THE RIPPLE EFFECT: Trauma & Dissociation in the Mainstream PRE CONFERENCE: MARCH 30-31, 2017 CONFERENCE: APRIL 1-3, 2017

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1 I S S T D 3 4 th A n n u a l C o n f e r e n c e THE RIPPLE EFFECT: Trauma & Dissociation in the Mainstream PRE CONFERENCE: MARCH 30-31, 2017 CONFERENCE: APRIL 1-3, 2017 CRYSTAL GATEWAY MARRIOTT, WASHINGTON DC

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3 Table of Contents Letter from the Conference Committee 4 Letter from the President 5 Conference Information 6 ISSTD Membership Information 9 Plenary Addresses 14 Center for Advanced Studies in Complex Trauma and Dissociation: Certificate Program 16 Detailed Schedule Conference Supporters 76 Index 77 Hotel Floor Plan FINAL CONFERENCE PROGRAM & PROCEEDINGS 3

4 Letter from the Conference Committee Welcome to Crystal City, VA in the Metro Washington, DC Area, & to ISSTD s 34 th Annual Conference: The Ripple Effect: Trauma & Dissociation in the Mainstream Your conference committee has outdone themselves this year in finding great speakers to present on the important and intriguing issues confronting trauma therapists today. LETTER FROM THE CONFERENCE COMMITTEE Our conference opens with a 11/2 hour plenary presentation from Bruce Perry leading us through an exploration of trauma and the developing brain. Understanding the impact of trauma and the interplay of neurobiological and developmental features helps inform us of the challenges our patients face in organizing their experience of their world. From this greater appreciation we can better determine which tools and strategies to use in trying to reach our patients hearts and minds. Dr. Perry will add to our knowledge by sharing more information in a 90 minute workshop following his plenary lecture. On Day Two, John O Neil moderates a stellar panel comprised of Julian Ford, Dolores Mosquera, and Warwick Middleton examining The Borderline Question. Looking into the crossover between Borderline Personality Disorder and survivors of complex trauma, the distinguished panel members will first offer their unique insights and then open the microphones to questions and comments from our audience. This plenary panel offers an exceptional opportunity for dialogue and discussion about a critical aspect of trauma treatment. Day Three opens with Pamela Alexander addressing The Intergenerational Cycles of Trauma and Dissociation." Understanding the role and impact of dysfunctional family dynamics on creating, condoning, and reinforcing trauma is central to understanding the developmental deficits and distortions that complicate our clients lives. As always our plenary presentations are complemented by a broad range of workshops, panel presentations, symposia, and paper presentations offering the best in clinical strategies and current research for understanding and treating complex trauma and dissociative disorders. Each year, we seek to create an atmosphere where we gather as friends; sharing our expertise, our strength, and our compassion. The work we do is difficult and draining. We sit with survivors, hearing the stories of abuse and pain. We study the depth and breadth of emotional wounds that words cannot adequately convey. We search for ways to heal, to offer hope. Against that backdrop, ISSTD and our Annual Conference offer a retreat and a resource; a gathering of great minds and of kindred spirits. Here we learn together. Here we support and nurture our hearts, our spirits, as well as our intellect and our acumen. To colleagues who are joining us for the first time, a hearty Welcome! Here, seasoned clinicians and scholarly researchers are eager to share their knowledge and experience. This conference is an invitation to join us on an arduous yet extremely rewarding journey. To our returning friends, Welcome back, welcome home. Take this opportunity to recharge and renew, to reconnect. Relax in this moment to greet old comrades and to waken new acquaintances. We hope you enjoy our gifts of wisdom and knowledge. May this gathering spark your mind, inspire your creativity, and warm your heart. Thank you for all you do and for what you bring to our gathering. THE ISSTD CONFERENCE COMMITTEE Kevin J. Connors, MS, MFT, President-Elect, Conference Co-Chair Heather Hall, MD Board Member, Conference Co-Chair Ken Benau, PhD Therese Clemens, CAE Executive Director, Conference Manager Lynette Danylchuk, PhD Past President Christine Forner, MA, MSW Treasurer Florence Hannigan, MA, BSW Warwick Middleton, MB BS, FRANZCP, MD Immediate Past President Kimber Olson, LCSW Board Member Kathy Steele, MN, CS Past President Adah Sachs, PhD Board Member Joan A. Turkus, MD Past President Mary Pat Hanlin Meeting & Marketing Manager Lizzy Bear Mullins, Meeting Manager Diamond Heeralall, Association Adminstrator Ex-Officio: Martin Dorahy, PhD President FINAL CONFERENCE PROGRAM & PROCEEDINGS

5 Letter from the President A Welcome from the President As members of an international society, our communication and connection are typically in electronic form. Our Annual Conference provides the only opportunity in the year where we as the collective membership of ISSTD get to meet in person; to share, learn, acquaint and reacquaint. We leave the relative isolation of our consulting rooms, our research laboratories and our offices, and come together with like-minded and similarly dedicated colleagues and friends, who more than others know first-hand what we face in our clinical and research work with complex trauma and dissociative disorders. Our dedication to the keyboard and written word is given over to the in-person intimacy of the spoken word, our ears replace our eyes as the dominant medium for taking in specialised information, and our eyes replace our imagination as we put faces to names, smiles to those unfamiliar and recognised excitement to those we know and admire. Our conference committee has worked with vigour and vision to bring us a packed program, with space also for the important outlets of networking and socialising. Our staff and volunteer members have diligently put the plans in place, made the arrangements and continue to work to make the conference flow smoothly. They all deserve our gratitude and thanks. So too does our social committee which has organized a visit to the spy museum. It s my great pleasure to welcome you to our 34 th Annual Conference in a city surrounded by iconic imagery and iconic symbols of remembrance, reverence, prosperity, and unity. Whether you are an old ISSTD member, a newer member or a non-member, I wish you a very exciting few days full of learning, laughing, warmth and excitement, where connections gets made, rekindled or reinforced. May this time fuel your energy as you move back to your clinical and/or research spaces. Martin Dorahy, PhD ISSTD President LETTER FROM THE PRESIDENT 2017 FINAL CONFERENCE PROGRAM & PROCEEDINGS 5

