2018 Annual Conference

Congratulations to the 2018 ISSTD Annual Award Winners!

Those of us who work in the trauma and dissociation field are a prolific, creative and hard-working lot. In the last year, many articles, books and book chapters have been written about complex trauma and dissociation. Research has been creative, inquisitive and critical. Clinical practice and training has expanded, and some of us have expressed ourselves through the creative arts. Others have worked hard behind the scenes to help ISSTD operate efficiently, and to grow in new areas.

Naturally, we want to encourage all this and show our appreciation.

This is where the Awards Committee comes in. The Awards Committee is composed of senior members of the Society who have an in-depth knowledge of the Society and the wider field, as well as an awareness of those who contribute directly to the Society. We are privileged to have Onno Van der Hart, Rich Chefetz and Steve Frankel on our Awards Committee, ably assisted by Lynette Danylchuk (and others, as co-opted). We are most grateful for their efforts.

Each year during October- December they receive nominations for the awards in all categories, evaluate each and then make a decision about Awards, all before our Annual Conference in March.

As Rich Chefetz said last October when he called for nominations for this year’s awards: “Lean in to the reality of making somebody feel real, special, appreciated.”

Well, lots of you did just that. We are happy to announce this year’s winners.

Therese O. Clemens Advocacy Award
Therese O. Clemens

Lifetime Achievement Award
presented to
Professor Warwick Middleton, M.D.

Lifetime Achievement Award
presented to
Colin A. Ross, M.D.

Lifetime Achievement Award
presented to
Joan A. Turkus, M.D., D.L.F.A.P.A.

Cornelia B. Wilbur Award
presented to
Milissa Kaufman, M.D., Ph.D

Morton Prince Award for Scientific Achievement
presented to
Dr. Michael Salter

Pierre Janet Writing Award
presented to
Daniel P. Brown, Ph.D.

Pierre Janet Writing Award
presented to
David S. Elliott, Ph.D.

Media Award – Audio Visual
presented to
Despina Noula Diamantopoulos

Media Award – Written
Hon. Justice Peter McClellan AM
Hon. Justice Jennifer Coate
Commissioner Bob Atkinson AO APM
Commissioner Andrew Murray
Commissioner Helen Milroy
Commissioner Robert Fitzgerald AM
Gail Furness SC

David Caul Award
presented to
Tuba Mutluer, M.D.

President’s Award of Distinction
Presented to
D. Michael Coy, M.A., LICSW

President’s Award of Distinction
presented to
Kate McMaugh

Student Award
Jonathan D. Wolff

Student Award
Abigail Percifield

ISSTD Fellow
Sheldon Itzkowitz, Ph.D, ABPP

ISSTD Fellow
Dolores Mosquera, Psy

ISSTD Fellow
Dr. Valerie Sinason, Ph.D MACP MInstPsychoanal FIPD

Taylor and Francis Richard P Kluft Award
Mentalization and Dissociation in the Context of Trauma: Implications for Child Psychopathology
Volume 18 Issue 1 (2017)
Karin Ensink PhD, Michaël Bégin BA, Lina Normandin PhD, Natacha Godbout PhD & Peter Fonagy PhD

Poster Award
A Look into Peritraumatic Dissociation in Childbirth-Evoked Posttraumatic Stress
Freya Thiel

Letter From The President

Updates & Opportunities

Kevin Connors, MS, MFT

Greetings ISSTD

We’re closing in on the final arrangements for our 35th Annual International Conference; Bridges to the Future scheduled for March 22nd through the 26th. I remember, as a kid, hearing television announcers remark that guests of Chicago based shows were staying at the historic Palmer House Hotel. I am so excited that we will be using that storied and beautiful hotel as the venue for this year’s conference.

If you haven’t yet made your reservations, be sure to do so as soon as possible. Hotel Reservation

I want to share a few conference highlights with you.

On Friday evening as you are all checking in we have two activities to make the evening and the conference experience much more enjoyable. For those new to our conference, we are holding a “New Participants’ Orientation at 6:30 on Friday evening. We’ll go over several key points to help those who might not be familiar with the rich and diverse parade of workshops, forums, symposia, and paper sessions all going on simultaneously. Helpful tips and important information will be shared. If you have colleagues who are first time attendees, be sure to let them know about this helpful meeting.

Meanwhile, later on Friday evening, from 7:00 to 9:00 pm, Tally Tripp will help us meet & greet everyone with our “Create and Connect” networking event. For a mere $25 you get the opportunity to join with friends as they arrive, tap into your creative parts, and share a drink with colleagues. (Did I mention that you get a drink coupon with the entry fee?) Registration for this event closed on March 5th, but there will be a limited additional number of tickets for sale on-site at the conference.

On Saturday afternoon, in addition to the regular academic content, we are offering our very first Professional Training Program Faculty Workshop. For those who are current ISSTD PTP Faculty or those interested in becoming a PTP faculty member, this workshop is essential. Su Baker and Joan Turkus will lead this first time workshop, offering their wisdom and experience in teaching tips and techniques. For more information on this workshop, click here!

Also on Saturday, we are holding our Student & Emerging Professionals Luncheon to welcome students and those new to clinical practice and to address their questions and concerns. We will be going off-site to sample some of Chicago’s fantastic pizza. Check in at the Society Lounge in the Exhibit Hall during the morning breaks to find out where we’ll be going.

Saturday evening, after the classes are done, we’ll still be going strong. From 5:00 to 6:00 will be our Poster Session offering you a chance to learn about interesting and important studies. The Poster Session blends into our President’s Reception where we have another opportunity to network and connect, to share thoughts and reacquaint ourselves with friends we only see once a year.

The President’s Reception leads into the Awards Dinner where we gather to acknowledge and honor people within our Society and within the field of Complex Trauma and Dissociation for how they have helped further our efforts. Join us in celebrating their work and in appreciating each other for all we do in helping and healing.

Sunday brings even more opportunities for connecting and networking. (I’m sensing a theme here.)

