written. I wondered if I could see if people were interested in getting rid of some difficult borderlines? So, I let it be known that I wanted to study refractory cases of Borderline Personality Disorder. And, to oversimplify, I suddenly was in full-time private practice. Within three months, I went from 3 patients to a full private practice.

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WM: When did you first achieve some traction with a published paper?

RPK: I (had) joined the American Society of Clinical Hypnosis in 1979. … I presented a paper in 1981 at the Boston meetings: “Varieties of hypnotic intervention in the treatment of multiple personality”.

I expected that paper would die, as it had died several times already, but the man who chaired the panel … was Editor of the American Journal of Clinical Hypnosis. As we walked out of the room, he said, “Well, I think I will get three publishable papers out of that panel”, and I assumed it was the other three. But, to my astonishment, he wanted my paper. That paper was accepted by the American Journal of Clinical Hypnosis and it won the Milton Ericson award for the best paper in clinical hypnosis that year. I was flabbergasted.

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Rick Kluft, MD and Martin Dorahy, PhD, ISSTD Annual Conference, San Francisco, 2016

WM: Can you say what it has actually been like for you – your journey in this field?

RPK: Well let me summarise it all by saying that my office for many years was 500 feet from the office of Martin Theodore Orne. He was one of the first scientific advisers of the False Memory Syndrome Foundation – the preeminent one. Martin made it his business to talk me down in that hospital and to periodically suggest that I should be removed from the staff or even [that] my licence should be challenged. That was very sweet of him. Harold Lief, the other main false memory person, was also on the staff of this hospital. Harold Lief, I refuse to say anything bad about. I worked with him, did some private cases with him. I was very sorry to find myself in opposition to him. I had a great deal of academic respect for the man and he was a very good teacher, so out of the gratitude for his educational contributions to my growth I am loath to go against him. I have had to, and always found the process repulsive …

… I encountered people on the hospital staff, the analytic institute, talking about me in weird ways. … My son came home from school and told my wife that his friend’s father (another psychiatrist in my group)… said [I] was a nut … My wife received sympathetic condolences for my fall from grace. … There was tremendous sabotage.

A turning point for DID and the DSM…

Finally, there was a debate at the American Psychiatric Association meeting in 1987 or 1988, in Montreal, one of the major events in the background of the modern history of DID and in my career. At that time there was a strong reaction against the more liberal and less concretized DSM-III-R criteria for DID, published the year before. Many believed that it opened the door for an epidemic of wild diagnostic enthusiasm. There was growing pressure to exclude DID from the next diagnostic manual.

I believe the topic was stated, “Resolved: multiple personality disorder is a legitimate psychiatric disease (or mental disorder)”. Martin Orne from Penn and Fred Frankel, a professor at Harvard who took the chair of my former mentor, John Nemiah, after he retired, were the negative speakers. David Spiegel and “an unknown debater” would be affirmatives. I became the unknown debater. It was quite an experience. David Spiegel is a masterful debater. He debated at Yale, where the debate team is famous as an incubator for prominent lawyers, judges, and politicians. The format was that after we presented our arguments, there would be audience discussion followed by rebuttals. David and I were sufficiently successful that at

Rick Kluft, MD and ISSTD President-Elect, Christine Forner, MSW, ISSTD Annual Conference, Washington, 2017

the end of the first part, Robert Spitzer, the head of the DSM process, stood up and said, “Well we can all go home – the affirmatives have won!”

And it was very simple … I described cases of multiple personality from the early articles of both Frankel and Orne and argued, “Who would dispute these great authorities? Frankel says it is a legitimate condition, Orne says it’s a legitimate condition.” I welcomed them, belatedly, to the affirmative side. That set them back on their heels. Their retort was basically, “It is okay if we diagnose it, but other people’s diagnoses of multiples are almost always wrong”.

Then David killed them. He said, “So if there is one legitimate case of multiple personality anywhere in the world, such as ones who were diagnosed by you, Drs. Orne and Frankel, then multiple personality is a legitimate psychiatric condition, which you have diagnosed.” He sat down and the audience laughed. It was a good moment.

