Committee Spotlight

Exciting New Webinar Training from ISSTD

Marilyn Korzekwa, Chair, Webinar Committee

As you may be aware ISSTD offers a range of webinars throughout the year, enabling people from all over the world to access cutting edge training in the skills necessary to work with complex trauma and dissociative disorders. These webinars provide an easy and affordable way to stay up to date. In addition, ISSTD members, students and emerging professionals get a discount on multi-session Webinars.

For the first time, in 2018 ISSTD is offering an ISSTD Webinar Pass for the whole year, enabling members to access all the webinars for one set price. This pass is only available for purchase through February 15! More information on the pass can be found here.

With all this in mind, your Webinar Committee has been hard at work planning a slate of wonderful live presentations for 2018:

Organizing Disorganization: Case Conceptualization for Structural Dissociation
February 9, 2018 at 1:00-2:30 PM (US Eastern Standard Time)
Presented by Kathy Steele
Registration Now Open!

All Day Child & Adolescent Webinar
April 27, 2018 from 9 AM to 5 PM (US Eastern Daylight Time)
Presenters: Sandra Baita, Renee Marks, Robert Slater, Fran Waters, Na’ama Yehuda

Relational Aspects of Therapy
June 8, 2018 at 12:00 PM – 1:30 PM (US Eastern Daylight Time)
Presented by Philip Kinsler

EMDR and Dissociation: An Introduction to the Progressive Approach
July 13, 2018 at 12:00 PM – 1:30 PM (US Eastern Daylight Time)
Presented by Dolores Mosquera

Dissociation 101
September 21, 2018 from 9:00 AM – 5:00 PM (US Eastern Daylight Time)
Presented by Christine Forner

RAMCOA: Advanced Workshop
October 5, 2018 from 9:00 AM – 1:15 PM (US Eastern Daylight Time)
Presenters: TBA

The Blending Protocol in DID: Teaching Clients When and How
November 9, 2018 at 12:00 PM – 1:30 PM (US Eastern Standard Time)
Presented by A. Steven Frankel

All of these presentations will all be recorded for our Webinar library in the Member’s Corner, which can be accessed anytime.
Details are available here!

Kid's Korner

Helping Dissociative Children Develop Self Reflection

Sandra Baita, PsyD

Five year old Luke was referred to therapy by his kindergarten teacher due to his disruptive behavior in the classroom and his constant refusal to follow rules. When I asked him what had happened at school before coming to see me, he was perfectly capable of giving a narrative of the facts. When I asked whether he knew what had caused him to behave in such a way, he said in a very confident manner: “When I´m bored I feel kind of a monster inside my chest that wants to come out and get some fun. I know I don’t have a monster but this is the way I feel with Miss Cecilia. She is so boring. She doesn´t allow me to get fun, she only wants me to sing her stupid songs.”

Had Luke been a dissociative child the answers to these questions might have been quite different. He might have shown amnesia for his behavior, or had blurred memories of it. He might have answered ‘I don´t know’ to the question about the trigger, or might have felt that the monster was really inside of him, taking control over Luke´s behaviors without him being able to stop it, and yet not knowing what caused the monster to behave like that.

The Inside-Outside technique (Baita, 2015) was developed to assist a little dissociative girl in curiously exploring her internal experience while she was seen by her siblings – in the outside world- as a crazy girl, a situation that was very upsetting for her. This is a common experience for dissociative kids: their behaviors and reactions might be baffling for those surrounding them, even though they make a lot of sense for the child´s internal experience. The big challenge is that most of the time, the child is also unaware of what has caused their behavior or reaction, and is often unable to properly communicate their feelings and concerns. When the child is in a safe situation, the present keeps triggering memories of their past that intrude into their daily life, and they cannot gain control over it.

