Membership

Strengthening the ISSTD International Community

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

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

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

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

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

Spreading the Word

The Blue Knot Foundation, Australia

Shelley Hua

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

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

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

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

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

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

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

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

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

Blue Knot Day – Monday 29 October 2018

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

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

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

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

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

Creative Space

Creative Space

Noula Diamantopoulos, Curator

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

Ruined and Improved

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

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

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

Un Divided

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

Un Divided
By Jan Ewing

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

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

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

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

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

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

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

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

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

Title: “A Part” By Noula Diamantopoulos

Trauma & Dissociation in the News

The Role of Shame within Domestic Violence Relationships

Christine Forner, BA, BSW, MSW, RSW

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Regional Conferences

Talking About Trauma and Dissociation in All Corners of the World

Joan Haliburn, MD, and Kate McMaugh

Hobart, Tasmania

Some might argue that it is a challenge to organise and present a conference in an island off the southern coast of … another island, quite literally on the edges of the world. But ISSTD is keen to reach all corners of the globe and we were fortunate that members Joan Haliburn MD and Jan Ewing PhD, were prepared to organise and lead a regional conference in Hobart, Tasmania last month. It just turns out that this conference was highly successful!

Joan and Jan were delighted to report that more than 100 people attended the conference. This comprised local health professionals as well as people who made the trek across the Bass Strait from all over Australia and New Zealand, and even one person from the US, who was holidaying in Australia. There were psychiatrists, psychologists, social workers, school counsellors and welfare workers, all interested in recent developments in the field of trauma and dissociation.

Jan reports that the audience, which varied from new graduates through to highly experienced clinicians, were all keen to add to their knowledge, skills and confidence in working with their wounded clients. She adds, “They were all enthusiastic and highly engaged. There was a palpable commitment to healing in the air, which was quite moving at times.”

Both presentations were well received with lots of questions and requests for references. Joan and Jan both report that there have been numerous emails since the conference from interested people, with all sorts of questions. At least half a dozen took ISSTD membership forms and we hope they have completed and sent them in!

Conference Venue

As is typical for this island state, Hobart put on a show for delegates – that is, showing them all four seasons in two days. While weather was fine and sunny on Friday, but it was cold and blustery on Saturday with a threat of a snow storm. Naturally we hope all interstate visitors heeded weather warnings and packed accordingly. The conference was complimented by great catering and a sensational venue in a new conference centre overlooking Bellerive Oval, dedicated to famous cricketers like Don Bradman and Ricky Ponting.

Organisers would like to thank local Clinical Psychologist, Serena King, who helped out enormously. Her support and assistance (including staffing the reception desk and providing free taxi services) was greatly appreciated!

We are happy to say that the Hobart Regional Conference was a resounding success from all points of view.

2019 Annual Conference

2019 Annual Conference Plans to Delight Attendees with Fine Array of Pre-Conference Workshops

Christine Forner

The 36th Annual conference, to be held in NYC in March, 2019, will offer a complete array of Pre-Conference workshops featuring some of the world’s leading trainers and thinkers in the field.

The Pre-Conference sessions have been set up to provide clinicians and researchers full day, in depth sessions of cutting-edge information. A lot of time goes into the preparation of these days and the Annual Conference Committee hopes that the information within these sessions rejuvenates, educates, and excites our attendees.

The list of Pre-Conference sessions include:

Thursday:

  • Sandra Baita: Shame, Avoidance and Rejection in the Clinical Work with Dissociative Children and adolescents
  • D. Michael Coy and Jennifer Madere: Integrating the Multidimensional Inventory of Dissociation into Clinical Practice .
  • Heather Hall and Michael Salter: Dissociative Disorders and Public Health
  • Rochelle Sharpe Lohrasbe: Harmonizing Body and Mind – Sensorimotor Psychotherapy, Trauma, and Dissociation
  • Billie Pivnick, Jill Bellinson, Moderated by Joan Turkus: Remembering the Vanishing Forms of 9/11: Ruptures, Ripples, and Reflections

Friday:

  • Kathy Steele, Dolores Mosquera, Suzette Boon: Integration Failures Across Diagnostic Categories in Traumatized Individuals
  • Ken Benau and Sarah Krakauer: Pride and Shame in Psychotherapy with Relational Trauma and Dissociative Disorders
  • Rick Kluft: Putting Ideas and Techniques to Work in the Treatment of DID: A Case Study-Driven Approach
  • Adah Sachs and Michael Salter: Organized Abuse: The Criminology of Sexual Exploitation and Therapeutic Approaches
  • Christine Forner and Mary-Anne Kate: Dissociation 101: A Comprehensive Exploration into the Field of Dissociation and Complex Trauma

As you can see, there are a variety of topics that cover issues with children, adolescents and adults. There is the updated Dissociation 101, which is designed to educate people who are beginning to work with complex trauma and dissociation. There will be a special course designed to explore, learn about and understand the impact of trauma and terror; this will include information regarding 9/11. There is a workshop on understanding how to use, and apply to clinical practice, the Multidimensional Inventory of Dissociation. There is a session that examines dissociation as a public health crisis, and another that examines organised sexual exploitation, with input from both criminology and therapeutic perspectives.

Some of the most asked-for sessions are those which address difficult clinical issues. We have attempted to make sure that the pre-conference workshops have a heavy emphasis on this. In addition to the above workshops, we also have sessions which examine: the differentiation of the various types of integration failures that occur with different disorders, something that is sure to assist with complex case formulation; the difficult and ubiquitous issues of pride and shame in therapy; as well as the practice of specific clinical techniques such as sensorimotor psychotherapy. Of course, we look forward to hearing the clinical wisdom of Rick Kluft, shared through a unique case-presentation format.

As a member of the conference committee since 2011, I have had the great vantage point of seeing the variety of sessions offered every year. We are working hard to include discussions that have been requested of us. If any Members have a great idea or a suggestion of a Pre-Conference lecturer or topic please send word to the conference committee. We will work towards including it in future conferences.

If you have never made the investment of attending the Pre-Conferences, I highly recommend you consider attending. During these courses, all participants get a chance to intimately connect with experienced clinicians, researchers and innovators within the field of trauma and dissociation, most of whom have been doing this challenging work for decades. These classes are set up to be intimate, and full of content that you may not get anywhere else, all designed to advance your clinical practice, broaden your thinking, and challenge your research

Kid's Korner

“I go in the closet in my head.” – Trauma and Dissociation in Children Living with Domestic Violence

Na’ama Yehuda, MSC, SLP

Eli, age seven, lives with his younger sister Marianne, age four, and their mother Lisa, in New York City. They had lived in a domestic violence shelter for a year, and before that with his stepfather, Mark, till Lisa fled with the kids following repeated violence. Huddled in his bed, Eli had often heard his stepdad beating his mother. He’d wait helplessly till she sought refuge in the children’s room once Mark stormed out. She’d sob herself to sleep on the floor by his bed as he lay awake, worrying his stepdad would return and hit her more.

Mark was the only father Eli knew. His biological father left shortly after he was born. Eli adored his stepdad. He loved it when Mark took him to the park and showed him “how to build muscles” on the monkey-bars. He also hated Mark for hurting his mother, and felt guilty for admiring the very strength that brutalized her. When one night his bruised mother took him, still in pajamas, to a “hotel for mommies,” Eli wanted to go back home. He cried and screamed and it made his mother cry. One of the shelter’s women told Eli he was being “selfish” and that if he “wanted to grow up to be a decent man” he would “stop hurting his mom.”Eli felt confused. Was he hurting his mommy like his stepdad hurt her? Sometimes his stepdad would apologize in the morning and say “he didn’t know his own strength.” Did Eli also not know his own strength? Did he hurt his mommy without meaning to?

Eli stopped fussing, but he still missed his stepdad. There were no dads in the shelter, only whiny babies, toys big kids wouldn’t share, and mommies with scared eyes and scary bruises. He didn’t like it there. He couldn’t go to his own school. He couldn’t see his friends or go to the park where he’d played catch with Mark. Instead, he had school in the shelter and played at the playroom where the carpet smelled funny. Eli tried to be good but still his mommy cried at night. Maybe he was hurting her by his thoughts of wanting to go home? He didn’t know how to stop wanting to go home.