6 CONFERENCE INFORMATION 34 TH ANNUAL INTERNATIONAL CONFERENCE COMMITTEE Kevin Connors, MS, MFT, USA ISSTD President-Elect, Conference Co-Chair Heather Hall, MD, USA Conference Co-Chair Martin Dorahy, PhD, New Zealand ISSTD President, ex officio Committee Member Therese Clemens, CAE, USA ISSTD Executive Director, Conference Manager Ken Benau, PhD, USA Committe Member Rosita Cortizo, USA Committee Member Lynette Danylchuk, PhD, USA Committee Member Christine Forner, MSW, RSW, Canada ISSTD Treasurer; Student & Emerging Professional Liason Florence Hannigan, MA, BSW, USA Committe Member Warwick Middleton, MB BS, FRANZCP, MD, Austraila ISSTD Immediate Past President, Committee Member Kimber Olson, LCSW, BCD, C-ACYFSW, USA Committe Member Adah Sachs, PhD, United Kingdom Committe Member Kathy Steele, MN, CS, USA Committe Member Joan A. Turkus, MD, USA Committe Member Mary Pat Hanlin, USA Meeting & Marketing Manager Diamond Heeralall, USA Association Administrator Elizabeth Bear Mullens, CMP, USA Senior Meetings Manager, MMG, Inc. SCIENTIFIC COMMITTEE Chair: Vedat Şar, MD (Turkey) ( ) Vice Chair: Warwick Middleton, MD (Australia) ( ) Bethany Brand, PhD (USA) ( ) Jackie Burke, PhD (Australia) ( ) Paul F. Dell, PhD (USA) ( ) Martin J. Dorahy, PhD (New Zealand) ( ) Benedetto Farina, MD PhD (Italy) ( ) Rafaelle Huntjens, PhD (The Netherlands) ( ) Mary-Anne Kate, PhD (Australia) ( ) Marilyn Korzekwa, MD (Canada) ( ) Christa Kruger, MD (South Africa) ( ) Alfonso Martinez-Taboas, PhD (Puerto Rico) ( ) Michael Salter, PhD (Australia) ( ) EDITOR, JOURNAL OF TRAUMA & DISSOCIATION Jennifer Freyd, PhD ISSTD SCIENTIFIC ADVISORY BOARD Suzette Boon, PhD (The Netherlands) Elizabeth Bowman,MD (USA) Chris Brewin, PhD (United Kingdom) Philip Bromberg, PhD (USA) Richard Brown, PhD (United Kingdom) Etzel Cardena, PhD (Sweden) Richard Chefetz, MD (USA) James Chu, MD (USA) Catherine Classen, PhD (Canada) Christine Courtois, PhD (USA) Constance Dalenberg, PhD (USA) Nel Draijer, PhD (The Netherlands) Brad Foote, MD (USA) Julian Ford, PhD (USA) Tanja Franciscovic, MD (Croatia) A.Steven Frankel, PhD, JD (USA) Paul Frewen, PhD (Canada) Serge Goffinet, MD (Belgium) Steven Gold, PhD (USA) Rachel Goldsmith, PhD (USA) David H. Gleaves, PhD (Australia) Rebecca Hannagan, PhD (USA) Daeho Kim, MD, PhD (South Korea) Richard P. Kluft, MD, PhD (USA) Ruth Lanius, MD, PhD (Canada) Ulrich Lanius, PhD (Canada) Roberto Lewis-Fernandez, MD (USA) Giovanni Liotti, MD (Italy) Richard Loewenstein, MD (USA) Brigitte Lueger-Schuster, PhD (Austria) Russell Meares, MD (Australia) Andrew Moskowitz, PhD (Denmark) Ellert RS Nijenhuis, PhD (The Netherlands) Ken Okano, MD (Japan) Miranda Olff, PhD (The Netherlands) John O Neil, MD (Canada) Erdinc Ozturk, PhD (Turkey) Frank Putnam, MD (USA) Simone Reinders, PhD. (The Netherlands) Colin A Ross, MD (USA) Martin Sack, MD (Germany) Ingo Schaefer, MD (Germany) Adriano Schimmenti, PhD (Italy) Shekhar Seshadri, MD (India) Daphne Simeon, MD (USA) Eli Somer, PhD (Israel) David Spiegel, MD (USA) Pam Stavropoulos, PhD (Australia) Kathy Steele, MN, CS (USA) Marlene Steinberg, MD (USA) Giovanni Tagliavini, MD, PhD (Italy) Anthony Tranguch, MD, PhD (USA) Onno van der Hart, PhD (The Netherlands) Annemieke van Dijke, PhD (The Netherlands) Eric Vermetten, MD, PhD (The Netherlands) Frances S.Waters, PhD (USA) Catherine Widom, PhD (USA) Tinakon Wongpakaran, MD (Thailand) FINAL CONFERENCE PROGRAM & PROCEEDINGS

7 WHO ARE WE? The International Society for the Study of Trauma and Dissociation (ISSTD) is a nonprofit professional association organized for the purposes of information-sharing and international networking for clinicians, educators, researchers, and theorists; providing professional and public education; promoting research and theory about dissociation, both normal and pathological; and promoting research and training in the identification, treatment, and prevention of complex post traumatic disorders, particularly the dissociative disorders. ISSTD VISION STATEMENT Social policy and health care will address the prevalence and consequences of chronic trauma and dissociation, making effective treatment available for all who suffer from the effects of chronic or complex trauma. MISSION STATEMENT ISSTD seeks to advance clinical, scientific, and societal understanding about the prevalence and consequences of chronic trauma and dissociation. WHO SHOULD ATTEND? All mental health professionals, researchers, and other academic professionals who are interested in the impact of chronic trauma and dissociation on individuals, groups, and society. CONFERENCE GOALS 1. The goal of each year s conference is to provide cuttingedge information about dissociation, the dissociative disorders, and all forms of complex trauma-related disorders. The conference offers information about the most recent developments in clinical interventions, theoretical concepts, and research in the field. Participants exchange ideas with one another via formal and informal presentations, networking, facilitated discussions, and critiques of current research and treatment. 2. The goal of ISSTD s 2017 conference is to study complex posttraumatic and dissociative disorders in a warm and collegial context that encourages exchange of ideas, curiosity, and relationship-building among professionals from around the world, and especially to support active and lively interchanges between researchers and clinicians. In particular, this year the focus is on the integration of knowledge, experience and research in complex trauma and dissociation and offers opportunity for the growth of the therapist. The conference will present theory, research, assessment, treatment, and other issues that are related to complex trauma, abuse, and neglect. CONFERENCE OBJECTIVES OVERALL CONFERENCE OBJECTIVES 1. Identify some of the most recent and salient research relevant to the trauma and dissociation field 2. Describe the central role of dissociation in complex trauma related disorders, particularly the dissociative disorders 3. Assess clients for dissociative disorders and complex PTSD and related comorbidity 4. Identify cultural, social, and religious effects on trauma, dissociation, and trauma-informed treatments 5. Assess and treat children, adolescents, and adults with complex PTSD, Developmental Trauma Disorder, and/or Dissociative Disorders 6. Describe the relationships among trauma, dissociation, and other psychological signs, symptoms, and disorders, including personality disorders 7. Employ new treatment approaches and interventions for complex trauma and dissociation 8. Identify and effectively work with countertransference, vicarious traumatization, and needs related to therapist self-care 9. Identify and effectively work with transference 10. Recognize, avoid, or resolve therapeutic pitfalls, resistances, counter-resistances, and impasses 11. Recognize the ethical and relational challenges posed by trauma and dissociation patients and discuss productive approaches to these issues 2017 CONTINUING EDUCATION CREDIT HOURS The Institute for the Advancement of Human Behavior (IAHB) is pleased to offer continuing education credit hours to counselors, nurses, psychologists, social workers, physicians, and certain other healthcare professionals for the ISSTD 2017 Annual Conference. Please view the CE packet in full which will be available onsite at the conference or on the conference website for download. It contains important information regarding sessions approved for CE/CME credit. Attendees will earn 1 CE hour per hour attended for approved sessions. Please check the ISSTD website at default.asp?contentid=454 for complete information. If you registered for CE/CME credits, please pick up CE/CME information at the conference for further information on how to obtain your credits. Please be sure to review this packet in full and complete all the steps necessary in order to receive CE/ CME credit. CONFERENCE INFORMATION 2017 FINAL CONFERENCE PROGRAM & PROCEEDINGS 7