Through the use of the Inside-Outside technique the clinician can assist the child, along the course of therapy, to increase:

  • self observation – What is going on inside of me right now?;
  • self awareness – What part of me is reacting like this right now?;
  • self monitoring – How intense is what I´m feeling right now? What do I want to do when I feel like this?; and
  • self reflection – when I feel like this I behave…; when I remember my Daddy hurting me, I feel like, and I think …; when my mommy hugs me, something inside of me wants to hurt her because I recall when I was hurt) (Waters, 2016)

The technique is very simple and can be used from the first meeting with the child and throughout the entire therapeutic process. To begin, the clinician draws a big circle on each side of a white sheet of paper, and starts with a very simple explanation that serves both the purposes of introducing the technique and providing some psychoeducation: Did you know there are some things outside your head that everyone can see? Here the clinician encourages the child to answer with the things everyone can see on her head (eyes, mouth, nose, etc.). Then the clinician keeps moving along with the explanation: And did you know there are some other things stored inside your head that you are the only person in this world who can see or listen to? Most kids will give answers like the skull or the brain and in that case the clinician can say something like: Yes, you are right, inside your head there is the skull and the brain, however a doctor can take a picture of both of them, and in that case he would also be able to see what is inside your head… but do you think the Doctor’s pictures would show a feeling or a thought, or even a memory?

The idea of this first part of the introduction is to allow the child to get in contact with the fact that she or he has feelings, thoughts and other experiences that are unique and personal, and outside others´ awareness. Then the clinician proceeds: Some of the things that happen to us can be easily seen by others, like if you have tears someone might think you’re sad. But the person who is with you doesn´t know what causes your sadness. The only one who really knows what’s going on is you. You are the only person who knows about your sadness that is stored inside of you. I have here this piece of paper with a big circle on each side. Would you please draw on one side what everybody can see outside your head? …OK, good. And now, would you please draw on the other side of the paper all the things that only you know are inside your head, and might be worrying or bothering you? This could help me understand you and help you better.

This is the only starting point. From now on the clinician can use this technique for multiple purposes, and asking countless questions related to past, present or future experiences: Do you remember what was inside your head when your Daddy used to do these things to you? What´s inside your head right now when you are telling this to me? What would you like to have inside your head when you grow older? What´s inside your head when you think of that/when you feel… (sad, angry, mad)?

Being able to reflect upon their own behavior, feelings and thoughts is an important step for the self regulation of a chronically traumatized and dissociative child. And the uses of this technique are certainly unlimited!

References

  1. Baita, S. (2015): Dalma (4 to 7 years old) – “I´ve Got All My Sisters with Me”: Treatment of Dissociative Identity Disorder in a Sexually Abused Young Child. In Wieland, S. (ed.) Dissociation in Traumatized Children and Adolescents. Theory and Clinical Interventions. Second Edition. (pgs. 41-88). New York, Routledge.
  2. Waters, F.S. (2016): Healing the fractured child. Diagnosis and Treatment of Youth with Dissociation. New York, Springer Publishing Company.

*A Spanish Language version of this article will be available on ISSTD Website under Spanish Language Resources.

Letter From The President

A Holiday Message From Your Presidents – Past, Present, and Future

On Tuesday (New Zealand time) December 12th, the Executive Committee of the ISSTD had its last meeting of the year (barring any emergencies!!). Our Secretary, Bob Slater, had a foot of snow outside his upstate New York office. Christine Forner, our current treasurer and next year’s President-Elect, was hunkered down in Calgary with many layers of clothing on. Our Executive Director, Mary Pat Hanlin, was feeling the chill in Virginia. Kevin Connors, our current President-Elect, was sitting outside in Southern California enjoying the midday winter heat. Our Immediate Past President Warwick Middleton was sweltering in Brisbane’s summer humidity, and I was enjoying a pre-christmas heat ‘wave’ (by New Zealand standards) in Christchurch, where temperatures were reaching 33˚C (91.4˚F).

Like the membership of the ISSTD we were geographically spread and sharing in no way the same season or weather conditions. But we were joined by a shared purposed, a weekly tradition, a set of acknowledged and time-honoured customs, and an opportunity to connect with each other. The holiday season represents a time when many of us are drawn to local, familial, cultural and religious traditions. We may engage in activities that are reserved for this time of the year, and bring us together with specific people that we don’t see at other times. We may get an opportunity to take a ‘breather’ from the year as it has played out, and join with others to share and connect. We may get some wanted or unwanted time alone. Whatever the customs, traditions, and activities you engage in this holiday season, I hope they are peaceful, rejuvenating, connecting, and bring some internal comfort and pleasure. Whether you are rugged against the cold, or trying to find ways to stay cool, I wish every member of ISSTD a very safe holiday season and an exciting start to the new year.