Robert Spitzer’s proclaiming our victory was a powerful blow to those trying to get it removed (from the DSM). Spitzer’s commentary served notice that DID, despite the power and prestige of those arrayed against it, had to be taken very seriously.

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WM: Can you give us an outline how the Journal “DISSOCIATION” came to be, and how it came not to be?

RPK: Buddy had plans for a journal. He was the thinker; the dreamer. He was going to take the first shot at putting it together. I forget whether it was going to be a year-book or a quarterly journal. For one reason or another, his efforts were not successful. So, I said I’d take it on and I formed a publishing company – Dissociative Disorders Research Publications, Ltd., with Catherine Fine and I holding the stock. With our own publishing company, people said, “Oh My God, they’re serious”, and the Ridgeview Institute, which was George Greaves’ turf, asked if they could be the sponsor. Who was I to refuse? They were very supportive sponsors and their editorial person, Beth Gault, was a pleasure to work with. Then Ridgeview came under the sway of the false memory movement. George Greaves had his position there. George Ganaway became a believer in the false memory cause, there was a new regime at Ridgeview, and that was that…

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Rick Kluft, MD and Julian Ford, PhD, ISSTD Annual Conference, Washington 2017

WM: What is your perspective on the evolution of the Society over the last 35 years – the highs, lows, mistakes, successes?

RPK: I think that one of the real highpoints has been survival. I mean, for all my disagreement with many of the people who were in our Society, and many of the things they did, I give them the highest grades for keeping things going.

…One of my big battles was against the idea of having a trauma and dissociation society because my prediction had been that we would become a mediocre trauma society and a mediocre dissociation society because we would not be able to compete with the ISTSS as a trauma society and we would be diluting our focus on our major raison d’etre. I was certainly in a minority in respect to this attitude change and name change. So, now we are a complex PTSD society that occasionally says something about dissociative disorders that is separate from complex PTSD, but not that often. And along with that there has been a major change in topics of interest and focus and I am less than happy about that, because there are a lot of people out there doing wonderful work on PTSD that are not necessarily part of this Society, and there are fewer and fewer people out there doing much work on DID. Take away the TOP DID study and a few others and you’re looking at a wasteland….

——————————————————————

WM: Why has [the Society] survived? God knows, there have been enough opportunities to kill it.

RPK: Well, I think there are enough courageous and gutsy members and enough naïvely optimistic members to see the plight of these patients and desperately want to be able to help them. I think human goodness plays a role in our survival, while human stupidity has compromised the quality of that survival.

——————————————————————

WM: Was there a highlight of being President?

RPK: Just the pleasure of collaborating with good people. I never had the sense that I was out there by myself. … I can tell you having a first-class executive, Anne Kadish, was wonderful. She understood what we were trying to accomplish. …The only real angst I had was in the last month of my presidency when I learned that Anne was resigning, and the low point was calling George Greaves and saying, “George, I have some news for you…” He took the hit and said he’d handle it, and he did.

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On Hypnosis and Dissociation

RPK: I’ve actually spent the last year and a half on that and it’s going to result in four articles that are coming out, starting at the end of this year, in

ISSTD Annual Conference, Chicago 2018

2018 maybe, in 2019 in the American Journal of Hypnosis. It’s called the “Hypnosis and Psychoanalysis Project” and includes John O’Neil, Ira Brenner, Mary-Jo Peebles, the late Thomas Wall, also Dan Brown and Stephen Kahn. Steve Lankton, Editor of the American Journal, pushed to get this project under way…

… The full story of Freud’s work with hypnosis and his thinking about it is pretty much unknown. Most generalizations Freud made about hypnosis and that others have made about Freud and hypnosis are inaccurate and incomplete. For example, Masson discovered a letter by a young Sigmund Freud to Minna Bernays in which he describes his own use of autohypnosis. Too complex to go into here… It took me two full articles to summarize the contradictions between the historical record and the generally accepted understandings surrounding these matters. So, long before all this stuff became what we think of it today, Freud was much more expert at hypnosis than is generally credited…

….It scares me that so many books have been written about dissociation without the word “hypnosis” appearing in their index. Paul Dell has just reconfirmed what we all knew since 1836 – that dissociatives are high hypnotisables. We have known that for a long, long time, but we try to deny it.