At lunch time there are several opportunities to explore different groups that ISSTD sponsors. Our Special Interest Groups will each have a room set aside where people can break bread and connect names to face as each group discusses issues important to them. Again, check in at the Society Lounge during the morning break to find out where the different SIGs will be meeting.

If you don’t have a special group meeting to attend, you can join plenary speaker Edward Tick who will be giving a reading of his poetry in the Society Lounge during the lunch break.

Note: All of these lunches are BYOB. So grab a To-Go lunch from a restaurant in the hotel or from one of the many eateries near to the venue and get back quickly to take part in in the activity of your choice.

Sunday evening, before the day wraps up, we hold our Annual Town Hall Meeting: Focusing on the Future of ISSTD and the field of Trauma & Dissociation. Bring your suggestions as to where you would like to see us going and your ideas on how to get there. This is a unique opportunity to share what is important to you and to help influence our discipline.

More ideas on how to maximize your conference experience can be found in another article here in the ISSTD News.

Website Update:
An on-going survey of new and established members has shown that the #1 issue people would like to see changed is an updated ISSTD website. Your Board of Directors is in complete agreement. Our website is our public face and often the first thing that people see when searching on-line for information about dissociative disorders.

We have charged D. Michael Coy LCSW, our new treasurer, with spearheading this overdue and much needed update. In last month’s ISSTD News he summarized the work ahead of us. Check out the article here!

However, as he noted and I must remind us, this level of over-haul does not come cheap. ISSTD has spent most of the last decade digging out from near financial collapse. We accomplished this gargantuan task by being extremely careful and financially conservative in any new expenses.

In order to raise the funds necessary for this important upgrade, we need to greatly supplement the limited revenue generated by our current projects. Therefore, we have recently launched our $35 for the 35th campaign. If we could get each member to donate $35 towards renovating our website, we would be able to complete this project in short order. If you believe that the work we do is critical to our clients and to the field of traumatology, please join me by making a small contribution here. Thank you for all you do to make our clients’ lives and our world a better place.
See you in Chicago!!!!


News You Can Use

News You Can Use

Kate McMaugh, Editor, ISSTD News

Leading Australian Complex Trauma Service Launches Paper on Trauma and Memory
As Australia’s ground-breaking Royal Commission into Institutional Responses to Child Sexual Abuse draws to a close, Australia continues to forge ahead with advocacy in the field of complex trauma.

Australia’s Centre of Excellence in Complex Trauma, the Blue Knot Foundation has launched a paper on the topic of memory and trauma. The paper, entitled The Truth of Memory and the Memory of Truth: Different Types of Memory and the Significance for Trauma is co-authored by ISSTD Members Dr Pam Stavropoulos and Dr Cathy Kezelman.

The paper was launched by Mark Tedeschi AM QC, the Senior Crown Prosecutor for New South Wales on 23 February in Sydney at the 20th Annual TheMHS Summer Forum, a two day conference exploring the impact of trauma on mental health. Speakers at the Summer Forum included ISSTD Immediate Past President, Professor Martin Dorahy and Dr Pam Stavropoulos, member of the Advisory Board of the ISSTD Scientific Committee, as well as other leading researchers and clinicians from the complex trauma field in Australia and New Zealand.

The paper aims to explain some of the complexities of memory and trauma to the general public, the media and policy makers and practitioners from all fields. It is a timely release, as there is confusion about trauma and memory among some professional groups, as well as the wider community. Much false information is circulated and this impacts negatively on both clients and therapists.

Broad in scope, the paper covers topics such as: different types of memory; the impact of trauma on memory; somatic memory; the protective role of ‘forgetting’; and recovered memory.

The Truth of Memory and the Memory of Truth is not a dense, academic document, but is instead a readable, general overview which references popular and accessible trauma books such as Levine’s Trauma and Memory. It promises to be accessible to a wide audience and will provide much-needed community education and serve as a valuable advocacy tool.

The paper, which is just as applicable to an international audience as it is to an Australian audience, is available here: https://www.blueknot.org.au/ABOUT-US/Our-Documents/Publications

In addition, to complement this document, the Blue Knot Foundation has also released a series of facts sheets on Trauma and Memory. There are five facts sheets in total, all available at https://www.blueknot.org.au/Resources/Fact-Sheets/Memory-factsheets

Significant New Book Exploring Victim-Perpetrator Dynamics

Leading ISSTD Members, including past Presidents Warwick Middleton MD and Martin Dorahy PhD, along with board member Adah Sachs PhD, have co-edited a volume of work exploring victim-perpetrator dynamics. This volume was originally published as a special double edition of the Journal of Trauma & Dissociation in 2017.

The book contains contributions from leading thinkers and writers in the field, including many members of ISSTD. It is worth noting that five of the contributing authors have been presidents of the ISSTD in the past, and indeed two of the Editors are our most recent previous Presidents.

As the title suggests, the focus of this book is on exploring victim-perpetrator dynamics and it does so with great breadth and depth. Topics covered include dissociative processes in intimate partner violence; treatment strategies for programming and ritual abuse; organised abuse; betrayal trauma; mother-child incest; attachment dynamics; and the impact of dissociation and chronic shame, amongst many others.

The book is available for purchase this month. Information is available from the publishers Routledge https://www.routledge.com/The-Abused-and-the-Abuser-Victim—Perpetrator-Dynamics/Middleton-Sachs-Dorahy/p/book/9780815380115

Welcome ISSTD New Members – February 2018!

Jennifer Allran
James Asbrand
Joan Boyd
Marc Bush
Kevin Drab
Meira Ellias
Nancy Ellis
Jean Gargala
Amanda Hansen
Jennifer Jacyszyn
Beta Leung
Joyce Mojica
Sue Moran
Rita Petersen
Debora Romeo
George Abbott
JoAnne Clark
Johanna Dobrich
Lisa Rocchio
Tammy Rovane
Pamela Sobo
Andre Monteiro
Andrea Kremer
Christianna Flynn-Christianson
Anna Fogarty
Alena Kryvanos
Lori Woehler

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: 20th of the month

•ISSTD Editor, Kate McMaugh: katemcmaughpsychology@gmail.com

Regional Conferences

International Conference on Developmental Trauma & Dissociation 2018!