Martin Dorahy, President, ISSTD

One of the exciting aspects of this holiday season is the beginning of a new year (for those of us marking time via the Gregorian calendar). With the New Year comes the sense of a new beginning and new opportunities for growth and change.

For ISSTD we have new board members joining us, Lisa Danylchuk, Dana Ross, and Michael Salter are all beginning their first terms on the ISSTD Board of Directors. We are excited about the fresh ideas and innovative approaches they will bring to the challenges facing our Society. We are excited about the new directions and projects they will guide us along.

I am personally excited about what the future holds for us. I have seen our Society rise on the excitement that came in the early 1980’s, recognizing dissociation and the amazing way traumatized people have coped with horrific abuses. I watched in grave concern as our Society faced two tremendous challenges; the Memory Wars of the mid 1990’s and our financial crisis of the early 21st century. I was honored to be part of the rebuilding process as our Society found solid fiscal footing and academic rigor. I am proud of our continuing commitment to educating and furthering the understanding of trauma and dissociation as evidenced by our flagship publication, the Journal for Trauma and Dissociation. I am thrilled that in the last two years our Center for Advanced Studies and the Professional Training Program awarded the first graduating scholars their Certificates of Training in Trauma and Dissociation. I am excited about extending the reach of regional seminars to global sites from Australia to England and across North America, and the renaissance of our annual conference (which by the way is now celebrating its 35th birthday in its hometown of Chicago)!!!! Annual Conference Website

Looking to the future of education, I am thrilled by our growing on-line presence. Our webinar program has already identified and planned for a full schedule of illuminating trainings showcasing the depth and breadth of ISSTD’s clinical and research based knowledge. Check out the full schedule here. 2018 Webinar Schedule

ISSTD continues to expand our on-line presence with the intimate and inspiring dialogues of our Virtual Book Club. The newest books and cutting edge Journal articles are shared and discussed. You have the opportunity to chat on-line with the authors, skilled clinicians, and knowledgeable researchers. The interplay is dynamic and inspiring. If you haven’t signed up to participate in one of the Virtual Book Club events, I heartily recommend you do so.

Brand new in 2017, and still in its fledgling stages, is our newest contribution to our educational offerings; Frontiers, our clinical e-Journal. In this innovative new approach we are sharing solid clinical acumen and information. Look for our next articles to come out in early 2018. (Frontiers can be accessed by logging into ISSTD’s Member’s Corner and clicking on the Frontiers Logo on the main page)

The New Year offers new hope, new opportunities, and new challenges. Your Board of Directors are keen to hear from you. What do you want to see in 2018? Where do you want our Society to go? I invite you to share your thoughts with us. More so, I invite and encourage you to get involved helping to grow our Society and guide our growth into the future.

All the best for 2018

Kevin Connors, President-Elect, ISSTD

At Christmas all roads lead home. For all those who have an additional home within our Society, the warmest wishes for the festive season!

Warwick Middleton, Immediate Past President, ISSTD

Donate to ISSTD

Thank You to Our 2017 Donors!

General Fund
Diane Adlestein
Letizia Adorno
Theresa Albini
Joy Anasta
Kathy Barclay
Elizabeth S. Bowman
Thomas G. Carlton
Therese Clemens
Juliana Cocola
Coral Compagnoni
Lawrence Compagnoni
Adrian J. Connolly
Kevin Connors
Christine A. Courtois
D Michael Coy
Michael R. Dadson
Lynette Schwarz Danylchuk
Charme S. Davidson
Garrett Deckel
Marilyn Dodd
Martin J. Dorahy
Rochelle Epstein
J.A. (Jan) Ewing
Brad Foote
Christine Colette Forner
Kara Fowler
Virginia S Frazier
Heather Genovese
Janice Goldman
Jean Goodwin
Richard Greenfield
Joan Haliburn
Heather M Hall
Mary Hanlin
Yuichi Hattori
Kim Havenner
Shielagh Shusta Hochberg
Richard A. Hohfeler, III
Camille Hood
Elizabeth F. Howell
Heather Hruby
Shelley Hua
Maureen Hudak
Eileen Isaacson
Sheldon Itzkowitz
Mindy Jacobson-Levy
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Ashley Kemp
Christa Kruger
Andreas Laddis
Ulrich F Lanius
Rebecca B Lee
Barry Levy
Lisa Lewis
Johanna Lynch
Lindsay Malcolm
Kathleen M Martin
Peter A. Maves
Claire McCarthy
Luanne McKenna
Kate McMaugh
Warwick Middleton
Joyce Morene
Louis Moser
Robert T. Muller
Tanya Oleskowicz
Jean Penczar
Joan Petty
Gary Peterson
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Michael Quinones
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ISSTD Clinical E-Journal Support
Paula Eagle
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DONATE TODAY!