Even when they finally left the shelter they didn’t go home. His mommy said their new apartment was “home, sweet home,” but it wasn’t. It wasn’t even near the park and he had a new school with different everything. Also, his mommy was scared again. She had a lot of locks on the door, and slept on the floor by his bed again. Like before. She cried even though Mark wasn’t there to hit her. Eli tried to take care of his mommy but he didn’t know how. He was doing it all wrong. He didn’t know what to do.

When I met Eli, he was repeating Kindergarten and showed difficulty with attending, comprehending, and meeting academic demands. Teachers reported he could be talkative but mostly seemed to be “in his own little world” and frequently complained of stomach-aches, asking for his mother to take him home. His occasional explosive aggression led to questions about whether he needed a more restrictive environment “for the protection of everyone involved.” Both Eli and Marianne had attended a therapeutic play group at the shelter, and the counselor there noted that Eli had “tended to keep to himself” and was “always with one ear to the door, listening his mom was okay.” The little boy hadn’t been aggressive toward others at the shelter, but the counselor wasn’t surprised to hear “some of that rage bubbled up eventually.”

“Lions are strong,” Eli emphasized. “They eat the deer.”
We had just finished reading a story about forest animals and their needs, and he seemed disappointed that no one got eaten.
“Yes,” he added, smacking his palm on the closed book. “Later, he’ll beat her up and then he’ll eat her. He can kill her …”
He shuddered and looked up at me and appeared a lot younger than seven.
“That sounds very scary,” I noted gently.
He pointed to the deer on the cover of the book. “Can she hide?” he asked.
I nodded and pointed in the direction of a napkin. I wanted to give him space to go where he needed. It was obvious this wasn’t about deer and lions.
Eli took in a trembling breath.
“I hide.” He whispered and reached for my hand. “I hide inside the closet in my mind.”

It’s what he did when mommy was being hurt and when she cried and when he missed his stepdad and when he didn’t know what to do: he went inside the closet inside his mind. Not the real closet, where people can find you, but a better one, in his head: A closet where only he could open the doors, where no bad sounds or smells got in. It wasn’t scary in his closet, just quiet. But sometimes he forgot to open the doors and pay attention and the teachers said he wasn’t a good listener and kids said he was stupid. His mommy told him that if she kept missing work to take him home from school she’d lose her job and they’d lose their apartment. But he worried about her. He heard her tell a friend on the phone that she was scared Mark would shoot her at work. Like on TV. He wanted mommy to take him home so she won’t be at work where Mark can come. And sometimes he thought he heard scary Mark coming so he’d jump out of his closet fast and hit but then people told him he was being bad, too. It made him want to go back in the closet inside his head but he needed to look after his mother. He was “the man of the house” now. He didn’t know what to do.

Exposure to domestic violence hurts children (Edleson 1999, Sousa et al 2011). Witnessing violence impacts children as much—and sometimes more—than being hit. It is unbearable to a child to be helpless to save the caregiver they need, and it can be even worse when the one harming the caregiver is also someone the child depends on. Children often convince themselves that the violence—and its prevention—is somehow theirs to control (Levendovksi et al 2003, Sousa et al, 2011). In a child’s mind, if only they were better, quieter, and less needy, the people they rely on would not become terrified or terrifying.

The very words that accompany domestic violence can be confusing. Did mom “ask for it?” Did stepdad “only hit her because he loved her?” Does saying “I’m sorry” mean it didn’t happen? Unable to make sense of what is happening around them, children—like Eli retreating into his “closet inside his mind”—might shut-down and dissociate. They can appear unemotional and numb, stop attending, and fall behind socially and at school. They might mirror the aggression they’d seen. Very often children feel guilty if they love the person who hurts the other person they love, and guilty for hating the person they love for hurting another person they love. They rarely have the words or space to describe any of this. Children who apply dissociation to cope with terror and helplessness may also shut down at reminders of the trauma, reinforcing dissociation and resulting in children who are less available for processing information and utilizing available support (Siegel 2012, Silberg 2013, Wieland 2011, Yehuda 2005, 2016).