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On the Future of our Field:

Rick Kluft, MD, ISSTD Annual Conference, San Francisco, 2016

RPK: If you look at the field now, you notice there are two or three major changes. One is the shift in distribution of professions and the membership, there being far fewer physicians … and there are far more women in the mental health professions – all the disciplines. We are at a point in time when women feel increasingly empowered and it may well be that the women of today, being a significant majority, and feeling much more strongly about this whole issue of being pushed around, would react in a much healthier way than the milder milquetoast-style individuals of the late 80s and early 90s …

I can only admire the courage of a lot of the people in the field which I do, side by side with chastising many of them for cowardice….

I think that I would like to see the field take a big deep breath and go back and re-include what it has excluded along the way. I think that there is more integrity in making use of all available knowledge than in earnest elaborations of particular paradigms of practice or research that marginalize or even dismiss what has been learned by scholars and clinicians informed by other models.

Committee Spotlight

ISSTD-UN Taskforce

Karen Hopenwasser, MD, ISSTD Representative to the UN

The ISSTD UN Taskforce consists of:

Lynette S. Danylchuk, PhD Chair
Karen Hopenwasser, MD
Vivien Pender, MD
Christa Kruger, MD
Lisa Danylchuk, MFT
Victor Welzant, PsyD

Together we work to develop our collaborative relationship with the UN.

In mid 2017, the UN’s Economic and Social Council (ECOSOC) granted ISSTD special consultative status. This enables us to actively engage with ECOSOC and its subsidiary bodies, as well as with the United Nations Secretariat programs, and with Member States and the United Nations system at large. Consultative status also enables the Council, or one of its bodies, to seek expert information or advice from us in the areas of our competence. We have information about the provisional agendas of the ECOSOC, and we can request the Secretary-General, through the Committee on Non-Governmental Organizations (NGOs) to place items of special interest in the provisional agenda of the Council.

Being affiliated with the UN will also give us the opportunity to network and develop connections with over 3000 NGO’s around the globe.

This project has been in development for some time and our involvement at the UN began before 2017. For example, in March 2016 three members of ISSTD (Karen Hopenwasser MD, Robert Schwab LCSW, and Roberta Estar PhD) attended the USUN (US mission to the UN) event: “Combatting the Trafficking of Women and Girls: What Role Can the Private Sector Play in Addressing and Preventing Human Trafficking and Modern-Day Slavery?” co-hosted by the Commission on the Status of Women.

Since then, with slow but steady progress, we are establishing a presence at the United Nations. One small way to do that has been to co-sponsor events being put on by other NGOs. Often this simply means putting the ISSTD logo on social media announcements. So for example we did that in October 2017, for World Mental Health Day.

Another way to participate is through the NGO Committee on Mental Health. This NGO represents many mental health related NGOS. I am currently a Member- at- Large on the Executive Committee of the NGO Committee on Mental Health. My official representation is for ISSTD. The other member organizations of this NGO can be found here.

As a member of the NGO Committee on Mental Health I am co-convener of the Trauma Working Group. Every February this subgroup organizes a presentation for the membership and extended community. These presentations are either at the UN or at a building nearby the UN. A few years ago I presented on Complex PTSD (before I represented ISSTD on the committee). Two years ago I presented on intergenerational transmission of trauma.

This past February I moderated a presentation entitled: “Shared Trauma: The impact of working with traumatized groups”. Our two presenters were:

  • Carol Tosone PhD, Professor and Director of the DSW Program in Clinical Social Work at NYU Silver School of Social Work, who presented on: “Shared Trauma: When the Professional is Personal”
  • Nina Urban MD, Assistant Professor of Psychiatry at New York University and a psychiatrist at the Bellevue World Trade Center Clinic and the NYU Program for the Treatment of Survivors of Torture, who presented on: “Refugees and trauma: implications for evaluation, treatment and vicarious trauma”

The moderators were Irit Felsen PhD and myself, both co-conveners of the NGO CMH Working Group on Trauma and Mental Health.