Membership

Welcome ISSTD New Members – December 2017

PROFESSIONAL MEMBERS
Roby Abeles
Yenys Castillo
Anne Dietrich
Lisa Gilbert
Norma Howes
Carrie Hunter
Dalal Musa
Scott Petersen
Joanna Razo
Ginger Rhodes
Nancy Rubin
Karen Schrock
Sandy Sela-Smith
Sheree Violon
Mark Wade
Sarah Watt
EMERGING PROFESSIONAL MEMBERS
Michael Brown
Karri Lewis
Geraldine Mapel
Serenity Sersecian

STUDENT MEMBERS
Jessica Culp
Sonja Garrett
Denesia Huttula
Ricardo Kriete
Deborah Mikita
Jennifer Silva

News You Can Use

Trauma Sensitive Fiction for Teens

Kate McMaugh, ISSTD News Editor

ISSTD Member Na’ama Yehuda has recently published a new book for children: Apples in Applath. This is Na’ama’s fourth book and her third work of fiction.
Apples in Applath is geared to teens and young adults (it is generally appropriate for children over 12 years of age). It tells the story of 12 year old Marcus who lost his parents as a baby, his grandma at age nine and his freedom at ten. Now he is on the run with two of his cell mates and one of them is gravely injured. Marcus is faced with life-changing decisions. Where can he and his friends go to? Who will help them? Most importantly, how will Marcus know whether to trust his friends or the ragtag group of runaways and the recluse bear of a man who harbors them? When the worst happens, will he put his own freedom on the line and at what cost?
Through this book readers can see that what makes a home or family is not always immediately obvious; and that hope and wariness, need and conscience, often compete inside those who seek a safe space to call home.
Though a work of fiction, this book deals with trauma and trauma reactions in children, and addresses issues of runaways, sexual and physical abuse, disability, grief, stigma, vulnerability, injustice and the complex realities so many children and teens face and need support with.
Although the book is targeted at teens and young adults, it may well be relevant to therapists working with at-risk populations, as well as to parents and caregivers.
This book is available on Amazon in both print and kindle versions. It is also available on other ebook formats on iBooks, Nook, kobo, etc.
https://www.amazon.com/Apples-Applath-Naama-Yehuda-ebook/dp/B077CWN3PG
Remember to use your Amazon Smiles account and select ISSTD as your charity!

Have News ISSTD Can Use?
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: 15th of the month
ISSTD News Contacts:
•ISSTD Editor, Kate McMaugh: katemcmaughpsychology@gmail.com

2018 Annual Conference

Annual Conference Preliminary Schedule

The online Conference Program for the ISSTD 35th Annual Conference is now available! Take a look at all of the amazing training opportunities and register to join us in Chicago in March!

To view the complete online program, click here!

For more information on Pre-Conference Workshops, Chicago attractions, and hotel and travel information, take a look at our Conference Website!

Early Bird Prices are available until 15 February 2018!

Special discounts on Hotel Reservations are available until 19 February 2018. Click here for more information!

Please note that this schedule is preliminary and will be updated.

Register Now!

PRE-CONFERENCE: MARCH 22-23
MAIN CONFERENCE: March 24-26
Hilton Palmer House Hotel | Chicago

Publications of Interest

Publications of Interest

Dear Colleagues

This quarter our Publications of Interest focuses on the role of shame in trauma and dissociation. Within this broad theme we bring you six articles which we hope you will find interesting.

You may notice, I am not the POI Editor. We are still looking for a new POI Editor. So, if you like new information on treatment and science, if you hang out to read the latest articles, this job is for you, and is an interesting and relatively easy way to contribute to ISSTD. Once a quarter you’d pick a topic you are interested in and find us links to 5-8 articles of your choice. In fact, the only pain is reducing it to such a low number! You don’t need to review the articles, just record the information. Have a look below and if this interests you contact me on: katemcmaughpsychology@gmail.com.