8 REGISTRATION Participation in the ISSTD 34th Annual Conference, which begins on Saturday, April 1, 2017 is limited to registered delegates. Full registration includes the following: Admission (Saturday Monday) to all workshops, papers sessions, symposia, forums, panels, poster sessions, plenaries and the Town Hall and Business meetings; Exclusive access to exhibitor offers; President s Reception (cash bar) on Saturday evening; Daily coffee and tea networking breaks; Awards Dinner Saturday Evening; Full access to the recorded conference presentations; Opportunity to purchase a variety of specialty books from the ISSTD bookstore; Final program and proceedings. REGISTRATION AND SERVICE DESK Registration will remain open during the following times: ARLINGTON BALLROOM FOYER WEDNESDAY, APR. 29 (ASCH Hypnosis Training Only, Registration in Jefferson Foyer) THURSDAY, APR. 30 (Pre-conference workshops only) FRIDAY, APR. 31 (Pre-conference workshops only) FRIDAY, APR. 31 (Pre-registrants bag pickup only) SATURDAY, APR. 1 SUNDAY, APR. 2 11:00 AM - 12:30 PM 7:30 AM - 12:00 PM 7:30 AM - 8:30 AM 6:00 PM - 10:00 PM 7:00 AM - 5:00 PM 7:30 AM - 10:30 AM CONFERENCE INFORMATION Single day registration does not include the cost of the Awards Dinner, the President s reception, or the conference recording. Tickets for these events (for single day and guests) and information to purchase the recordings are available at the registration desk. Students must provide verification of full time student status via student ID card or other acceptable documentation. Fax to (703) BADGES All attendees are required to wear their name badges for admission to all conference-related educational and social events. MESSAGE BOARD A notice board is located at the ISSTD Society Table area for conference goers to leave written messages for each other. MEDICAL ATTENTION There is a hotel physician on call 24 hours. In Emergency dial 911 George Washington Memorial Hospital rd St NW, Washington, DC Distance from hotel: 3.8 miles MONDAY, APR. 3 7:30 AM - 10:30 AM CONFERENCE ATTENDEES NEEDING GUIDANCE A Conference Attendee Orientation Welcome will be held in the Arlington Ballroom Foyer on Saturday, April 1 at 7:45 AM before the Opening Welcome. Come have coffee and get started! If you would like assistance please visit the ISSTD Society Table located near registration and someone will be happy to help you. ISSTD BOOKSTORE Mentor Books will be onsite as the official ISSTD Bookstore in the Exhibit Hall. Please visit and order your books. SESSION RECORDINGS Access a world of knowledge with the ISSTD Learning Center! Enjoy the ISSTD Annual International Conference without feeling rushed, and have more time to network with all your colleagues. Experience all that the ISSTD Learning Center has to offer: Over 150 hours of recorded audio content Downloadable MP3 files Access to content anytime, anywhere! INOVA Urgent Care 4600 Lee Hwy, #C, Arlington, VA Distance from hotel: 6.2 miles CANCELLATION POLICY Cancellations must be received in writing via to or via fax to A processing fee of $75 will be charged for cancellations received on or before 10 March, No refunds will be issued for no-shows. Refund requests will not be accepted after 10 March, Not all requests will be granted. Substitutions for attendees are accepted at any time. All paid, Full Conference Registrants may access the ISSTD Annual Conference recordings for FREE! Notice will be sent when these recordings are available approximately six weeks after the conference concludes. One-day registrants may order the conference and preconference recordings at any time. Conference recordings may be purchased through the ISSTD website at FINAL CONFERENCE PROGRAM & PROCEEDINGS

9 ISSTD Membership Information 2017 ISSTD MEMBERSHIP CAMPAIGN Sign up before or during the conference and be entered in a drawing to win a free membership for one year! Pick up a membership renewal form at the Society Table. NEW MEMBERS! ISSTD Membership is based on the anniversary date of joining. New members who sign up during the conference will enjoy 365 days before renewing. RENEWING MEMBERS The online version of the Journal of Trauma & Dissociation is included when you renew this year. You can purchase the print version for an additional opt-in fee of $27. Make sure you renew to avoid a reactivation and processing fee of $25. Visit us at and renew online. ISSTD AWARDS Awards will be announced at the Annual Awards Dinner on Saturday, April 1st. Join us for fun and prizes. CORNELIA B. WILBUR AWARD: The Cornelia B. Wilbur Award is given to an individual for outstanding clinical contributions to the treatment of dissociative disorders. Examples are (a) furthering the availability of diagnosis and treatment of dissociative disorders, (b) clinical research in diagnostic or treatment modalities, including treatment outcome, (c) advances in diagnostic instruments or diagnostic criteria, (d) diagnostic studies in various populations, or (e) new treatment techniques. MORTON PRINCE AWARD FOR SCIENTIFIC ACHIEVEMENT: Given to an individual who has made outstanding cumulative contributions to research in the area of dissociative disorders. DISTINGUISHED ACHIEVEMENT AWARD: Given to an individual or individuals who have distinguished themselves in the ISSTD. DAVID CAUL MEMORIAL AWARD: Given for the best published or non-published paper, thesis, or conference abstract written by a resident or trainee in the field of dissociation and/or trauma. PIERRE JANET WRITING AWARD: Given to an individual for the best clinical, theoretical or research paper in the field of dissociative disorders and/or trauma within the past year. MEDIA AWARDS: Given to an individual or organization for the best-written media (e.g., books, newspapers) and best audiovisual media (e.g., films, television, videos) that deal with dissociation and/or trauma. PRESIDENT S AWARD: Given to an individual who has given outstanding service to the Society. STUDENT AWARD: Given to a trainee (i.e., undergraduate, graduate, pre-graduate intern or post-graduate resident) for: (a) outstanding service to the Society; (b) an exceptional contribution to or innovation in clinical or service delivery in the field of dissociative disorders; or (c) an exceptional contribution to or innovation in training in the field of dissociative disorders. LIFETIME ACHIEVEMENT AWARD: The highest recognition given to an individual or individuals who have contributed over a generous span of time to the field of dissociation and/or trauma and the ISSTD. SÁNDOR FERENCZI AWARD: Given for the best published work in the realm of psychoanalysis related to trauma and dissociation in adults and/or children. BEST POSTER AWARD: Given to the author(s) who have: (1) made a significant contribution to the clinical or research arena; (2) demonstrated excellence in quality of research or conceptualization of the literature; clinical or design analysis, presentation, and interpretation; (3) provided appropriate and clear graphics; (4) excelled in writing abilities (style, organization, clarity, format, etc.); and (5) presented an aesthetically pleasing poster. RICHARD P. KLUFT AWARD FOR JOURNAL OF TRAUMA & DISSOCIATION BEST ARTICLE: Sponsored by Routledge DISCLAIMER FOR THE INTERNATIONAL SOCIETY FOR THE STUDY OF TRAUMA AND DISSOCIATION The diagnosis and treatment of Dissociative Identity Disorder and other dissociative disorders continue to be in an evolutionary stage of development. There are many differing approaches. The techniques and suggestions as presented in papers, slides, audio tapes, video, or demonstrations at Society conferences are those of the authors and presenters and do not necessarily reflect or represent the opinions or suggestions of the Society. While these techniques may have been successful in the hands of workshop presenters, it must be understood that it does not follow that this will be so for every therapist or in every case. Participants are advised to ensure that they exercise their own independent professional judgment when treating patients, consistent with the prevailing standard of care in their locality and the current literature on dissociative disorders. The material presented here is for the purpose of information exchange only. Those who choose to use it do so at their own risk and professional responsibility. The material presented is of a preliminary nature. Speakers, titles, and topics are subject to change. For the latest information consult the ISSTD Web site at Presentations on trauma and dissociation have the potential to be distressing to some conference attendees. Individuals are strongly encouraged to use prudent caution and judgment in deciding whether a given workshop is appropriate to attend, particularly in the case of those programs that offer an experiential component. CONFERENCE INFORMATION 2017 FINAL CONFERENCE PROGRAM & PROCEEDINGS 9