As a representative of ISSTD, I was registered to attend the 56th Session of the Commission for Social Development January 29, 2018 – February 7, 2018. Unfortunately, I was not able to attend and could not find anyone on short notice in my place.

In March we had at least one other ISSTD member registered for the 2018 Commission on the Status of Women. There were many parallel meetings going on and for ISSTD it was an opportunity to network.

On May 17th I attended the UN Forum Supporting the Voices of Youth Against Gun Violence. This event was co-sponsored by the NGO Committee on Mental Health. Vivian Pender MD, Chair of the NGO Committee on Mental Health spoke. Here is a link to UN – TV – Click here

At most events I try to tweet something and include @ISSTD to get it out to our membership.

We are currently planning for our next Trauma Group presentation in February. Understandably there is a lot of interest in refugee/asylum issues and the long-term consequences of parental separation.

Come and join us! The more ISSTD representatives show up and contribute in meetings, the more helpful information about trauma and recovery there will be in the UN. We need more ISSTD people in the NYC area, or in Geneva or Vienna, to join us. If you have an interest, please email Karen Hopenwasser at: khopenwasser@gmail.com

Membership

Even more SIGs being formed!

Kate McMaugh, Editor, ISSTD News

Just last month we brought you news of three new potential Special Interest Groups (SIGs). We now have two other SIGs being developed.

For those of you unaware of the role of SIGs in ISSTD, these groups provide ISSTD members with information and support targeted to specific areas within the trauma and dissociation field. Developed by members, for members, they are open to all ISSTD Members who share that interest. These forums are a great source of collegiate support and active forums for education and information-sharing. SIGs are also active in planning webinars and developing conference presentations.

In order to move ahead and establish new SIGs we need to see if there are enough interested members. If you are interested in participating in any of these new SIGs, please email the contact for the group.

MD SIG
The mission of this potential SIG is to provide a forum for MDs working with severe post-traumatic stress disorder and dissociative disorders. The SIG would aim to:

  • share information about current and emerging treatment options;
  • share experiences working with these challenging patients;
  • investigate ways of promoting MD awareness and education about these disorders; and
  • provide peer support and peer consultation.

Those interested in joining the SIG may contact Heather Hall at heatherhallmd@gmail.com

Vicarious Trauma and Self Care SIG
Clinical work in trauma field, with all its excitement and satisfaction, carries risks and burdens for the professionals involved in the form of vicarious trauma. Even though there has been some research done on vicarious trauma, our day to day awareness of it is still very new. Additionally, the rate of burnout in our profession suggests that we are not adequately equipped to deal with this issue yet.

Therefore, the Vicarious Trauma and Self-Care SIG seeks to create an open forum for ISSTD members to discuss, share, learn, practice and research about:

  1. the impact of clinical work with trauma on their personal selves; and
  2. strategies, tools, & protocols to protect and sustain one’s self in the long-term career of a trauma professional.

In addition, this SIG will work on raising awareness of and attention to the vicarious trauma in our clinical/research field.

As this is a new SIG there is space for the scope and mission of the group to evolve as it gains in membership and is shaped by members’ specific interests. If interested in joining, please contact:
Irina V Diyankova, Ph.D: dririnadiyankova@gmail.com

For more information about the other three SIGs being formed click here.

In addition, don’t forget that ISSTD already has three vibrant and active SIGs. For more information about these SIGs please contact:

Regional Conferences

ISSTD Regional Conference – New York City, October 5, 2018

Join ISSTD for “Relational Healing in Complex Trauma and Dissociation: Psychoanalytic and Integrationist Perspectives”, an ISSTD Regional Conference in New York City on October 5!

The day will kick off with “Six Relational Crises: The Relational Healing of Complex Trauma” with Philip Kinsler. Dr. Kinsler will examine six choice points in the therapy of chronically traumatized patients that present relational challenges, including presentation of countertransference struggles throughout the process.