Kind Regards

Kate McMaugh
ISSTD News Editor (NOT POI Editor!)

Highlighted articles on Shame, Trauma and Dissociation for 2017

Platt, Melissa G.; Luoma, Jason B.; Freyd, Jennifer J. (Jan 2017) Shame and Dissociation in Survivors of High and Low Betrayal Trauma, Journal of Aggression, Maltreatment & Trauma; Abingdon, V26 (1): 34-49.
http://dx.doi.org/10.1080/10926771.2016.1228020

Shame and dissociation co-occur in trauma survivors. Bypassed shame theory posits that dissociation reduces pain by interrupting shame. We tested this theory by inducing dissociation. The hypothesis that higher baseline shame would predict larger increases in dissociation following the induction was marginally supported. However, in contrast to bypassed shame theory, shame scores increased rather than decreased following the induction. An alternative theory, betrayal trauma theory (BTT), proposes that dissociation reduces awareness of betrayal to protect a needed relationship. Shame might also serve this function. We aimed to replicate prior research indicating traumas higher in betrayal (HBT) are uniquely related to both shame and dissociation compared to traumas lower in betrayal (LBT). The hypothesis that HBT would relate to higher shame was supported. The results suggest that other explanations than bypassed shame theory, such as BTT, might better account for the relationship between shame and dissociation in trauma survivors.
Free Access Article: http://dynamic.uoregon.edu/jjf/articles/plf2017.pdf

Cunningham, Katherine C; Davis, Joanne L Wilson, Sarah M Resick, Patricia A (October 23, 2017). A relative weights comparison of trauma-related shame and guilt as predictors of DSM-5 posttraumatic stress disorder symptom severity among US veterans and military members. The British Journal of Clinical Psychology, Oct 2017

Abstract

OBJECTIVES: Veterans and military service members have increased risk for post-traumatic stress disorder (PTSD) and consequent problems with health, psychosocial functioning, and quality of life. In this population and others, shame and guilt have emerged as contributors to PTSD, but there is a considerable need for research that precisely demonstrates how shame and guilt are associated with PTSD. This study examined whether a) trauma-related shame predicts PTSD severity beyond the effects of trauma-related guilt and b) shame accounts for a greater proportion of variance in PTSD symptoms than guilt.

DESIGN: We collected cross-sectional self-report data on measures of PTSD symptom severity based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, trauma-related shame, and trauma-related guilt via online survey.

METHOD: Participants included 61 US veterans and active duty service members. Hierarchical multiple regression and relative weights analysis were used to test hypotheses.

RESULTS: In step 1 of regression analysis, guilt was significantly associated with PTSD. However, when shame was added to the model, the effect of guilt became non-significant, and only shame significant predicted PTSD. Results from relative weights analysis indicated that both shame and guilt predicted PTSD, jointly accounting for 46% of the variance in PTSD. Compared to guilt, trauma-related shame accounted for significantly more explained variance in PTSD.

CONCLUSIONS: This study provided evidence that among US veterans and service members, trauma-related shame and guilt differ in their association with PTSD and that trauma-related shame, in particular, is associated with the severity of PTSD.

PRACTITIONER POINTS: Trauma-related shame and guilt explained almost half of the observed variance in PTSD symptom severity among this sample of US military veterans and service members. Trauma-related shame and guilt each made a unique contribution to PTSD severity after accounting for the similarity between these two emotions; however, shame was particularly associated with increased PTSD severity. These results highlight the importance of assessing and addressing trauma-related shame and guilt in PTSD treatment among military populations. We suggest that emotion- and compassion-focused techniques may be particularly relevant for addressing trauma-related shame and guilt. Limitations of the study Cross-sectional data does not allow for determination of causal relationships. Although sufficiently powered, the sample size is small. The present sample self-selected to participate in a study about stress and emotions.