Even after a parent flees domestic violence, strain often continues, and children might mirror it in ways that reflect not only past trauma, but also current issues. A parent who escaped domestic violence can still be vulnerable. They might still be scared. They might have limited financial, social, and emotional resources. Children sense this, and may hide their own difficulties to protect the parent from distress. When feelings of resentment, anger, worry, or grief inevitably overwhelm them, the children can feel doubly guilty. Unfortunately, just as Eli was scolded at the shelter, children might be chided if they misbehave and be told “there’s already enough to deal with.” They might dissociate to avoid added shame and helplessness. They might become hyper-aware of the parent’s mood and try to accommodate it (Ostrowski et al 2007, Lyons-Ruth & Block 1996).

A loss of home—even the mere risk of it—can be overwhelming and preoccupying, leaving children anxious, wary, worried, angry, or withdrawn. The parent may be managing depression, posttraumatic stress, financial insecurity, and grief; all of which can inadvertently reinforce unhealthy dynamics. This is why it is crucial anyone who works with families fleeing domestic violence, understands children’s behaviors and the functions they serve.

Domestic violence hurts children. While children don’t always communicate their distress verbally, they almost always do so in their behaviors: In aggression and acting out, in shutting down, in falling behind, in what they won’t talk about, in what they do or cannot do (Silberg 2013, Waters 2005, 2016, Yehuda 2005, 2011, 2016). It is paramount we hear them, for our reaction may become the measure of whether they believe help is available.

Eli’s mother was depressed, but she was also determined to keep her children safe and to minimize the impact of trauma on their future. She entered counseling to deal with her own unresolved history, and enrolled Eli in a therapeutic playgroup. She became more involved in his therapy with me, and learned to support his narrative when he spoke of his feelings, including difficult ones about the violence he’d witnessed. Together, at his request, we made a visual representation of the “closet inside his mind” using a shoebox that the two of them painted to fit his inner representation. Eli was able to put his “big feelings” into the closet-box for safe keeping so that he can attend better at school. He was delighted when his mother made a small blanket for his closet “so even the biggest feelings can be cozy and safe.”

With his mother less frightened and himself less alone, Eli was able to let in play, instruction, joy, and praise. His explosive aggression ceased, and he was catching up on language, academics, and friendships.

“Remember when I told you about my closet in my mind?” he said at one of our sessions. “I don’t need to hide there anymore. It’s old and it’s too small for me,” he added without judgment. “I was little, but now I can speak up and if I get scared I can go to mommy or the teacher … or you. I don’t need that closet. The bad memories can rest there.”

Bibliography:
Edleson, J.L. (1999). Children’s witnessing of adult domestic violence, Journal of Interpersonal Violence, 14:839-870.

Levendosky, A.A., Huth-Bocks, A.C., Shapiro, D.L., Semel, M.A. (2003). The impact of domestic violence on the maternal–child relationship and preschool-age children’s functioning, Journal of Family Psychology, 17(3):275–287.

Lyons-Ruth, K., Block, D., (1996). The disturbed caregiving system: Relations among childhood trauma, maternal caregiving, and infant affect and attachment, Infant Mental Health Journal, 17(3):257-275,

Ostrowski, S.A., Norman, M.A., Christopher, C., Delahanty, D.L. (2007). Brief report: The impact of maternal Posttraumatic Stress Disorder symptoms and child gender on risk for persistent Posttraumatic Stress Disorder symptoms in child trauma victims, Journal of Pediatric Psychology, 32(3):338–342.

Siegel, D.A. (2012). The Developing Mind: How relationships and the brain interact to shape who we are, 2nd Edition, New York: The Guilford Press.

Silberg J.L. (2013). The Child Survivor: Helping Developmental Trauma and Dissociation, New York: Routledge Publishers.

Sousa. C., Herrenkohl, T.I., Moylan, C.A., Tajima A.E., Klika, J.B., Herrenkohl, R.C., Russo, M.J. (2011) Longitudinal study on the effects of child abuse and children’s exposure to domestic violence, parent–child attachments, and antisocial behavior in adolescence, Journal of Interpersonal Violence, 26(1):111–136.

Waters, F. (2005). When treatment fails with traumatized children. . .Why? Journal of Trauma and Dissociation, 6:1–9.

Waters, F. (2016). Healing the Fractured Child: Diagnosis and treatment of youth with dissociation, Springer, New York.

Wieland, S. (Ed.) (2011). Dissociation in Traumatized Children and Adolescents: Theory and clinical interventions, Psychological Stress Series, Routledge Publishers.