After a brief break, the conference will reconvene with Sheldon Itzkowitz’s presentation, “An Interpersonal-Relational Approach to Working with Critical and Aggressive Dissociated Self States”. Dr. Itzkowitz will address the emergence of critical and aggressive protector/perpetrator self-states and how we works with them from an interpersonal-relational psychoanalytic perspective.

Following the mid-day break for lunch, which will be provided, Elizabeth Howell will present “The Self-Critical Conundrum: Reframing harsh, Pathological Superego in Terms of Dissociation and Attachment”. In this presentation Dr. Howell will examine the understanding of harsh superego as an elaboration of a posttraumatic dissociative structure.

After a final break, the day will conclude with “Relational Healing of Complex Trauma: An Integrative Discussion”, with Rebeca Gonzales-Scherman moderating a panel discussion between all three presenters.

Full Conference abstracts, speaker bios, venue details, and more information can be found on the Conference Website.

Register now and take advantage of Early Bird Pricing!

Thank you to our Supporters!

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Learn more about Therapy Notes and The Trauma Disorders Program at Sheppard Pratt!

Interested in becoming a supporter or exhibitor? Check out opportunities on the Conference Website!

Publications of Interest

Childhood Trauma’s Impact on Sexual and Gender Minorities

Lynn Hazard, LCSW, POI Editor

Lynn Hazard, POI Editor

For the second quarter, the overall theme is childhood trauma’s impact on sexual and gender minorities. There is a higher risk for polyvictimization and serious adverse mental health outcomes for these groups. The trauma field around the world is gradually increasing research in this area.

Clements-Nolle, K., Lensch, R., Baxa, A., et.al. (2018). Sexual Identity, Adverse Childhood Experiences, and Suicidal Behaviors. Journal of Adolescent Health, 62(32), pp. 198-204. DOI: 10.1016/j.jadohealth.2017.09.022
To link to this article: https://www.ncbi.nlm.nih.gov/pubmed/29223563

Abstract: PURPOSE: The objective of this study was to examine the influence of sexual identity
and adverse childhood experiences (ACEs) on suicidal behaviors in a population-based sample of high school students. METHODS: A two-stage cluster random sampling design was used to recruit 5,108 students from 97 high schools. A total of 4,955 students (97%) provided information that allowed for classification of sexual identity into three groups: (1) lesbian, gay, or bisexual (LGB) (10%); (2) not sure (4.6%); and (3) heterosexual (85.4%). Five measures of childhood abuse and household dysfunction were summed, and the ACE score was categorized as 0, 1, 2, and 3-5 ACEs. Weighted logistic regression was used to assess the influence of sexual identity, ACEs, and their interaction on suicide ideation and attempts in the past 12 months.
RESULTS: Compared with heterosexual students, those who were LGB and were not
sure had higher odds of suicide ideation and attempts. There was also a graded relationship between cumulative ACE exposure and suicidal behaviors. Although sexual identity/ACE interaction was not observed, LGB/not sure students who experienced a high number of ACEs were disproportionately affected. Compared with heterosexual students with 0 ACE, LGB/not sure students with 0 ACE (adjusted odds ratio [AOR] = 3.32, 95% confidence interval [CI] = 1.96-5.61), 1 ACE (AOR = 6.58, 95% CI = 4.05-10.71), 2 ACEs (AOR 13.50, 95% CI = 8.45-21.58), and 3-5 ACEs (AOR = 14.04, 95% CI = 8.72, 22.62) had higher odds of suicide ideation. A similar pattern was observed for suicide attempts. CONCLUSIONS: LGB and students not sure of their sexual identity with greater exposure to ACEs have disproportionately high levels of suicide ideation and attempts. Trauma-informed interventions for these populations are warranted.