Correspondence author: Katherine Cunningham: katherine-cunningham@utulsa.edu
Dyer, Kevin F W, Dorahy, Martin J, Corry, Mary, Black, Rebecca, Matheson, Laura, Coles, Holly, Curran, David, Seager, Lenaire, Middleton, Warwick (March 2017). Comparing shame in clinical and nonclinical populations: Preliminary findings.  Psychological trauma : theory, research, practice and policy Vol. 9(2), 173-180.

Abstract

OBJECTIVES: To conduct a preliminary study comparing different trauma and clinical populations on types of shame coping style and levels of state shame and guilt.

METHODS: A mixed independent groups/correlational design was employed. Participants were recruited by convenience sampling of 3 clinical populations-complex trauma (n = 65), dissociative identity disorder (DID; n = 20), and general mental health (n = 41)-and a control group of healthy volunteers (n = 125). All participants were given (a) the Compass of Shame Scale, which measures the four common shame coping behaviors/styles of “withdrawal,” “attack self,” “attack other,” and “avoidance,” and (b) the State Shame and Guilt Scale, which assesses state shame, guilt, and pride.

RESULTS: The DID group exhibited significantly higher levels of “attack self,” “withdrawal,” and “avoidance” relative to the other groups. The complex trauma and general mental health groups did not differ on any shame variable. All three clinical groups had significantly greater levels of the “withdrawal” coping style and significantly impaired shame/guilt/pride relative to the healthy volunteers. “Attack self” emerged as a significant predictor of increased state shame in the complex trauma, general mental health, and healthy volunteer groups, whereas “withdrawal” was the sole predictor of state shame in the DID group.

CONCLUSIONS: DID emerged as having a different profile of shame processes compared to the other clinical groups, whereas the complex trauma and general mental health groups had comparable shame levels and variable relationships. These differential profiles of shame coping and state shame are discussed with reference to assessment and treatment.

Holl, Julia; Wolff, Sebastian; Schumacher, Maren; Höcker, Anja; Arens, Elisabeth A, Spindler, Gabriela; Stopsack, Malte; Südhof, Jonna; Hiller, Philipp; Klein, Michael; Schäfer, Ingo; Barnow, Sven (Aug 2017) Substance use to regulate intense posttraumatic shame in individuals with childhood abuse and neglect, Development and Psychopathology; Cambridge, 29 (3), 737-749.

Abstract
Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (trauma SUD group), healthy controls with CAN (trauma HC group), and without CAN (non-trauma HC group). Multilevel analysis showed a positive linear relationship between high intensity of both emotions and substance use for all groups. The trauma SUD group showed heightened substance use in low, as well as in high, intensity of shame and sadness. In addition, we found an interaction between type of emotion, intensity, and group: the trauma HC group exhibited a fourfold increased risk for substance use in high intense shame situations relative to the trauma SUD group. Our findings provide evidence for the drinking to cope model. The trauma SUD group showed a reduced distress tolerance for variable intensity of negative emotions. The differential effect of intense shame for the trauma HC group emphazises its potential role in the development of SUD following CAN. In addition, shame can be considered a relevant focus for therapeutic pre-interventions and interventions for SUD after CAN.

Dorahy MJ, Gorgas J, Seager L, Middleton W (Nov 2017) Engendered Responses to, and Interventions for, Shame in Dissociative Disorders: A Survey and Experimental Investigation. Journal of Nervous and Mental Disease ;205(11):886-892.

Abstract
This study examined shame and responses to it in adult dissociative disorder (DD; n = 24) and comparison psychiatric (n = 14) samples. To investigate how helpful different therapeutic responses are after shame disclosures in therapy, participants heard two vignettes from “mock” patients disclosing a) shame and b) surprise. Participants rated the helpfulness of five potential responses. Interventions covered withdrawing from the affect (withdrawal focused) to feeling it (feeling focused), with other interventions on cognitions (cognitive focused), management strategies (management focused), and previous experiences (history focused). The DD sample reported higher characterological and bodily shame, and more shame avoidance and withdrawal. There was no difference across groups for intervention ratings. For shame, interventions focused on feelings, cognitions, or previous shame experiences were deemed most helpful, but this was qualified by experiencing dissociation while hearing the script, where the history intervention was reported less helpful. Exposure to shame while monitoring dissociation should accompany therapy for DDs.
McCarthy-Jones, Simon (Aug 2017): Is Shame Hallucinogenic? Frontiers in psychology Vol. 8,  1310.