ISSTD is pleased to join with CTC Psychological Services for a special conference in the UK at the luxurious Grosvenor Hotel and Spa in the heart of the beautiful and historic city of Chester!

The conference will take place June 23-24, 2018, from 9:00AM – 4:30PM.

2018 sees both the 30th anniversary of CTC Psychological Services and the 35th anniversary of the ISSTD. To celebrate, we are presenting a two-day conference featuring four incredible keynote speakers: Richard Chefetz, Martin Dorahy, Ruth Lanius, and Joyanna Silberg.

Of key focus will be the work CTC undertakes as an Adoption Support Agency with adopted children and their families. Highlighting the impact of trauma on cognitive and emotional development, as well on the body, presentations will offer a variety of therapeutic approaches to both the impact and remedy of unresolved Developmental Trauma.

The conference will also feature two days of parallel sessions (papers and workshops).

For more information on conference fees, check out the conference flyer!

To register, email conference@ctcps.co.uk


Board Briefs

The Latest News From Your Board

Willa Wertheimer, PsyD

The ISSTD Board is a busy group of members who meet every month for 90 minutes, to oversee the activities of the Society and drive many projects to help our Society grow and develop. Here are some of the newest developments.

The Board has been overseeing our growing conference program and planning well-ahead for a busy schedule. This year there will be regional conferences in New York City, Hobart, Australia, and Chester, United Kingdom.

We also continue our conference collaboration with ESTD. Our Immediate Past President, Dr. Martin Dorahy recently attended the ESTD conference in Bern in 2017, and met with the ESTD Board to provide updates on current joint projects, most pressingly the joint research task force. The president of ESTD, Andrew Moskowitz, will be speaking to us in Chicago, at the upcoming conference. In turn, the President-Elect of ISSTD, Christine Forner, will be presenting at the ESTD Conference in Rome in 2019.

The time is growing near and we are all quite excited about the upcoming 35th Anniversary Annual Conference in Chicago. Not only is there a great variety of seminars and skill-building inspirations, but many of us will see each other once again, from “all four corners” of the world. It is always so wonderful to see old friends and make new ones. It is a chance for emerging professionals and students to meet the leaders in our field of study.

At the conference we are looking forward to sharing the results of The Past Presidents Project, a collection of interviews with former presidents of ISSTD. Their perspectives, wisdom and stories of our history is a not-to-be-missed feature this year. This presentation will also be available later to members unable to attend the conference.

UN Collaboration
Internationally, we continue our active collaboration with over 4,000 other non-government organizations (NGO’s) via our Special Consultative Status at the UN’s Committee on NGO’s. We are working together in a connective and relational world to heal the effects of trauma.

The development of a new EMDR training module has been developing at a steady pace. The faculty of our expanding Professional Training Program has been increased. We now will have a much further reach, providing professional development to clinicians around the world. We have both in-person training, as well as teleseminars and asynchronous online courses. Our webinar program is expanding to include all-day programs such as the recent Ritual Abuse, Mind Control, Organized Abuse (RAMCOA) Webinar. We also now are pleased to offer connection via the new Creative Arts Therapy SIG. There, ideas for interventions take on a whole new language!

Other Activities
I will mention again, our Virtual Book Club, which this year has studied several books as well as articles. The Board has also been delighted to launch ISSTD’s new clinical e-journal Frontiers in the Psychotherapy of Trauma & Dissociation. If you have not already done so, check out the latest edition by logging in to Member’s Corner and clicking on the Frontiers image at the top right of the page.

These are the latest headlines of what the Board has been working to provide. We are striving to offer a rich and multifaceted array of educational opportunities to trauma clinicians around the world. Our next Board meeting will be face to face in Chicago.

Spring is around the corner, the beginning of a fresh new season of energetic ideas.

Warm Regards,

2018 Annual Conference

Conference Pro Tips: Insider Hacks

Kevin Connors, MS, MFT

Greetings Gentle Reader,

In this article, the members of the Conference Committee thought we would share with you some tips and “insider information” that might enhance your time attending our conference.

Come early and locate the workshop rooms in the hotel. Orient yourself.

Go over the conference program and note the workshops that appeal to you.

If you have questions about workshops, visit the Society Lounge and talk to the people who are there – they are ISSTD members, Committee Chairs, and Board members who are there to help you.

Don’t feel bad if you can’t get to all of the workshops you’d like to attend. Pick the one that fits best for the day – all of the workshops are recorded, and you can listen to the rest at home.

Sit up front.

Dress is usually business casual; although some prefer a more business formal, especially if they are presenting. Whatever you choose, dress comfortably and in layers. Temperatures in the different break-out rooms can vary quite a bit and getting hotel staff to adjust the thermostats can take time.

Hydrate. The air conditioners in the hotel tend to make the air dryer than normal and when one is spending most of several days inside, we need to keep up the “healthy” fluid intake.

Snacks at the refreshment breaks are just that; snacks. In the morning, there will be coffee & hot water for tea, some juice, and the occasional pastry. Afternoon breaks are usually just beverages, coffee, tea, maybe sodas or juices. If you want a more filling breakfast or afternoon nosh, there is the hotel restaurant, a Starbucks within the hotel, and several eateries within walking distance of the hotel.

Talk to the people near you whenever possible – introduce yourself and find
out who they are and where they’re from. Who knows, you may meet neighbors,
or people from far, far away. These are your colleagues.

Feel free to introduce yourself to others and to join into conversations. Feel free to ask questions. We are gathered together to “confer”. We already share one common bond in our commitment to learn about and share about the important work we do.

Check out the extra-curricular activities.