Gartner, R.E. & Sterzing, P.R. (2018). Social Ecological Correlates of Family-Level and Environmental Microaggressions Toward Sexual and Gender Minority Adolescents. Journal of Family Violence 33(1), pp. 1-16. DOI: 10.1007’s10896-017-9937-0.
To link to this article: https://link.springer.com/article/10.1007/s10896-017-9937-0

Abstract: Microaggressions are associated with mental and behavioral health problems and are common experiences for sexual and gender minority adolescents (SGMA). Little is known about the social ecological correlates of family-level interpersonal and environmental microaggressions for SGMA. Utilizing a national sample of SGMA (N = 1,177), this study (a) identified the frequencies of family-level interpersonal and environmental microaggressions by participant demographics and (b) examined individual-, family-, and structural-level factors associated with interpersonal and environmental microaggressions. Outness to parents, a transgender or genderqueer identity, and higher levels of gender role non-conformity were associated with higher frequencies of interpersonal microaggressions. Higher levels of family-level child maltreatment and religiosity were associated with higher frequencies of interpersonal and environmental microaggressions. State-level non-discrimination protections were associated with lower frequencies of environmental microaggressions. Suggestions for increased individual-level support for gender non-binary adolescents as well as family targeted preventive strategies are discussed. Areas for future research are highlighted.

Cárdenas, M., Barrientos, J., Meyer, I., et.al. (2018). Direct and Indirect Effects of Perceived Stigma on Posttraumatic Growth in Gay Men and Lesbian Women in Chile. Journal of Traumatic Stress, 31(1), pp. 5-13. Published by the International Society for Traumatic Stress Studies. DOI: 10.1002/jts.22256
To link to this article: https://onlinelibrary.wiley.com/doi/abs/10.1002/jts.22256

Abstract: This study examined the direct and indirect effects of perceived stigma on
posttraumatic growth (PTG) in a sample of gay men and lesbian women in Chile, with coping strategies (positive reappraisal, social support seeking, and active coping strategies) as intermediate variables. Data from 467 gay men (57.4%) and lesbian women (42.6%) were analyzed. A respondent‐driven sampling (RDS) method was used. The hierarchical regression analysis indicated the important predictive role of active coping, β = .23, and positive reappraisal, β = .45, in PTG, R2 = .31, p < .001, f2 = 0.16. Results revealed that, in the presence of positive reappraisal coping as an intermediate variable, partial indirect effects are detected between perceived stigma and PTG. Seeking instrumental social support did not produce indirect effects between perceived stigma and PTG, whereas active coping produced partial indirect effects. These findings suggest that the positive reappraisal of a traumatic experience is essential for reporting personal growth. Implications of these more complex relations for counseling interventions and further research are discussed.

McConnell, E.A. (2018). Risking It Anyway: An Adolescent Case Study of Trauma, Sexual and Gender Identities, and Relationality. Journal of Issues in Mental Health Nursing, 15 January 2018, pp. 73-82. DOI: 10.1080/01612840.2017.1400134
To link to this article: https://www.tandfonline.com/doi/abs/10.1080/01612840.2017.1400134

Abstract: This article presents the case of a Chinese–American adolescent with a significant trauma history who was questioning her sexual and gender identities. The implications of the client’s intersecting identities for case conceptualization and treatment are considered within the framework of affirmative practices for sexual and gender minority (SGM) clients. The impacts of stress and trauma on this client’s experiences—and SGM clients more broadly—are also considered, particularly with respect to how this client understood and negotiated her experiences of relational trauma. This case is intended to illustrate some best practices with SGM clients within an intersectional framework which underscores the importance of multiple salient cultural identities.