10 Accreditation Information CONFERENCE INFORMATION The Institute for the Advancement of Human Behavior (IAHB) is pleased to offer continuing education credit hours to counselors, nurses, psychologists, social workers, nurses, physicians, and certain other healthcare professionals for the ISSTD 2017 Annual Conference. Please reference the onsite CE program for detailed continuing education information. The Institute for the Advancement of Human Behavior (IAHB) has been approved to offer continuing education and continuing medical education (except where otherwise noted) by the following: COUNSELORS & MFTS: IAHB is approved by the State of Illinois Department of Professional Regulation (License # ). This course meets the qualifications for MFTs as required by the California Board of Behavioral Sciences (Provider # PCE 36). IAHB has been approved by the Texas Board of Examiners of Marriage and Family Therapists to provide CE offerings for MFTs. Provider Number 154. EDUCATORS: The Institute for the Advancement of Human Behavior has been approved by the Washington State Professional Educator Standards Board (WESPSB), a member of NASDTEC, as a Clock Hour Provider for Educators. Learners may claim one Clock Hour for each activity hour attended. Please contact your individual state boards for information regarding reciprocity and any additional requirements. NURSES: The Institute for Advancement of Human Behavior is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. IAHB is approved by the California Board of Registered Nursing, to provide 1 CE hour per contact hour (BRN Provider CEP#2672). PSYCHOLOGISTS: IAHB is approved by the American Psychological Association to sponsor continuing education for psychologists. IAHB maintains responsibility for this program and its content. Notice to Psychologists- Please remember to check speaker/ planner conflict-of-interest disclosures prior to registering at SOCIAL WORKERS: Institute for the Advancement of Human Behavior, #1426, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www. aswb.org, through the Approved Continuing Education (ACE) program. Institute for the Advancement of Human Behavior maintains responsibility for the program. ASWB Approval Period: 3/16/2017 3/16/2020. Social workers should contact their regulatory board to determine course approval for continuing education credits. Social workers participating in this course will receive 1 clinical continuing education clock hours per hour attended. IAHB SW CPE is recognized by the New York State Education Department s State Board for Social Work as an approved provider of continuing education for licensed social workers #0091. The sessions are approved for 1 hour per contact hours attended. This course meets the qualifications for CE credit for LCSWs as required by the California Board of Behavioral Sciences (Provider #PCE 36). IAHB has been approved by the State of Texas Board of Social Work Examiners, MC 1982, PO BOX , Austin, TX (512) , to provide continuing education activities for social workers. License No PLEASE NOTE: Many state boards accept offerings accredited by national or other state organizations. If your state is not listed, please check with your professional licensing board to determine whether the accreditations listed are accepted. PHYSICIANS: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Institute for the Advancement of Human Behavior (IAHB) and ISSTD. IAHB is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. IAHB designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s) per hour attended. Physicians should only claim credit commensurate with the extent of their participation in the activity. ALSO NOTE: This advanced workshop includes descriptions, videotapes, audiotapes, and/or reenactments of actual therapy sessions. Some of the case material may contain graphic descriptions of violence, sexual activity, or other content which could be disturbing, especially to participant who themselves have had similar experiences. The workshop is intended for healthy professionals and advanced students, who participate in at their own risk. If you find portions of the program upsetting, or if you need assistance for any other reason, please notify the instructor or program coordinator FINAL CONFERENCE PROGRAM & PROCEEDINGS

11 Announcing: Frontiers in the Psychotherapy of Trauma & Dissociation: An Exclusive ISSTD Member Benefit in 2017! After a long time of planning, the ISSTD will publish the first volume of the new official clinical journal of the Society in 2017! The inaugural articles are currently under review and preparation for publication. Dedicated to the promotion of creative clinical practices, our E-Journal s name will be Frontiers in the Psychotherapy of Trauma and Dissociation. It will restart the function of our earlier clinical journal Dissociation and will complement the cherished function of the Journal of Trauma and Dissociation, which acts as the forum for conceptual and research articles. We have taken on the editorship of the E-Journal and look forward to the challenges and triumphs ahead in making it a successful ISSTD outlet for cutting-edge ideas related to the treatment of complex trauma disorders. THE NEW JOURNAL S MISSION As the editors of Frontiers, we envision it becoming the stage for clinicians who strive to break gridlocks in psychotherapy s course. In the Mission Statement for Frontiers we state: Clinicians observations from testing the rationale for their interventions, for one patient and one treatment session at a time, are indeed the seed for ideas to update existing theories and for hypotheses to test experimentally. We want to publish articles with insights about how such gridlocks get broken, by authors from inside and outside our Society. We will ask authors to state the rationale for their improvisations and how their clients measured the benefit. Such rationale from everyday practice is the rudiments for better theory. How self-change matters to clients, in turn, suggests how we should measure our interventions maturation. PREPARATIONS We are recruiting the editorial board, have several inaugural articles underway by well-known clinicians, have applied to the Library of Congress for registration, have raised funds through sponsorships to support this launch, and are looking forward to receiving article submissions from all who have an interest in this important work. Fundraising efforts are underway, and all are welcome to contribute. Further information can be found by visiting Access to Frontiers will be through membership in ISSTD. Look for updates and information in the ISSTD News, on the ISSTD website, and in forthcoming announcements! ISSTD CLINICAL E-JOURNAL A. Steven Frankel, PhD, JD Editor, Frontiers in the Psychotherapy of Trauma & Dissociation Andreas Laddis, MD Editor, Frontiers in the Psychotherapy of Trauma & Dissociation 2017 FINAL CONFERENCE PROGRAM & PROCEEDINGS 11