Attend the President’s Reception on Saturday Evening. This is a great opportunity to meet and greet and get to know new people. There will be a cash bar to get a refreshing adult beverage to help relax after the full day of exciting and stimulating presentations.

The ISSTD Special Interest Groups (SIGs) will be having “Bring Your Own” Lunch meetings on Sunday. If you’re interested in learning about and possibly joining one of the SIGs, now is the time to go.

Invite people to join you for lunch or dinner. Most of us are traveling alone and would love some company. I have watched a small dinner party grow to an exciting and animated group that has since grown into long-standing friendships.

Take time to unwind and process what you’re learning. This conference is so jammed full of innovative and inspiring content, it can be a bit overwhelming. Know when to take a break and re-charge your batteries.

Have we mentioned we are in Chicago? Maybe you want to plan an extra day to play tourist. A certain ISSTD President will be spending time at the Chicago Art Institute to visit some of his favorite Impressionist and Modern art pieces. Chicago is home to world class museums, the Shedd Aquarium, amazing architecture, and great pizza.

Be bold – ask questions, reach out to others, show up, and make the most of your conference experience.

Welcome to ISSTD. We’re glad you’re here!

Committee Spotlight

Virtual Book Club

Rick Hohfeler, PsyD, Joan Haliburn, MD, and Garrett Deckel, MD, PhD

Our Origins
Some years ago our past president Lynette Danylchuk envisioned an online space where ISSTD members of all levels of experience could join prominent authors in our field for discussion of cutting-edge, clinically relevant literature. The idea was brought to life in 2014 with the formation of the Virtual Book Club.

What We Do
As it was then, it still remains our mission to bring you a lively discussion of the latest and best publications relevant to clinical work in the trauma and dissociation field. This is a free benefit of membership in ISSTD and can provide invaluable professional development and networking opportunities at no extra cost.

The Virtual Book Club offers ongoing, on-line discussions between ISSTD members and the authors of the featured works. These discussions are conducted in a listserv format on our Basecamp platform. This means that you have the opportunity to ask questions, make comments, and become acquainted with leading thinkers in our field!

Discussions are moderated by three well informed and experienced clinicians, Rick Hohfeler PsyD, Joan Haliburn MD, and Garrett Deckel MD, PhD. We strive to provide you with 3-4 books each year and various journal articles that we feel are pertinent and potentially pregnant for lively discussion.

Time frames for each book/journal article are varied, but are designed to encourage a thorough discussion of the books and articles, depending on their length and density of content. For books each discussion period can range from four to ten weeks and articles from three to five days.

Our selections aim to serve all levels of expertise and experience in our field of practice as ISSTD is an inclusive society. We believe that the literature in our field represents some of the most fertile and versatile thinking in the practice of psychotherapy. By its very nature ISSTD has been on the cutting edge of psychotherapy of complex trauma for decades. Our Bookclub showcases this innovation in a welcoming and accessible way.

Writing in the field of trauma and dissociation has now has become even more prolific, with a surge of new literature. Because of this growing momentum, we feel even more committed to helping all of our members to keep growing along with this steep learning curve. The discussion format of the Book Club also keeps us united as a Society dedicated to the treatment of those suffering from severe abuse and neglect.

In our first four years we have featured a significant number of varied books and articles. Books have included:

  • The Child Survivor– Joy Silberg
  • Communicating Trauma– Na’ama Yehuda
  • Healing the Fractured Child– Fran Waters
  • Intensive Psychotherapy for Persistent Dissociative Processes– Rich Chefetz
  • Treating Complex Trauma and Dissociation– Lynette Danylchuk and Kevin Connors
  • Healing the Traumatized Self– Paul Frewen and Ruth Lanius
  • The Dissociative Mind in Psychoanalysis– Edited by Elizabeth Howell and Shelly Itzkowitz
  • The Way We Are– Frank Putnam
  • Traumatic Narcissism– Dan Shaw
  • Neurobiology and Treatment of Traumatic Dissociation– Ulrich Lanius, Sandra Paulsen, and Frank Corrigan
  • Treating Trauma-Related Dissociation– Kathy Steele, Suzette Boon, and Onno van der Hart

Upcoming Books
We will be kick-starting the bookclubs for 2018 very shortly and promise to bring you a year of studies just as rich and diverse as was offered in 2017.

Books planned for the near future include:

  • Understanding and Treating Chronic Shame– Patricia De Young
  • Complex Psychological Trauma: The Centrality of Relationship– Phil Kinsler
  • Dissociation, Mindfulness, and Creative Meditations– Christine Forner

And lest we forget some of the original and still relevant concepts in our field, we also plan to include some of the more timeless classic literature that we feel gives perspective to our field’s developmental trajectory.

Please join us as we put our collective minds together to discover, analyze, even critique new ideas that are being generated at a fast pace. Make sure you look out for updates in ISSTD News as we launch each new Bookclub event.

We also solicit your ideas for future books and journal articles that can be added to what we already have. Please send any ideas to

Rick – rhohfeler@altlig.com
Joan – jhalibur@bigpond.net.au
Garret – deckelmd@gmail.com

Members Clinical Corner

Commentary on Lisa Butler PhD & Oxana Palesh PhD, `Spellbound: Dissociation in the Movies’, JTD, Vol.5 (2) 2004, pp.61-88.

Pam Stavropoulos, Editor, Member’s Clinical Corner

Dear Fellow ISSTD Members,

For this edition of MCC I have taken the liberty, as MCC editor, of contributing a commentary myself. This is largely because despite a few invitations from both myself and ISSTD News Editor Kate McMaugh, few readers have volunteered to contribute a short commentary on a paper of their choice from any past issue of JTD or the new clinical e-journal, “Frontiers”.

So, in introducing my own commentary on this occasion (on Butler and Palesh’s 2004 paper `Spellbound: Dissociation in the Movies’) I would like to again invite ISSTD members to register your expressions of interest to write a short (1000-1500 word) commentary on any paper previously published in JTD or “Frontiers”.