Yehuda, N. (2005). The language of dissociation. Journal of Trauma and Dissociation, 6:9–29.

Yehuda, N. (2011). Leroy (7 Years Old)—“It Is Almost Like He Is Two Children”: Working with a dissociative child in a school setting, in Wieland’s (Ed.) Dissociation in Traumatized Children and Adolescents: Theory and clinical interventions, New York: Routledge, Psychological Trauma Series.

Yehuda, N. (2016) Communicating Trauma: Clinical presentations and interventions with traumatized children, Routledge, New York.

Kid’s Korner is a regular feature of ISSTD News, published every January, April, July

and October.

If you have an idea for an article for Kid’s Korner please contact Kate McMaugh at:

katemcmaughpsychology@gmail.com

Letter From The President

Increasing Diversity: ISSTD Rising to the Challenge

Kevin Connors, MS, MFT

September is Student and Emerging Professional Month here at ISSTD, a month where we highlight and celebrate the work of this important member component.

I am particularly proud of the work done by incoming President Christine Forner in establishing and developing this vital group. Today this group is an active part of the ISSTD landscape with 200 Student and Emerging Professional Members. After many years of dynamic leadership, Christine has invited Christianna Flynn-Christianson to serve as co-chair of the Student and Emerging Professional Committee.

Many members of this group are contributing to our Society in numerous meaningful ways. Abigail Percifield and Stergio Skatharoudis contribute regularly to our Annual Conference Committee helping to plan and shape the future of how ISSTD educates and encourages new clinicians and researchers. Shelly Hua and Rachel Friedman are vital parts of the team transitioning ISSTD into the 21st Century with our move to a new, more accessible website and the more flexible and dynamic Higher Logic Community platform. David Seagull and Abigail Percifield are active on our membership committee, with Abigail now serving as co-chair.

Most committees and task forces now actively seek out student members to contribute to the dialogue. The dialogue on the Student and Emerging Professionals Forum is among the most active discussion groups ISSTD has running. This year, 2018, we begin to have a bit more balance with a significant drop in the average age of Board Members.

Where did this all begin? Many years ago, serving as the ISSTD Vice-President, I had the honor of attending a special luncheon held during the annual conference. The luncheon was a gathering of Past Presidents invited to share their wisdom and insights as to how to face the challenges confronting our Society.

In the middle of the luncheon, Rick Kluft stood up and asked us to look around the room. He asked us to reflect on what was wrong with the scenario laid out before us. Several long seconds of silence passed. He pointed out, in the quiet, most articulate language that Rick is so well known for, that the average age in the room was well past the age when most people retired. No one in a leadership position was under the age of 55. He noted that we had no input from anyone coming up in the field. We were deaf to the needs, concerns, and issues confronting anyone seeking to enter into the study of trauma and dissociation

A few short months later there was an unexpected opening on the Board of Directors. Recognizing the validity and value of Rick Kluft’s observation, a young, relatively new member of ISSTD was appointed to fill that opening: This was our incoming President Christine Forner. As I’ve already described, one of Christine’s first suggestions was the Student and Emerging Professionals Committee and ISSTD has been richer for this ever since.

However, I am mindful of Rick Kluft’s comment still. It was echoed by Catherine Classen at our last Town Hall Meeting when she looked around the room and noted the lack of diversity among attending members.

We still have work to do in growing and developing our Society.

We are recognizing and responding in some important ways. The theme of our 36th Annual Conference, held in New York City from late March to April 1st 2019, is the World Congress on Complex Trauma. To address and heighten awareness of international perspectives on trauma and dissociation, we have assembled a panel of experts from around the globe to broaden our understanding.

The distinguished panel includes:

  • Argentina – Sandra Baita
  • Spain – Dolores Mosquera
  • India – Adithy
  • Turkey – Vedat Sar
  • South Africa – Christa Kruger
  • Canada – Gabor Mate

Adding further insight into the need to embrace diversity in our field is the work of Heather Hall, MD and Michael Salter, PhD, co-chairs of the ISSTD Public Health Task Force. They will present a pre-conference workshop focusing on treating and hopefully preventing complex trauma and dissociation. They examine how “the risk and impact of Complex Trauma and Dissociation (CTD) is shaped by a range of social, economic and political inequalities.” They go on to note that “access to treatment and opportunities for recovery from CTD are also inequitably distributed” across similar socio-political and economic lines. Their findings and recommendations will shape ISSTD efforts and hopefully find their way to informing policy makers at all levels.