12 Special Features and Events Below are a few not to be missed general session events. Be sure to stop in and say hello! at the ISSTD Society Table located near the registration desk in the Arlington Ballroom Foyer. THURSDAY, MARCH 30 8:30 AM 4:30 PM Treatment of Dissociative Identity Disorder Lynette S. Danylchuk, PhD; Kevin J. Connors, MS, MFT Room: McLean Understanding and Working with Chronic Shame Richard A. Chefetz, MD; Martin Dorahy, PhD Room: Alexandria Working Through Trauma: Process and Pitfalls with Complex Trauma and Dissociative Patients John A. O'Neil, MD, FRCPC; Su Baker, MEd Room: Rosslyn I CONFERENCE INFORMATION Fundamental Things About Stage 1 Treatment of DID: All the Things You Were Afraid to Ask, Didn t Know You Needed to Ask, Forgot to Remember to Ask, or Just Wanted to Know Richard J. Loewenstein, MD Room: Rosslyn I Treatment of Complex Trauma in Children and Adolescents: Addressing Attachment, Dissociation, Behavior, and Communication Na ama Yehuda, MSC SLP; Niki Gomez-Perales, MSW, RSW Room: Manassas Addiction and Trauma as Co-Occurring Disorders: From Affect Dysregulation to Stabilization Jan Beauregard, PhD; Denise Tordella, MA, LPC Room: Alexandria FRIDAY, MARCH 31 8:30 AM 4:30 PM 5:00 PM 7:00 PM SPECIAL TICKETED EVENT: Scavenger Hunt at the International Spy Museum Supported by: Sheppard Pratt Health System and the Trauma Disorders Program at Sheppard Pratt Participants will be put into teams of 6-7 and compete against each other as they answer questions, find a "dead-drop", decipher an encrypted message, and "bug" other teams. Prizes will be awarded to the winning team. SATURDAY, APRIL 1 7:45 AM 8:00 AM Conference Attendee Orientation Room: Arlington Ballroom Foyer 8:00 AM 8:30 AM President s Welcome Room: Arlington Ballroom Salons III-IV Back to the Future: Rediscovering the Past to Improve Treatment Results in DID and Allied Dissociative Conditions in the Present Richard P. Kluft, MD, PhD Room: McLean Caboose No More: The Association of Dissociation is the Engine of EMDR Therapy Sandra Paulsen, PhD Room: Manassas Introduction to Opening Session Room: Arlington Ballroom Salons III-IV 8:30 AM 10:00 AM PLENARY ADDRESS: PIERRE JANET LECTURE: Introduction to the Neurosequential Model of Therapeutics: Using a Neuroscientific, Developmentally Appropriate Treatment Approach in Clinical Work Bruce Perry, MD, PhD Room: Arlington Ballroom Salons III-IV FINAL CONFERENCE PROGRAM & PROCEEDINGS

13 10:00 AM 10:30 AM Exhibit Hall Opens Room: Arlington Ballroom Foyer Mentor Books Bookstore will have many titles on hand recommended by presenters. Say hello to our exhibitors who generously support our conference. Make sure to visit and enjoy the Poster Submissions, visit our Exhibitors, and shop at the Mentor Books throughout the conference! 12:00 PM 1:30 PM Students and Emerging Professionals Lunch & Meeting Supported by: Sheppard Pratt Health System and the Trauma Disorders Program at Sheppard Pratt Room: Rosslyn Calling all students and emerging professional! The SEP Committee invites you to learn more about new opportunities to become involved in ISSTD and network with distinguished ISSTD members. These seasoned professionals will share their experiences in the industry and answer your questions. Lunch will be provided. 6:15 PM 7:00 PM President s Reception (included in full conference registration) Room: Arlington Ballroom Foyer Come chat with friends old and new! One drink ticket provided with your registration. Cash bar (Please, no checks or credit cards). 7:00 PM 10:00 PM Awards Dinner and Entertainment (included in all conference registration) Room: Arlington Ballroom Salons III-IV 6:15 PM - 6:45 PM Annual Business Meeting (ISSTD Members Only) Pamela C. Alexander, PhD Room: Arlington Ballroom Salons III-IV 5:15 PM 6:15 PM Annual Town Hall Meeting (All Attendees Invited) Room: Arlington Ballroom Salons III-IV 8:30 PM 10:00 PM SPECIAL DOCUMENTARY PRESENTATION: The Hunting Ground Room: Arlington Ballroom Salons III-IV MONDAY, APRIL 3 8:30 AM 10:00 AM PLENARY ADDRESS: Intergenerational Cycles of Trauma and Dissociation: The Family Context of the Attachment Relationship Pamela C. Alexander, PhD Room 1:30 PM - 6:00 PM Bootcamp for Clinicians: Culturally Sensitive Therapy with the Military Elizabeth F. Pillsbury, MSW, LICSW; Christian Labra, MD Room: Arlington Ballroom Salon I CONFERENCE INFORMATION Be sure to drop off your ticket to the Awards Dinner at check-in! We ll have music and prizes. Come, relax, network, eat and be merry. There will be a cash bar available. (Please, no checks or credit cards). SUNDAY, APRIL 2 8:00 AM 10:00 AM PLENARY ADDRESS: The Borderline Question Moderator: John A. O Neil, MD, FRCPC Julian Ford, PhD; Warwick Middleton, MD; Dolores Mosquera, Psy Room: Arlington Ballroom Salons III-IV Managing the Effects of Vicarious Trauma with Creative Arts Therapies Tally Tripp, MA, MSW, ATR-BC; Barbara Sobol, MA, ATR-BC, LPC, CTT Room: Arlington Ballroom Salon II Neurofeedback and Neural Regulation: Brain and Body Ulrich F. Lanius, PhD Room: Arlington Ballroom Salon V Trauma and Sexuality: Engaging and Treating the LGBT Client Sara Mindel, LICSW Room: Arlington Ballroom Salon VI 2017 FINAL CONFERENCE PROGRAM & PROCEEDINGS 13

14 Plenary Addresses SATURDAY, APRIL 1 SUNDAY, APRIL 2 PLENARY ADDRESSES 8:30AM 10:00 AM PLENARY ADDRESS 1 Room: Arlington Ballroom Salons III-IV SESSION LEVEL: ALL PIERRE JANET LECTURE: Introduction to the Neurosequential Model of Therapeutics: Using a Neuroscientific, Developmentally Appropriate Treatment Approach in Clinical Work Bruce Perry, MD, PhD The development of a young child is profoundly influenced by experience. Experiences shape the organization of the brain which, in turn, influences the emotional, social, cognitive and physiological activities. Insights into this process come from understanding brain development. Based on a neurosequential understanding of brain development, the Neurosequential Model of Therapeutics (NMT) is a developmentally sensitive, neurobiologically-informed approach to clinical problem solving that integrates core principles of neurodevelopment and traumatology to inform work with children, families, and the communities in which they live. This session will provide an overview of key principles of neurodevelopment, review key functions of the brain, and outline the hierarchy of brain development. From there, Dr. Perry will describe how the NMT approach can help professionals determine the strengths and vulnerabilities of a child and create an individualized intervention, enrichment, and educational plan matched to his/ her unique needs. Provide an overview of key principles of neurodevelopment crucial for understanding the role of experience in defining functional and physical organization of the brain Describe the emerging clinical and research findings in maltreated children that suggest the negative impact of abuse, neglect and trauma on brain development Outline the clinical implications of a neurodevelopmental approach to child maltreatment 8:00 AM 10:00 AM PLENARY ADDRESS 2 Room: Arlington Ballroom Salons III-IV SESSION LEVEL: ALL The Borderline Question Moderator: John A. O Neil, MD, FRCPC Julian Ford, PhD; Warwick Middleton, MD; Dolores Mosquera, Psy This interactive panel discussion regarding "The Borderline Question" commences with short presentations by panel members, all of whom have done research and written on issues involving "borderline personality disorder" in the context of complex trauma/dissociative disorders. These multiple perspectives on contemporary issues incorporate a historical perspective on the evolution of the "borderline" construct, leading into the Moderator asking specific questions of the panel regarding issues raised. This is followed by the general audience being invited to contribute questions or comments.. Identify one primary similarity and one primary difference between borderline personality disorder and complex PTSD. Appreciate that while borderline personality disorder (BPD), is often seen in those who meet diagnostic criteria for dissociative identity disorder, this is by no means an inevitable association and indeed BPD may on occasions be seen in individuals with no apparent childhood history of severe trauma/neglect.»» Track the evolution of the "borderline" construct through earlier concepts incorporating views of overlapping symptoms of "psychosis" and "neurosis", though debates about the nature of "personality disorder" and whether such conditions are best conceptualized dimensionally rather than by selected "diagnostic criteria", through to an appreciation of how the term "borderline" can have perjorative contexts FINAL CONFERENCE PROGRAM & PROCEEDINGS