Please don’t be intimidated! ISSTD News aims for a more casual and relaxed article than a formal journal article and, as highlighted above, submissions can also be much briefer than a typical journal article. You do not need to be an ‘expert’ on the topic. This an opportunity for peer comment and analysis… or even just some intellectual pondering on the topic. Perhaps you have always wanted to write a journal article, but haven’t known where to start? Well, start with us! As Editor I can work with you and help you shape and develop the article, if necessary.

If you are interested there is an archive of previous MCC articles on the Website (to access the archive, please log in to the ISSTD Member’s Corner and click on “Member’s Clinical Corner” on the left side of the screen) This archive is currently in the process of being updated, but will still give you an idea of previous content. In addition some more recent articles are available on the ISSTD News Website (MCC Archive)

Submission dates for commentaries can be quite flexible; it would be great at this point to hear from those of you who think you may like to write such a commentary anytime in the future. The beauty and pleasure of this task is that due to the vast array of papers accessible in the JTD archive, as well as the new journal “Frontiers”, your choice of topic is virtually limitless.

Please contact me directly pstavropoulos@iprimus.com.au if you think you may like to write a commentary for MCC at any time over the next twelve months.

One of several papers addressing the theme of dissociation in culture, `Spellbound: Dissociation in the Movies’ explores issues of interest to researchers and clinicians alike. As the lead author notes in her editorial for this special issue of JTD, at the time of writing (2004) consideration of culture represented, as far as she was aware, one of the first attempts `to explore dissociative experience across a variety of relatively common, and surprisingly normative, life activities’ (p.1). As such, it also foreshadowed and delineated recurring challenges in conceptualization of dissociative processes and phenomena. Over a decade later, the questions to arise remain salient.

Of all the cultural practices to which the lens of dissociation can be applied, what is more richly suggestive than that of movie making and viewing? In `Spellbound..’, Butler and Palesh advance the provocative thesis that film makers both examine and exploit `the plot-expanding possibilities that inhere in the topics of memory, identity, and multiplicity’ (p.61). In so doing, we are told, `film-making and film-watching experience rely on the audience’s innate understanding of dissociative phenomena’ (p.61).

The authors further contend that reliance on innate audience understanding of dissociation suggests `the pervasive nonpathological presence, integration and use of dissociative processes in everyday life’ (pp.61-62). Indeed, Butler and Palesh suggest that `the act of watching a film may be viewed as a voluntary engagement in a positive dissociative experience’ (p.61).

In considering this paper, it is helpful to attune to the organising perspective which underlies it. This is the `continuum’ model of dissociation to which other contributors to the special issue on culture and dissociation also subscribe. If, as Butler outlines in her introductory editorial, `mental disorders typically reflect alterations or perturbations in what are usually ordered processes, it would seem reasonable to look for the functional value of ordered dissociation in everyday life’ (Butler, 2004:4; original emphasis).

Intriguingly, Butler does this by identifying the `pathological counterparts’ of `three general varieties’ of dissociation in everyday life – namely, dissociation as `a forum for mental processing’, dissociation as `an escape’, and `positive dissociative experience as reinforcement’ (p.5). In the first case – that of dissociation as `a forum for mental processing’ – the normative experience of, for example, dreaming, has its pathological counterpart in the processing failures of intrusive, repetitive thoughts, flashbacks, nightmares, and traumatic re-experiencing (Butler, 2004:7, referencing Horowitz, 1986).

In the second case (dissociation as `escape’) the potentially restorative experience of distraction from daily life stress has its pathological counterpart in `involuntary immersion’ in maladaptive behaviours deployed to manage and potentially stave off disturbing affective states (p.8). In the third case, `positive dissociative reinforcement’ relates to the narrowing of focus in activities of personal significance of diverse kinds (and which potentially include `flow’ and `peak’ experiences). This variety of dissociation has its pathological counterpart in peritraumatic dissociation, in which the gratification afforded by self-efficacy is precluded by a challenge which `exceeds or overwhelms existing resources and capabilities’ (p.9).

The above is a fascinating encapsulation of the conceptual challenges posed by dissociative phenomena and processes. It repays consideration even if the reading of dissociation as `ubiquitous’ in `normative human activities’ (p.3) is contested. For Butler et al, the corollary is that `when voluntary phenomenal self-awareness is curtailed, when the full scope of internal and external reality is no longer engaged or accessible, when symptoms persist or reactions are overgeneralised, dissociation has become maladaptive’ (p.4).

The lead author of `Spellbound..’, as all contributors to this special issue of JTD on the topic of dissociation and culture, subscribes to the continuum model of dissociation according to which adaptive, non-pathological expressions fall at one end and dysfunctional, maladaptive manifestations at the other. This is a perception, we are told, which `both the classical and modern dissociation literature’ upholds (p.63).

As compelling as a continuum model of dissociation is, however, not all in the field subscribe to it. For example, van der Hart et al (2006) caution against too capacious a reading of dissociation, and seek to distinguish and preserve `structural’ dissociation from the many other and more benign forms of psychological experience to which adherents of the `continuum’ model lay claim. The Haunted Self was published after the issue of JTD in which `Spellbound’ appears. Nor was it the brief of Butler et al to examine the limits of a reading predicated on the pervasiveness of dissociation in everyday life.

Butler’s above described distillation of the `normative/pathological’ problematic remains enormously suggestive, and deserves wide citation for its succinct presentation of dilemmas we continue to debate. Nevertheless, while the `continuum’ understanding of dissociation remains powerful, it needs to be noted that not all in the field would agree with it.

So how does `Spellbound’ elaborate its contentions? Butler and Palesh contend that many Hollywood directors have `long intuitively recognised…and capitalized’ on recent epidemiological findings that dissociative experiences `are far more common to everyday experience than previously recognized’ (p.63). Referencing Greenberg and Gabbard (1999), a particularly interesting observation is the `mysterious parallelism’ between cinema and science as alternative but complementary sites for exploration of `the same inchoate notions about perception, consciousness and memory which arose synchronously in the collective mind-set because the time was ripe’ (p.76).