Abstract
Research into the causes of “hearing voices,” formally termed auditory verbal hallucinations (AVH), has primarily focused on cognitive mechanisms. A potentially causative role for emotion has been relatively neglected. This paper uses historical and contemporary case studies of AVH to tentatively generate the hypothesis that shame can be a causal factor in the onset of AVH. Other sources of support for the generation of this hypothesis are then sought. First, evidence is examined for a role of shame in the etiology of post-traumatic stress disorder, a condition that is characterized by phenomena related to AVH (intrusions and dissociation) and in which a substantial minority of sufferers report AVH. Second, the effect on AVH of a psychological therapy specifically designed to counteract shame(Compassion Focused Therapy) is noted. The hypothesis generation process is then expanded to propose mechanisms that could mediate a relation between shame and AVH. It is proposed that employing absorbed or avoidant strategies to deal with shame may lead to AVH through mediating mechanisms such as rumination, suppression, and dissociation. Evolutionary reasons for a relation between shame and AVH are also proposed, including that AVH may be an evolved mechanism to encourage self-protective behaviors in the wake of trauma. It is concluded that existing research supports the generation of this paper’s hypothesis, which is now worthy of dedicated empirical testing.
Free Access Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541028/pdf/fpsyg-08-01310.pdf

Other Relevant Articles (no abstracts available)
Ken Benau (May 2017). Shame, Attachment and Psychotherapy: Phenomenology, Neurophysiology, Relational Trauma and Harbingers of Healing, Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, 11 (1), pp 1-27
Richard A Chefetz (August 2017) Dignity is the Opposite of Shame and Pride is the Opposite of Guilt, Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, 11 (2), pp 119-133

Trauma & Dissociation in the News

35th Meeting of the Interpol Specialists Group on Crimes Against Children – Lyon, France 13-17 Nov 2017

Dr. Michael Salter, PhD

I recently attended the annual meeting of the Interpol working group on crimes against children, which brings together police, non-government organisations and others from around the world to share their experience and developments in the prevention, investigation, prosecution and management of child abuse. The efforts of the Specialists Group have increasingly turned to online child sexual exploitation and the disruption of child abuse material. I was asked to attend and present a seminar based on my research on adult survivors of organized child sexual abuse.

The conference was held at Interpol headquarters in Lyon, France. Attendees came from all around the world, and the conference was held in a room surrounded by soundproofed booths for translators. As presentations were given in a variety of languages, we all used headsets to access real-time translation. The conference was structured around four sub-groups: child victim identification, internet-facilitated crimes against children, serious and violent crimes against children, and sex offender management. It was heartening to see the level of activity and commitment evident in combatting child abuse around the world.

There was a clear distinction between the child abuse challenges facing middle and low income countries, such as Kenya or Thailand, and those facing high income countries such as Canada and the United States. Representatives from lower income countries spoke about the difficulties of sustaining basic child protection infrastructure to address the prevalence of abuse and neglect, including increasingly complex forms of child sexual exploitation from perpetrators at home, abroad and online. These presentations highlighted significant resourcing problems for developing countries in preventing and investigating child abuse, and the need for ongoing international aid and collaboration.

In contrast, police and non-government representatives from high-income countries discussed high-tech interventions in online child abuse, including the development of artificial intelligence and algorithms to detect and remove child abuse material, and assist in the identification of victims. Their focus on online exploitation and technological interventions is indicative of the considerable investment of police resources in internet safety over the last twenty years, led by public concern in Western countries about online child abuse offenders. While policing efforts in this arena have led to important breakthroughs in online detection and disruption of abuse, there has not been an equivalent response to the evidence that most abuse networks operate ‘face to face’ even where they use technology in abuse. The fields of social work, mental health and child protection were notably absent from these presentations.

My seminar on the final day of the conference was based on my research with over 40 adult survivors of organized sexual abuse, and 20 mental health professionals who specialize in their care. I focused on the circumstances in which organized abuse takes place, the types of maltreatment that victims are subjected to, and the challenges and opportunities that organized abuse poses to law enforcement. In particular, I emphasized the considerable expertise on organized abuse held by specialist mental health practitioners, such as those members of the ISSTD RAMCOA special interest group. While there are specialists in organized abuse in policing and mental health, there has been limited exchange between these two groups. I also flagged the need for a therapeutically informed style of policing and prosecution of serious child sex offences, since rigid or inappropriate criminal justice processes are frequently intolerable or revictimising for adults or children with a dissociative disorder.