15 MONDAY, APRIL 3 8:30 AM - 10:00 AM PLENARY ADDRESS 3 Room: Arlington Ballroom Salons III-IV SESSION LEVEL: ALL Intergenerational Cycles of Trauma and Dissociation: The Family Context of the Attachment Relationship Pamela C. Alexander, PhD The notion of relational trauma is grounded in attachment theory, suggesting that complex trauma emerges in large part from the relationship with the attachment figure. Indeed, research demonstrates that overt abuse is not necessarily even required for disorganized attachment and dissociation to occur. However, the parent-child attachment relationship does not exist within a vacuum. Instead, the family context of this relationship may set the stage for and allow the development of disorganized attachment or alternatively, protect the child from its effects. Reciprocally, an individual s experience of abuse or trauma may have ripple effects on the family of creation as evidenced by intergenerational cycles of trauma. These ripple effects may even be observed in the absence of overt abusive behavior through the mechanism of attachment behavior toward children and partners. One goal of this session is to describe the many ways in which the family affects, is affected by and interacts with the parent-child attachment relationship in the development of intergenerational cycles of trauma and dissociation. Another goal is to explore how the family of origin and family of creation are important potential sources of resilience and healing. Identify how the parent-child attachment relationship may contribute to trauma and dissociation, even in the absence of overt abuse. Explain how the family of origin may either facilitate the development of insecure attachment including disorganized attachment or guard against its occurrence.»» Describe how the family of creation may either contribute to or interrupt intergenerational cycles of trauma and dissociation FINAL CONFERENCE PROGRAM & PROCEEDINGS 15

16 CENTER FOR ADVANCED STUDIES IN TRAUMA AND DISSOCIATION ISSTD Center for Advanced Studies in Trauma and Dissociation: Certificate Program ISSTD launched the ISSTD Center for Advanced Studies in Trauma and Dissociation at the Annual Conference in The Center is devoted to comprehensive training in assessment and treatment of complex traumatic stress disorders and dissociative disorders. This is the first program developed from an analysis of the Core Areas of Knowledge, previously delineated by a task force of senior scholars and clinician members of ISSTD and identified as required for indepth knowledge of trauma and dissociation. The Certificate Committee has been working since early 2012 translating these core areas into an integrated program of postgraduate study in trauma and dissociation. ISSTD then created the Center for Advanced Studies in Trauma and Dissociation. The Center has guided a restructuring of ISSTD s educational offerings (Annual Conference, Professional Training Program, Regional Seminars and Conferences, and Webinars) so that they emphasize the Core Areas of Knowledge. Using this new foundation, the Institute has now developed an important new pathway for postgraduate training in trauma and dissociation - the ISSTD Certificate Program through The Center. The Center offers a multi-tracked training program at Introductory, Intermediate, and Advanced Levels. Completion of the tracks will lead to a Certificate acknowledging completion of hours of training from The Center. We are very pleased to designate portions of this conference to apply to hours needed for the Certificates. By your attendance at any of the checked courses in the program or listed below, you will already have begun to accumulate the hours required for the Certificate! We encourage you to continue your journey towards comprehensive mastery of trauma and dissociation through participation in the Center s programs. Other training programs stop just as traumatic reactions and patients become complex. We start where others leave off. HOW DO I EARN A CERTIFICATE? You can earn your State-of-the-Art Certificate in Trauma and Dissociation by completing 72 hours of workshops and courses in the Core Areas of Knowledge. You can also earn an Advanced Certificate in Trauma and Dissociation by completing 100 hours of workshops and courses in the Core Areas of Knowledge. You can earn ISSTD credits at this conference toward a Certificate of Advanced Studies in Trauma and Dissociation WHY SHOULD I EARN A CERTIFICATE? The Core Areas of Knowledge provide a pathway of learning for every professional from novice to expert. No matter what you already know, courses in the ISSTD Core Areas will deepen your knowledge, guiding your learning of important material beyond your current expertise Be one of the few in your community to be formally recognized for further, postgraduate education focused on trauma and dissociation! Better yet, acquire the habit of constant learning; keep broadening, enriching, and deepening your understanding of trauma and dissociation. Let the Certification Program and the Core Areas of Knowledge lead the way. Your clients, students, colleagues and community will all be the better for your efforts. So will you. WHAT DOES THE CERTIFICATE COST? Through the generosity of ISSTD members and other donors, ISSTD is able to offer the Certificate Program to you at no additional cost. Registration for the certificate process, tracking your accumulating credits, and being granted the Certificate are all part of the program. You can earn credits when you purchase and attend designated courses, workshops and conference sessions. HOW DO I RECORD AND TRACK MY CREDITS TOWARD A CERTIFICATE? ISSTD will keep a record of the courses you take and the hours that apply to the Core Areas. However, it is highly recommended that you keep track of the hours you ve earned as well. When you have accumulated the requisite number, your courses will be reviewed and confirmed, and your certificate will be sent to you. Note: this is a different process from recording your Continuing Education hours. Continuing Education credits and the Certificate Program are different from one another and must be recorded separately. The good news: in many cases ISSTD educational events qualify for both Continuing Education credits and ISSTD Certificate credits. Join the fun! Come along with us and walk the path of the Core Areas of Knowledge that leads to comprehensive mastery of trauma and dissociation Warm regards, The Certificate Committee The Center for Advanced Studies in Trauma & Dissociation Joan A. Turkus, MD Paul F. Dell, PhD Phil Kinsler, PhD Joan Golston, DCSW, LICSW Lynette Danylchuk, PhD FINAL CONFERENCE PROGRAM & PROCEEDINGS

17 BELOW IS THE LIST OF IDENTIFIED AREAS AND HOURS REQUIRED TO EARN A CERTIFICATE FROM ISSTD: CORE AREAS OF KNOWLEDGE CREDITS TOWARDS ISSTD CERTIFICATE OF STUDY CHILD, ADOLESCENT & ADULT I. INTRODUCTORY LEVEL: 1.1. Complex posttraumatic effects and responses: Complex posttraumatic effects and responses 3 Foundational areas of knowledge Assessment Assessment of trauma and dissociation--des, PCL TSI Treatment of complex trauma and dissociation II. INTERMEDIATE LEVEL Introduction to the Treatment of Complex Trauma- Child, Adolescent or Adult 3 Establishing & conducting an effective trauma therapy 3 Memory, trauma, and suggestibility 3 Staged treatment the road map: Stage I, Stage II, Stage III Models of treatment of posttraumatic disorders Intermediate Assessment Frankel article- Dell & O Neill, Loewenstein s Office Mental Exam, MID Treatment of Complex Trauma & Dissociative Disorders Relational challenges in trauma/dissociation therapy 6 Transference/countertransference patterns Vicarious traumatization 2.4. Management of self-injurious behaviors Ethics/professional issues and risk management 6 III. ADVANCED LEVEL 3.1. Advanced treatment of DID: Trauma processing, fusion/integration Relational challenges in trauma/dissociation therapy Tutorial on neurobiology of trauma, concepts of dissociation Tutorial on current research in complex trauma and dissociation Psychopharmacology of complex traumatic disorders Comorbid Disorders: Medical illnesses, substance use, eating disorders Historical/Societal TBD CENTER FOR ADVANCED STUDIES IN TRAUMA AND DISSOCIATION Credits toward the ISSTD Certificates of Study in Trauma and Dissociation are SEPARATE AND DISTINCT from continuing education or continuing medical education credits (CE/CMEs). CE/CME credits are different and must be purchased separately FINAL CONFERENCE PROGRAM & PROCEEDINGS 17