Not only is this a fascinating observation in its own right. It also evokes the disconcerting notion of popular culture (in this context via the medium of movies) as generator – albeit influenced by the findings of science – as well as contributor to conceptions of mental health.

As vehicles for portrayal of interior landscapes, movies possess a number of advantages. Film, say Butler and Palesh, `is the only medium in which time can be objectively expanded or condensed to parallel the subjective change in time perception commonly reported by trauma survivors’ (69) While home entertainment systems and a plethora of devices now challenge the monopoly of the multiplex, movies retain singular advantages in depicting the myriad complexity of psychic life.

Nor is it only trauma-related dissociation that movies compellingly convey. Of course audiences view movies for entertainment. But also not only for the purpose of pleasurable distraction. As Butler and Palesh (referencing Gabbard, 2001) point out – `audiences do not attend films merely to be entertained…. The screen in the darkened theatre serves as a container for the projection of their most private and often unconscious terrors and longings’ (p.73)

In addition to the 1945 Hitchcock thriller for which the paper is named (and which `conveys two major themes that have recurred in films since: the restorative potential of examining traumatic life events and the necessity of continuity in autobiographical memory for the maintenance of coherent identity’, p. 74) `Spellbound’ surveys a wide range of movies which, Butler and Palesh contend, presuppose dissociative experience even when it is not depicted in the plot line.

A major means by which this is achieved and exploited is via the mechanism of suturing, whereby `the filmgoer is able to connect and integrate separate scenes into a coherent narrative in spite of distinct story lines and cinematic editing cuts’ (p.61, referencing Silverman 1992). Successful suturing means that critical reflection and judgement is suspended, `viewers lose awareness of their surroundings and perceive the events on the screen as life-like’ (p.65). This is a process which `parallel[s] elements of some nonpathological dissociative experiences such as hypnotic states’ (p.65).

Unconscious processes including time disruption, depersonalisation, derealisation, and other dissociative indicators are portrayed with singular effectiveness by the medium of film, which, irrespective of the particular plotline, has a range of cinematic techniques at its disposal. Thus movies do not need to be `about’ dissociation per se (even as interestingly many are) to draw upon and amplify what Butler and Palesh contend to be the innate dissociative capacity and tacit acceptance of dissociative processes by audiences.

The plethora of movies surveyed in `Spellbound’ span a broad period. They include Three Faces of Eve [1957], Psycho [1960], The Manchurian Candidate [1962], Sybil [1976], Total Recall [1990], Color of Night [1994], The Matrix (1999); Fight Club [1999; there is a wonderful separate paper on this movie by Steven Gold in the same issue], Vanilla Sky [2001] and The Bourne Identity [2002], among others. In light of this `breadth rather than depth’, and the sheer scope of the authors’ key claims about the prevalence of dissociative phenomena and processes in everyday life, it might be surmised that Butler and Palesh draw too long a bow.

But this would be to misunderstand their intention. In inviting us to reflect on `the big screen dramatic elaborations of the smaller experiences many of us confront in daily life’ (p.80) Butler and Palesh challenge us to consider instances of normative dissociative more seriously. Correspondingly, they challenge us to explain why, and on what grounds, a vast array of everyday practices are not normatively dissociative if we want to contest their reading.

In `Spellbound’, Butler and Palesh contend that `the active pursuit of (nonpathological) dissociative activities…may represent a cornerstone of everyday existence – one so common and so second-nature, that its role in our lives has not been fully appreciated or examined empirically’ (p.67; original emphasis).

Even for those who disagree with the first part of this claim, it is hard at many levels to contest the second. In their enlivening account of the processes (and frequently plotlines) represented in and by movies, Butler and Palesh have also amply succeeded in highlighting conceptual challenges around dissociation which, well over a decade later, remain ongoing.

Butler, L.D. (2004) `The Dissociations of Everyday Life’, JTD, Vol.5 (2) 2004, pp.1-13.
Butler, L.D. & Palesh, O. (2004) `Spellbound: Dissociation in the Movies’, JTD, Vol.5 (2), pp.61-88.
Gabbard, G.O. & Gabbard, K. (1999) Psychiatry and the Cinema, 2nd edit, Washington DC, American Psychiatric Press.
van der Hart, Onno, Nijenhuis, Ellert & Steele, Kathy (2006) The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization, New York: Norton.

International Spotlight

The Trauma and Dissociation Field in the UK: Reflections on the Last 3 Decades

Sue Richardson, Attachment-based Psychoanalytical Psychotherapist, UK

(An earlier edition of this article was published in ESTD News, 2016. We thank ESTD for permission to publish this updated version.)

Introduction: Background history
In 1989 I found myself professionally isolated twice over. Firstly, as a result of being at the centre of the 1987 Cleveland child abuse crisis, in which the medical diagnosis of sexual abuse in 127 children led to a major public inquiry (Richardson and Bacon, 1991). Secondly, as a psychotherapist with adults disclosing extreme trauma. The way in which children and adults presented in both contexts introduced me to the world of dissociation. I read as much as I could on the subject and joined the ISSD (now ISSTD) but apart from the support of my psychotherapy training, at what is now the John Bowlby Centre, I felt very alone.

In a bid to overcome this, I contacted the eight UK members of the ISSD. Remy Aquarone and Jeanie McIntee responded and in 1990 the UKSSD was launched. In 2007 the organisation merged with the ESTD. The UK membership has since remained one of the largest groups in ESTD. In addition, the UK is one of the biggest member nations of ISSTD and membership includes a significant number of UK leaders in the field.

In my experience, the development of training and practice in the UK has gone in stages. Each stage has been subject to four influences: the impact of high profile cases; the initiative of individual practitioners; the role of experts by experience and the vicissitudes of the backlash, especially the memory wars.

