Psychotherapists often feel most overwhelmed by cases in which clients with histories of complex trauma present with some form of dissociation–whether it involves the client’s tendency to be “far away” or “spaced out” in session, or the dissociation of the client’s self into fragmented, and often conflicting, parts. “Discussing Dissociation” is a seminar designed to offer therapists tools and support as they learn together to manage these cases and to take enhance their own resilience as they help clients facing significant challenges.
Adaptations to survive early trauma often require individuals to fragment aspects of their experience (emotions, memories, beliefs, sensations and impulses) into separate compartments in order to bear the ordeals they endure. While such strategies can foster survival, they also can exact a heavy toll. Dissociation of the self can occur on a continuum from everyday skills of adaptively spacing out to the extremes of Dissociative Identity Disorder (DID).
The structural dissociation model, developed by van der Hart, Nijenuis & Steele, and elaborated by Janina Fisher, posits that under stress the personality fragments according to the “existing fault lines” of our survival defenses: fight, flight, freeze, submit and attachment cry. Even for clients who do not meet diagnostic criteria for DID or DID-NOS, this framework offers a clear model for compassionate understanding and effective intervention with clients who in one part of the session may be ready to fight with us, followed by a desire to flee treatment, and end with a plea for us not to abandon them. The seminar will integrate resources based both on the structural dissociation model and from psychodynamic interventions.
Ongoing discussion, reading, and case consultation groups are available for graduates of the Discussing Dissociation seminar and can be arranged with the instructor.Read More»