Wright, A.L. (2018). Relationship Between Obesity, Childhood Sexual Abuse, and Attitudes Toward Obesity in Sexual-Minority Women. Journal of Gay & Lesbian Mental Health. DOI: 10.1080/19359705.2018.1429975
To link to this article: https://www.tandfonline.com/doi/abs/10.1080/19359705.2018.1429975

Abstract: Sexual-minority women (SMW) are more likely to be overweight, have a history of
childhood sexual abuse (CSA), and have more positive attitudes toward obesity compared to their heterosexual counterparts. In this exploratory study, the author sought to identify any associations between CSA, obesity, and attitudes toward obesity among SMW. Eighty-five SMW completed a survey assessing their weight, history of CSA, and attitudes toward obesity. An ordered logistic regression (OLS) and an analysis of variance (ANOVA) revealed CSA to be negatively correlated with BMI, as well as no association between SMW’s attitudes toward obesity and CSA nor BMI. Lastly, SMW did not report significantly different attitudes toward BMI based on their own BMI and history of CSA. This study provides evidence that SMW, particularly those residing within the Deep South, are at high risk for both CSA and for obesity, and highlights the importance of developing future culturally tailored weight loss programs designed specifically for SMW with histories of trauma.

Giovanardi, G., Vitelli, R., Vergano, C.M., et.al. (2018). Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria. Frontiers in Psychology 2018. DOI: 10.3389/fpsyg.2018.00060
To link to this article: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00060/full

Abstract: The current study investigated attachment representations and complex trauma in a sample of gender dysphoric adults. Although it has been proven that the psychological wellbeing of gender diverse persons is largely mediated by family acceptance and support, research on their relationships with parental figures is scarce. A total of 95 adults took part in the study. The attachment distribution was as follows: 27% secure, 27% insecure and 46% disorganized. Regarding early traumas, 56% experienced four or more traumatic forms. Further, gender dysphoric adults showed significantly higher levels of attachment disorganization and polyvictimization, relative to controls. Comparisons of subgroups, defined by natal gender, showed that trans women, compared to control males, had more involving and physically and psychologically abusive fathers, and were more often separated from their mothers; trans men, relative to female controls, had more involving mothers and were more frequently separated from and neglected by their fathers. The research has several implications for treatment, clinical health psychology, family support and education.

Taylor, S.W., Goshe, B.M., Marquez, S.M., et.al. (2017). Evaluating a Novel Intervention to Reduce Trauma Symptoms and Sexual Risk Taking: Qualitative Exit Interviews with Sexual Minority Men with Childhood Sexual Abuse. Journal of Psychiatry, Health, & Medicine, 23(4), pp. 454-464. DOI: 10.1080/13548506.2017.1348609
To link to this article: https://www.tandfonline.com/doi/abs/10.1080/13548506.2017.1348609

Abstract: Childhood sexual abuse (CSA) continues to affect sexual minority men (SMM) at
disproportionate levels and contributes to multiple negative health outcomes, including sexual-risk taking and HIV acquisition. This paper presents qualitative evaluative feedback from SMM (N = 9) who participated in a 10-session Cognitive Behavioral Therapy-Trauma and Sexual Health (CBT-TSH) intervention to reduce CSA-related posttraumatic stress reaction and distress. The treatment was designed to increase accurate sexual risk appraisals and to improve self-care health behaviors related to HIV/STI acquisition. The researchers identified four emerging themes: (1) motivation to participate, (2) response to cognitive therapy, (3) process of change, and (4) considerations for intervention improvement. These qualitative findings provide useful feedback on the acceptability of an innovative program that integrates CBT for trauma related to CSA with sexual risk-reduction counseling.

Crump, L. & Byers, E.S. (2017). Sexual well-being of sexual minority women in dating
relationships who have experienced childhood sexual abuse and/or adolescent and adult sexual victimization. The Canadian Journal of Human Sexuality, Vol. 26(2), pp. 163-173. DOI: 10.3138/cjhs.262-a4
To link to this article: https://www.utpjournals.press/doi/abs/10.3138/cjhs.262-a4