Stage 1: The foundations
High profile cases of child sexual abuse throughout the UK in Nottingham, Cleveland, Orkney, Rochdale and Ayrshire meant that, however much the facts were disputed, the issue of childhood trauma was firmly established on professional, societal and political agendas. An insight into the long term impact of this era is provided by Nelson (2016).

Both the UKSSD and individual professionals like Norma Howes were instrumental in bringing colleagues together to learn from established clinicians such as Colin Ross, Bessel van der Kolk and Marlene Steinberg. The shared hunger and thirst for knowledge at these events remains a vivid memory. Theory and practice were based on clinical experience in the US, where the shift from abreactive to stage-orientated work took place.

With the exception of Cleveland, where controversy centred on the medical diagnosis of child sexual abuse, high profile cases in the UK concerned allegations of ritual abuse. In 1989, Ritual Abuse Information Network and Support (R.A.I.N.S) was set up for professionals working with this issue (Buck, 2008). Awareness of extreme, organised and ritual abuse developed sufficiently for R.A.I.N.S and other organisations such as Trauma and Abuse Group (TAG) to host trainings at both introductory and advanced levels led by colleagues from the US such as George Rhoades. We learned more about the impact of trauma on memory and consistently were given sound advice on avoiding leading questions and false positives. Even so, the training events were attacked by the proponents of false memory as responsible for causing moral panic and for allegedly creating a myth concerning the existence of ritual abuse. It seemed to me that the more the battle raged, the more survivors, often with pre-existing memories of trauma, came forward in the hope of finding a therapist who could help them. Learning from survivors has been an essential component of development at every stage.

Stage 2: Development of UK practice and training
UK training and practice moved to becoming more home grown. Two independent clinics were set up: the Pottergate Centre by Remy Aquarone and the Clinic for Dissociative Studies by Valerie Sinason. A small group of UK trainers were approved by ISSTD to deliver their standard and advanced courses. Responses to the material provided by the ISSTD were mixed. It reflected the work of the American pioneers and did not always resonate with a UK audience, not all of whom liked the seminar format. As a result, the ESTD UK went on to develop its own training modules. Uniquely, these were developed in an equal partnership with experts by experience from First Person Plural (FPP), the UK’s only survivor-led organisation for persons suffering dissociation, their carers and associates (www.firstpersonplural.org.uk.)

All the UK trainers are highly experienced trainers and clinicians. The days run by FPP also use experienced trainers who have a high level of personal insight, allowing them to bring clarity to some of the more complex issues. This remains a key strength of us all working together. Their contribution to the field was recognised in the 2018 New Year Honours when Kathryn Livingston, the founder of FPP received a Queens award – a British Empire Medal – for services to dissociative disorders. Her award for addressing a condition which some deem not to exist has give us all a boost. An article about this prestigious award was published in ISSTD News in January.  Alongside First Person Plural, ESTD UK has contributed to government consultations, but as yet no clinical guidelines for treating complex trauma and dissociation have been issued in the UK.

The original aims and principles established at this stage have remained unchanged: to encourage a co-ordinated approach to training; to avoid the fragmentation which can characterise this field of work; and to work collaboratively with experts by experience.

Other agreed principles are that all training should be targeted accurately at the participants’ level of knowledge and experience; specific to the needs of the UK; provide for different learning styles; use a variety of training methods including experiential learning; draw on the relevant literature; incorporate an element of self-directed and reflective learning; relate to different practice contexts; allow for incremental learning; be aware of equal opportunities and provide for difference; and be peer-evaluated using feedback from participants.

The core curriculum was established as: stage-orientated treatment; safety and affect regulation; methods of assessment; origins of dissociation of childhood and attachment issues; the structural model of dissociation; consideration of extreme/organised abuse; supervision and organizational issues; and expert by experience perspective on all topics. The target audience was identified as caregivers in the professional and voluntary sectors such as social workers, mental health workers, therapists/counsellors, volunteer workers and the health sector. Participant feedback has been overwhelmingly positive and enthusiastic. The engagement of staff in the national health service (NHS), especially psychiatry, has been slow.

The discussion of ritual abuse became muted during this stage. In response to the controversy it evoked, practitioners were either cautious or fearful. This did not stem the flow of survivors seeking help for whom R.A.I.N.S stood as a significant resource for them and their therapists.

Stage 3: To the present
The ESTD UK training has expanded from a 4 day foundation course to additional 4 days post-foundation training, providing 8 one day modules in all. A master supervision class is run at intervals. The courses offer a progressive learning experience and solid foundation for understanding structural dissociation and working therapeutically. The post-foundation level reflects the growing number of practitioners with some training and experience.

Work to engage clinicians from the NHS is ongoing and some breakthroughs are being made. There is more acceptance and recognition of dissociation, although there is often not a formal diagnosis. The hearing voices movement also promotes a dissociative framework within its own model of recovery.

In addition, individuals are bringing about change in their own health authorities. Mike Lloyd (2015) has demonstrated the cost effectiveness of appropriate treatment. Angela Kennedy (2014) has demonstrated similar patient improvement and is advancing the provision of trauma-informed care. Remy Aquarone has helped to set up and consult to staff teams. His work with Melanie Goodwin from FPP in taking forward training to NHS staff at a hospital in Norwich, led to a 2 day ESTD UK conference in March 2017 on ‘Facing the Challenge’. This was the first major collaboration between the statutory and voluntary sectors on this issue and was attended by 240 people. Over 85% of participants gave the conference their highest rating. Most of all, they enjoyed the friendly, collegial atmosphere and the excitement and energy generated by being with a group of like-minded people.

The need for awareness raising and foundation level training is enormous. To assist in the size of this task, ESTD UK has produced a series of information sheets (available on the ESTD website) and collaborated with First Person Plural to produce an introductory training DVD, now followed by a second, focused on therapy. In addition, a co-authored article reaching out to therapists and counsellors who may be new to work with dissociation was welcomed by one of the main therapy journals (Aquarone, Goodwin & Richardson, 2017).