18 CENTER FOR ADVANCED STUDIES IN TRAUMA AND DISSOCIATION ISSTD Certificate Program 2017 Annual Conference Credit Acquisition Instructions ON-SITE Individuals participating in the ISSTD Center for Advanced Studies in Trauma and Dissociation Certificate Program and obtain Certificate Credits must record the unique verification codes for each of the workshops they attend. Upon check-in, attendees will receive a sheet of paper in their Conference tote bags that will list all of the presentations by date and will have unique verification codes for each session. The verification codes will begin with the prefix DC17. Please be sure to make a note of which sessions you attend because you will need these verification codes will grant you access to take the required post-conference quizzes. POST-CONFERENCE A few weeks following the conference, attendees will receive a username and access key to the post-conference website. Once you have gained access, you will select Certificate Program Credits on the left sidebar. You will then see a series of tasks that need to be completed, in order to obtain Certificate Credits for participating in the 2017 Annual Conference. These are: TASKS: Sessions Attended Click on Sessions Attended under Tasks. This is the page you will enter in your verification codes. After you have completed this task, select Continue. Sessions Post-test Click on Sessions Post-test under Tasks. This will lead you to your quiz questions. Each workshop/presentation will ask 3 quiz questions. You will need to receive a passing rate in order to obtain the credits in the various Core Areas of Knowledge. Certificate of Study This document is a record of your attendance for the 2017 Annual Conference. This is not your Certificate for achieving 72 or 100 credit hours. This document can be saved, printed, or ed. Thank you for your participation! Visit the ISSTD website or for further information FINAL CONFERENCE PROGRAM & PROCEEDINGS

19 ISSTD Center for Advanced Studies in Trauma and Dissociation: Certificate Program We start where others leave off. Most training programs focus on simple trauma. The ISSTD Center s programs focus on complex trauma. Continue your journey towards mastery of complex trauma and dissociation. ISSTD provides courses throughout the year. Core Area of Knowledge Credits can be earned through these course offerings. Visit our website for specific times and locations of these courses: INTRODUCTION TO THE TREATMENT OF COMPLEX TRAUMA This two-part course addresses chronic, complex trauma treatment. Participants will gain a working knowledge of complex trauma and dissociation. DIAGNOSIS AND TREATMENT OF COMPLEX TRAUMA AND DISSOCIATIVE DISORDERS - THE STANDARD COURSE At the end of this this two-part course, participants will have sufficient knowledge to be able to diagnose complex trauma, Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder (OSDD), and will have essential knowledge and skills needed to conduct individual psychotherapy to treat these disorders. DIAGNOSIS AND TREATMENT OF COMPLEX TRAUMA AND DISSOCIATIVE DISORDERS - THE ADVANCED COURSE This program emphasizes attachment, special techniques, special adjustment of the treatment frame, transference and counter transference, boundaries, communications with alters, integration, and termination. ASSESSMENT AND TREATMENT OF TRAUMATIZED CHILDREN AND ADOLESCENTS WITH DISSOCIATIVE SYMPTOMS AND DISORDERS - THE CHILD & ADOLESCENT COURSE This program is designed for clinicians in both private and public sectors. Participants will have sufficient knowledge to be able to diagnose dissociative symptoms and disorders in traumatized children and adolescents and will have essential knowledge and skills needed to conduct individual psychotherapy to treat complex trauma in children and adolescents. MASTER CLASSES Master Classes develop from interest and participation of students in some Advanced Courses. They are comprised of individuals who have completed an Advanced Course together and wish to continue studies with the guidance of an instructor. These classes often become a professional resource for participant Course Formats IN-PERSON COURSES meet monthly in a given location designated by the faculty. Students are assigned presession reading which are then discussed in class. HYBRID COURSES allow students to participate either inperson or virtually in a live course. These courses follow the same structure as in-person courses. Virtual participants are provided to access to the course using the ISSTD teleconferencing system. ONLINE COURSES are asynchronatic and are facilitated entirely online using discussion forums through our online learning management system. For each session, the faculty will schedule time for reading followed by time for discussion of the reading. CENTER FOR ADVANCED STUDIES IN TRAUMA AND DISSOCIATION 2017 FINAL CONFERENCE PROGRAM & PROCEEDINGS 19

20 DETAILED SCHEDULE WEDNESDAY, MARCH 29, 2017 WEDNESDAY, MARCH 29 9:00 AM 4:30 PM Room: Alexandria Annual Board Meeting (by Invitation) 11:00 AM 12:30 PM Room: Jefferson Foyer Registration Desk Open for ASCH Training Only **Pre-registered participants only 12:00 PM 8:00 PM Room: Jefferson LEVEL: INTERMEDIATE (01-003) ASCH Intermediate Hypnosis Training Reinhild Draeger-Muenke, PsyD, LMFT, Primary Presenter; Mary Jo Peebles, Co-Presenter; Susan Sacks, Co-Presenter Your Beginning Hypnosis training taught you the fundamentals of how to do hypnosis. The Intermediate Level training in clinical hypnosis will allow you to strengthen your skills and confidence in being hypnotic, beyond the mechanics and into the process of facilitating change. An experienced faculty will offer thorough didactic, experiential, and practical supervised learning. During the three small group practices, you will have ample opportunity to refresh and expand your hypnotic induction and intensification skills. You will have the opportunity to increase your understanding of the decision making processes that go into offering competent, effective, and constructive hypnosis in a variety of clinical situations, including the treatment of traumatized and dissociated people. Among many topics, we will address: Insight-oriented and exploratory hypnotic techniques; treatment choices and how to make them; creating therapeutic metaphors; hypnotic approaches to trauma and dissociation, pain management, and affect regulation; working hypnotically with anger and depression, anxiety and habit disorders; hypnosis with children. Join us for an exciting training and complete your next step toward ASCH certification in clinical hypnosis. To register, you must be a licensed clinician or a student of a mental health care discipline attending an accredited institution, and you must have attended an ASCH approved 20 hours of BASIC/FUNDAMENTAL training in clinical hypnosis. Discuss indications and contraindications for using an insight-oriented hypnotic approach in the exploratory phase of the treatment of trauma and dissociation. Describe at least three exploratory hypnotic techniques. Experience ideomotor exploration via pendulum. 2:00 PM 2:30 PM Room: Jefferson Foyer ASCH Training Break 4:00 PM 4:30 PM Room: Jefferson Foyer ASCH Training Break 5:00 PM 9:00 PM Room: Skyview ISSTD Board Reception & Dinner (by Invitation) 6:00 PM 6:30 PM Room: Jefferson Foyer ASCH Training Dinner FINAL CONFERENCE PROGRAM & PROCEEDINGS