Increased law enforcement awareness of child abuse material, due to its ubiquity on the internet, has in many ways validated the long-standing work of clinicians in the trauma and dissociative disorders fields. Online child abuse material provides incontrovertible evidence for those forms of abuse and exploitation that severely victimized children and adults have been disclosing for decades. While the online distribution of this material needs to be investigated and prosecuted as a serious offence, it is symptomatic of the broader, and as yet, inadequately addressed problem of abuse and exploitation. I left the conference with a clearer vision of the work that still needs to be done in addressing ‘offline’ as well as ‘online’ child sexual exploitation, in high income countries such as my own as well as in the developing world.

Volunteer

Volunteer Spotlight

Rochelle Sharpe Lohrasbe – Chair of Social Media Sub-Committee

Tell us a bit about yourself
I think I have been a wanderer, though not lost. I took many backdoor routes on this journey of learning, exploring and working with Trauma and Dissociation. I got my first exposure to the realm of trauma and dissociation through personal experience. Then later, as a student psychiatric nurse aged 19 years old, I was posted to a male maximum security ward and assigned to complete court-ordered assessments on men with mental illness who came into conflict with the law.

My next assignment took me to a juvenile forensic psychiatric unit to complete the same tasks. I stayed in forensic psychiatry for about 8 years before shifting to a private practice. There I worked with clients who represented the other side of the trauma coin: the victims/survivors. I got to see trauma (and dissociation) from both sides, but also realized the “offenders” also arose from traumatic/adverse experiences. From these early experiences, I became fascinated with states of mind (and being).

I also started a Master’s degree where I could explore risk, vulnerability, and resilience – more of what we know as ACEs now. I continued with academic explorations of growth and development, as I reasoned that early life had not only the potential to harm but also to create grit in a person. I became enthralled in how to work with traumatic experience and to helps others find resolution. Although initially trained in Rogerian and Psychodynamic approaches, EMDR and Sensorimotor Psychotherapy have become much more significant in the current incarnations of my practice. They and their theoretical underpinnings have become my home base for case conceptualization.

Tell us something most of us may not know about you?
I love the ancient art and craft of Bonsai: The miniaturization of living trees. It has taught me patience. In fact, I have had this strange attraction to the miniature realm since I discovered trial sized products as a child.

What is your volunteer role in ISSTD?
I am the current chair of the social media sub-committee.

What led you to volunteer?
This has been a two-pronged approach between friends and colleagues identifying a need within ISSTD, and my desire to do what I can to contribute.

As an early adopter (for my generation) of technology, I see and appreciate not only the contribution of technology, but can also envision its potential to support ISSTD goals and initiatives, quickly disseminate information, and to educate our membership and the public about Trauma and Dissociation. For me, this is an easy way to give to the broader scope and help more people.

What’s good about volunteering? What do you get from it?
In a world where trauma can bring people down, the camaraderie, the connection to like-minded people, within ISSTD, is inspiring. It helps sustain me during the hard hours of sitting alone with client experience in private practice. In this industry (and sadly mental health care has become an industry), I have encountered organizations who play the elitist card, where learned and respected individuals hold their knowledge and expertise close. At ISSTD, I have experienced very little of this elitism. The learned scholars, the seasoned clinicians, and the up and coming, meet together to share information, to debate theory and concept, to challenge conventions and welcome innovation, in the service of their client’s well being, rather than personal gain and prestige. For this, I have respect.

Would you like to help ISSTD and our trauma clients through social media?

Do you have a social media affinity? Perhaps you would like to promote ISSTD and relevant clinical issues through the discussion forums of LinkedIn? Or do you dream of moderating a discussion list? Or have you always dreamt of developing a blog for the public on topics relevant to ISSTD? Do you have a completely new idea?

We could use more social media exposure across our three audiences:
(1) Existing members;
(2) potential members/referral sources/professional affiliates, and
(3) the public, including potential clients as well as the public in general.

We would love the assistance of creative people with a passion for social media. If you are interested please contact me on: rochelle@resilutions.com

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