Another developing partnership is with the British Institute for Child Trauma and Dissociation (BICTD), which provides services to children as well as their families/carers. The Clinical Lead Therapist and ISSTD Fellow Dr Renée P. Marks is a member of the ESTD UK training group and her in-put on the childhood antecedents of dissociation is an integral component of our courses. In collaboration with BICTD, ISSTD Fellow Fran Waters recently visited the UK for a two-day national conference on child trauma and dissociation.

As far as I am aware, the John Bowlby Centre is the only school of psychotherapy in the UK which gives dissociation a significant profile during training and which openly names ritual abuse and mind control. Evaluation at referral includes pointers to the diagnosis of dissociation. The Blues Project provides a low cost service to increase access to therapy and there are a number of therapists at the Centre who work with severe complex trauma and organised abuse. Articles on dissociation, mind control and ritual abuse have been regularly published in the Attachment Journal (e.g Epstein, 2011, Richardson, 2010) and Centre members have addressed the manipulation of attachment needs inherent in organised abuse (Epstein et al, 2011).

Elsewhere, the fear of including extreme/organised abuse on the agenda has abated somewhat. The subject has re-emerged on the agenda of the ISSTD conferences. The ISSTD has recently offered a full day webinar training on this issue. The ESTD UK training group is exploring the development of a module on this issue in collaboration with the Clinic for Dissociative Studies. In 2013, R.A.I.N.S hosted a 2 day training led by ISSTD Member Alison Miller whose publications have done much to extend clinical knowledge. (Miller, 2012 & 2014). The publication of a co-authored feature on working with extreme abuse by members of ESTD/ISSTD was welcomed by practitioners (Anonymous, with BuckS, Miller A, Richardson S, Therapy Today, 2016). The spotlight of public concern has shifted to allegations of institutional abuse and its cover up, currently the subject of another major public inquiry. Meanwhile, the demand from those with dissociative conditions for appropriate therapy continues to outstrip the supply of available therapists.

Conclusion: Challenges and future directions
While practitioners still often feel isolated, I hope that no-one need feel as alone as I did in 1989. The mere existence of organisations like ESTD and ISSTD is validating and supportive. The challenge is to maintain them, to expand networking, co-ordination and collaboration and to hand on to the next generation.

Backlash still remains a factor. The early conferences described above are still quoted as an alleged source of contamination, false memory and moral panic. The challenge is to avoid being too fearful to integrate consideration of extreme, organised and ritual abuse routinely into existing theory and practice (Richardson, 2013).

The grassroots initiatives of pioneering professionals in partnership with experts by experience has achieved much. It is now time for top down recognition of the prevalence of trauma and dissociation, the need to develop resources and a training initiative which claims ownership of complex trauma and dissociation as a public health issue. Incorporating such training into other professional foundation training would be another major advance. Advances in on-line learning is another exciting focus for the future, making education more accessible to a wider audience.

The next ESTD UK conference will be held in March 2019 to continue the focus on improving services for people with trauma-related dissociation and provide a forum for these challenges to be explored.

We need to improve communication between ESTD and ISSTD in regard our respective endeavours and both the leadership of ESTD and ISSTD are committed to increased communication and collaboration between our two groups. Meanwhile, there is always a group of UK practitioners at the ISSTD conference, the next of which will be held in Chicago 22- 23 March 2018.

Anonymous, with Buck S, Miller A, Richardson S. Working with extreme abuse. Therapy Today 27(3): 14–19.

Aquarone, R., Goodwin, M.& Richardson, S. (2017) Holding the parts as one. Therapy Today, 28, 10, 26-29.

Buck, S. (2008) The R.A.I.N.S Network in the UK. In: Noblitt & Perskin Noblitt ( Eds.) Ritual Abuse in the 21st Century: Psychological, Forensic, Social and Political Considerations (pp., 307-326). Robert D. Reed Publishers: USA

Epstein, O. (2011) The leap from object use to intersubjective relatedness- a detailed clinical vignette. Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, 5, 1, pp. 39–44.

Epstein, O., Schwartz, J & Wingfield Schwartz, R. ( Eds.) (2011) Ritual Abuse and Mind Control: The Manipulation of Attachment Needs. Karnac: London.

Kennedy, A. ( 2014) Developing dissociation informed mental health services. Presentation at ESTD 2014 Conference, Copenhagen, 27-29 March 2014.

Lloyd M.(2015) Reducing the Cost of Dissociative Identity Disorder: Measuring the Effectiveness of Specialised Treatment by Frequency of Contacts with Mental Health Services. J Trauma Dissociation. 2015 Nov 2.

Miller, A. ( 2012) Healing the Unimaginable: Treating Ritual Abuse and Mind Control. London: Karnac.

Miller, A. ( 2014) Becoming Yourself: Overcoming Mind Control and Ritual Abuse. London: Karnac.

Nelson, S. ( 2016) Tackling child sexual abuse – Radical approaches to prevention, protection and support. Bristol: Policy Press.

Richardson, S. & Bacon, H. (Eds.)(1991) Child Sexual Abuse: Whose Problem? – Reflections from Cleveland. Birmingham: Venture Press.

Richardson, S. (2010) Reaching for relationship: Exploring the use of an attachment paradigm in the assessment and repair of the dissociative internal world. Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, 4,1: pp. 7–25.

Richardson, S. (2013) Installed structural dissociation: Cool thinking about a hot debate. ESTD Newsletter , Vol 3, No. 3, June 2013, 6-8.

Clinical E-Journal

JTD and Frontiers Table of Contents (February 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 2
Volume 19, Issue 1
Volume 18, Issue 3
Volume 18, Issue 4
Volume 18, Issue 5

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Frontiers in the Psychotherapy of Trauma & Dissociation

Table of Contents


  • Maladaptive Daydreaming: Ontological Analysis, Treatment Rationale; a Pilot Case Report (Eli Somer, Ph.D.)


  • 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 of ISSTD.

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