Abstract: Few studies have examined the sexual sequelae of child sexual abuse (CSA) for sexual
minority women (SMW), particularly SMW in dating relationships. We examined the impact of CSA on several aspects of sexual well-being. Participants were 299 SMW in a non-cohabiting dating relationship who completed an online survey that assessed CSA, adolescent and adult sexual victimization (AASV) and their behavioural, motivational, and cognitive-affective sexual responses. Four groups were formed based on sexual abuse experiences before the age of 14: No lifetime sexual abuse (NSA Group); AASV only (AASV Group); CSA limited to fondling (CSAfon Group); and, CSA involving attempted/completed vaginal, oral and/or anal penetration (CSApen Group). Women in the CSAfon and CSApengroups were significantly more likely to report having experienced AASV (77% and 56%, respectively) than were women in the AASV and NSA groups (32%). Women in the CSApenGroup reported significantly lower sexual desire and sexual satisfaction, and more frequent negative automatic sexual thoughts than women in the other groups but no differences in their frequency of sexual behaviours, sexual duration, sexual esteem, or sexual anxiety. The AASV Group did not differ from the NSA Group on any of the sexual well-being variables. Overall, women in all four groups generally reported positive sexual well-being. These results suggest CSA involving attempted/completed penetration with or without subsequent AASV negatively affects only some aspects of SMW’s sexual well-being. They also suggest SMW who have experienced sexual abuse can and do enjoy healthy sexual well-being within the context of a dating relationship.

Volunteer

Spotlight on Volunteer: Susan Hykes

Susan Hykes

Tell us a bit about yourself.

I was raised in Lorain, Ohio, and am a graduate of the University of Michigan (1963) with a BA in Mathematics. I worked for IBM and moved to Oklahoma. I ‘retired’ to raise five children -two adopted children from my first marriage and three step-children from my second marriage.

I’ve been sober since 1970. After my second divorce it was suggested by a pastor and a good friend that I become a counselor. I was living in Colorado where it was legal to be an unlicensed psychotherapist. So in 1989 I became an unlicensed psychotherapist and was supervised, just as licensed people were, and there I began the career-long journey to get the professional development and the supervision I needed to fill in the gaps in my knowledge. Ultimately, I ended up serving nine years as a professional member of that same supervisory board – a volunteer position. This included three years as chair of the board.

Tell us something most of us may not know about you?

Camping out as a form of self care: Susan’s tent where she camps each year to get away from it all

Good self-care is a priority for me. I have a hot tub, get massages regularly, take voice lessons and sing in a community choir. The best self-care I do is ten days of tent camping on my 2.5 acres at 9500 ft. altitude. I’m really just an old Girl Scout!

What lead you to join ISSTD? What is your favourite thing about ISSTD?
One of my first clients was a survivor of ritual abuse. During the coffee break of a presentation, she said, “I am like that.” I said that I would find a therapist who had that experience and refer her. She said, “Why don’t I buy the book and you read it?” That is what we did and I also found a local therapist who was a member of ISSTD. I joined shortly after that. And some years later attended my first conference in Philadelphia. My favorite thing is the collegiality. The sense that we are all in this together and we share so generously with each other.

What are your volunteer roles in ISSTD? (or roles) and what led you to volunteer?
At that first conference I volunteered because there was a registration price reduction. The price reduction has gone away but I have volunteered at other conferences.

Two years ago there was a vacancy on the RA/MC SIG Executive for the position of Listserv Moderator. I waited for others to volunteer. Finally, I asked how much time it took. I am now in the second year of doing that job. In that time we have changed our name to the RAMCOA SIG (Ritual Abuse Mind Control and Organised Abuse) SIG in recognition of the wide and overlapping spectrum of organised abuse. We have a vibrant list serv, a book club, organise webinars and members present at conferences regularly.

What’s good about volunteering? What do you get from it?
I was a Girl Scout as a child and learned to volunteer there. My family were also volunteers in the community, so it was a family tradition as well. Today as a professional with significant experience I give back as the volunteer convener of a monthly trauma and dissociation study group for other therapists.

I don’t have wealth with which to endow ISSTD, but I can give back. I can share with the members of the SIG my experience and my questions. As Moderator I get to read every posting and sometimes kindly work through gnarly difficulties. And I get to work with members of the exec committee which is certainly a privilege for me.

I am thinking of something that I heard David Calof say some years ago: That we need tasks with a beginning and an end to sustain us in this work that can seem to have no end. Volunteering provides that.

Any drawbacks?
Because I have a full-time practice – about 39 hours a week on average – sometimes there are time crunches.

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