And… We still have work to do in growing and developing our Society.

How can we expand our network of clinicians and researchers to be more inclusive and embrace diversity? How can we extend our ability to reach and teach others so that quality mental health care informed by the understandings of complex trauma and dissociation that ISSTD brings can be available to more people in all the corners of the world and at all socio-economic levels?

We saw one area where we needed to grow. We rose to the challenge and now have an active and growing group of students and emerging professionals. We see our next challenge. Will you help us meet that one too?

Let’s roll up our sleeves and get to work.

Thanks,
Kevin

LAST MINUTE SHAMELESS PLUG:
Please help support our $35 for the 35th campaign. This important campaign raises funds to grow and support student member opportunities and activities and to provide for our much needed website updates and improvements as well.

You can help by making a donation of any size by visiting the 35 for the 35th webpage on the ISSTD website. One time and monthly installment payment options are available.

Thanks for helping grow ISSTD!

News You Can Use

News You Can Use

Kate McMaugh, Editor, ISSTD News

Tara Tulley at ISSTD Annual Conference, San Francisco

ISSTD Member Tara Tulley, LCSW, LDEM has spoken on a podcast for Rational Faiths about her experience of organised abuse within the Mormon Community. Tara speaks of her personal experience of organised abuse within her LDS family and the wider community, as well as the journey that lead her to become a social worker, treating other survivors of abuse.

Tara and the other speakers discuss issues that survivors in Mormon communities face, and the difficulties LDS survivors face when they disclose the abuse. The Podcast also discussed the Pace Memorandum, the science of memory and the impact of lingering misconceptions left behind in the wake of the FMS advocacy.

Tara explains that this advocacy is part of activism efforts in Utah to empower survivors and to spread awareness about the hidden abuse and human trafficking that occurs in Utah. Tara also explains that this is not a discussion that is against the LDS church or implicating them directly, but rather to help people understand the abuse that can occur within the experience of growing up in a Mormon home and culture around being a Mormon survivor. For those interested the podcast can be accessed here.

Welcome ISSTD’s New Members in August!

PROFESSIONAL MEMBERS
Roslyn Badcock
Randy Brazie
Elizabeth Conroy
Megan de Souza
Leslie Deutsch
Karen Druce
Michelle Epstein
Linda Guhe
Fredlee Kaplan
Megan Maloney
Kathleen Maxey
Gilda Ogawa
Shingo Oshima
Janine Petrass
Michelle Rhodes
Robert Solomon
Christie VonVille
Jill Bellinson
Laura Dekle
Santiago Delboy
Jennifer Dritt
Eliza Fernandes
Ian Fowler
Susan Gutwill
Amy Sinjem
Jeanna Smith
Cynthia Wilson
Agnes Wohl
EMERGING PROFESSIONAL MEMBERS
Mehtap Anderson
Catherine Fries
Dianna Hansen
Jessica Wansart
Fiona Fairbrother
STUDENT MEMBERS
Anu Abu-Rus
Sharon Schonteich
Christine Shaw
Robyn Yaxley
Lori Kucharski

Do You Have News ISSTD Members Can Use?
We need your help to make NYCU a great feature, full of news and connecting us all!
Do you have a book or journal article coming out that you wish to share? Have you received an award for your work in the field? Have you been part of developing a new website or training course? If so, we want to hear from you! Don’t be shy, submit your news to us so that we can share with other members.

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

Clinical E-Journal

JTD and Frontiers Table of Contents (September 2018)

Journal of Trauma & Dissociation

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

Table of Contents
Volume 19, Issue 1
Volume 19, Issue 2
Volume 19, Issue 3
Volume 19, Issue 4
Volume 18, Issue 5

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

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

Frontiers in the Psychotherapy of Trauma & Dissociation

Table of Contents

2018

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

2017

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

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

© 2018 International Society for the Study of Trauma and Dissociation.  |  Home  |  Contact Us  |  About ISSTD  |