21 THURSDAY, MARCH 30, :30 AM 8:30 AM Room: Arlington Registration Registration Desk Open for Pre-conference Only 8:00 AM 5:00 PM Room: Jefferson LEVEL: INTERMEDIATE ASCH Intermediate Hypnosis Training body-based treatments like Sensorimotor Psychotherapy and trauma sensitive yoga as effective treatment strategies that promote the integrative capacities and empowerment of clients. Define the DSM-V diagnostic criteria for addictive disorders and other assessment tools to support the evaluation and integrated treatment planning for clients who present with co-occurring, trauma-related disorders. Incorporate the neurobiological research on the treatment of addiction from a trauma-informed perspective. 8:30 AM 4:30 PM CONCURRENT PRE CONFERENCE SESSIONS PRE CONFERENCE INSTITUTE 4 Room: Alexandria LEVEL: ADVANCED (02-004) Addiction and Trauma as Co-occurring Disorders: From Affect Dysregulation to Stabilization Jan Beauregard, PhD, Primary Presenter; Denise Tordella, MA, LPC, Co-Presenter Recent research on the treatment of chronically traumatized individuals has awakened practitioners in the mental health and addiction fields to examine the complex interactions between addictive disorders and trauma-related treatment challenges. Whether the addiction is to substances or a process addiction like compulsive sexuality, it impacts and alters the brain. The addictive behavior serves as a maladaptive strategy for affect regulation for clients who have limited coping strategies as well as limited abilities to form healthy attachments. Pathologizing the addictive behavior often replicates the pattern of abuse; it becomes the client s fault rather than a desperate attempt to maintain affect within a window of tolerance that has been severely compromised due to traumatic experiences. When sexual addiction, as well as other addictive behavior, is not seen through the lens of adaptation to trauma, individuals are at risk for being misdiagnosed, receiving misdirected treatment, being over-medicated and left with residual shame. How the multibillion dollar pornography industry has hijacked sexuality and produced a public health crisis in our culture will also be addressed. In this workshop, we will look at addiction as both a chronic brain disorder and an attachment disorder and explore the impact of this compensatory survival strategy on the clients ability to self regulate in a safe manner. Principles of stage-oriented trauma treatment using EMDR, internal family system/ego state models will be highlighted along with newer Identify five (5) creative treatment strategies and modalities to support individuals in implementing adaptive coping strategies that regulate arousal level and modulate affect. Participants will be able to teach simple trauma - sensitive yoga postures to stabilize and empower clients who struggle with dissociation and stabilization. PRE CONFERENCE INSTITUTE 3 Room: Rosslyn I LEVEL: INTRODUCTORY (02-005) Fundamental Things About Stage 1 Treatment of DID: All the Things You Were Afraid to Ask, Didn t Know You Needed to Ask, Forgot to Remember to Ask, or Just Wanted to Know Richard J. Loewenstein, MD, Primary Presenter In this presentation, based on his over 30 years experience with several thousand dissociative patients, Dr. Loewenstein will discuss a series of basic issues in early phases of Stage 1 Treatment of Dissociative Identity Disorder (DID) from the vantage point of DID as a complex posttraumatic developmental disorder. If the early treatment is not adequately established, the remaining stages will be far more difficult to negotiate. He will discuss understanding the developmental origins of and working with the negative transference (and counter-transference), particularly when the patient has been sadistically abused; conceptualizing and formulating successful interventions to establish safety; working with traumatic memories early in treatment; and practical ways of working with self states, particularly malevolent and introject self states, as well as the self state system. He will discuss a basic approach to understanding the nature of responsibility for behavior in DID patients, and how to pragmatically work with this problem, especially early in treatment. He will discuss problems like what is a self state? or who is the patient?, and practical approaches to resolving these questions. He will review the findings in studies of psychological structure of DID, and how this helps us understand and work with both THURSDAY, MARCH FINAL CONFERENCE PROGRAM & PROCEEDINGS 21

22 THURSDAY, MARCH 30 the resilience of DID patients, and, on the other hand, the extreme maladaptations found in these patients, and alterations between these. He will also discuss the interaction between PTSD symptoms and DID, and describe practical ways of educating patients about these, and helping patients more effectively manage these symptoms. He will also describe practical approaches to the problem of patients who report organized sadistic abuse. He will review a pragmatic approach to psychopharmacology for DID patients that will be helpful to both the medical and non-medical practitioner. He will also discuss EMDR disasters, based on patients admitted to the Sheppard Pratt Trauma Disorders Inpatient Unit, and pitfalls in using this modality without careful attention to staging in phasic trauma treatment. He will review the structure of EMDR and how this can help us understand negative responses to this modality in DID patients.the goal of this workshop is to provide the attendee with not just with a theoretical framework for establishing the early treatment of the DID patients, but also specific, pragmatic ways of approaching problems with these patients, and understanding the reasons why some interventions work, and others do not, and/or lead to major problems. For example, at the end of the workshop the attendee will have learned the pragmatic importance of understanding the UN Security Council for work with DID. Identify the three most important issues in stage 1 of Phasic Trauma Treatment for Dissociative Identity Disorder. Conceptualize the forensic implications of a safety agreement in the treatment of Dissociative Identity Disorder. Describe the importance of holding the Dissociative Identity Disorder patient responsible for the behavior of any personality state. PRE CONFERENCE INSTITUTE 2 Room: Manassas LEVEL: INTERMEDIATE (02-006) Treatment of Complex Trauma in Children and Adolescents: Addressing Attachment, Dissociation, Behavior, and Communication Na ama Yehuda, MSC SLP, Primary Presenter; Niki (Veronica) Gomez-Perales, MSW, RSW, Co-Presenter Complex childhood trauma is known to have widespread impact on children s and teen s development, behaviour, clinical presentation and needs. Disruption in attachment relationships, behavior and communication issues, and dissociative coping mechanisms are frequently present, complicating the clinical picture and impacting assessment and treatment outcomes. Caregiver interactions, family dynamics and professionals interpretations of treatment needs, priorities, and even their own reactions are affected by these presentations. This daylong workshop will focus on interventions with children and teens affected by complex trauma, along with their caregivers and support systems. The role of dissociation in regulating and managing stress will be elucidated, and suggestions will be given for how to walk the fine line between addressing dissociative coping without dismantling it before its time. The need to work with the whole child will be highlighted, along with ways to communicate with (and through to) dissociated aspects of the child. Strategies will be shared for ways to help minimize dissociative coping during daily interactions while not limiting the child s exposure to everyday experiences and opportunities. The use of (verbal and non-verbal) language and behavior as communicating distress will be detailed, as well as ways to use language and communication as reparative tools in the treatment of trauma and dissociation by clinicians, caregivers and educators. Suggestions for understanding, preventing and coping with meltdowns, flashbacks, difficult behaviors, and severe dissociative episodes will be explored. Specific neurologically integrative techniques for managing experiences, exploring trauma and coping with daily challenges and attachment dynamics in children, teens, and their caregivers will be described. The role of attachment repair and dyadic work will be emphasized throughout. Issues such as working with co-morbidity (e.g. language/learning and attention issues, health and chronic pain issues, sensory regulation and processing issues) will be discussed, as well as preparation for and management of medical interventions in children with complex trauma, including those with medical trauma. The complex realities of traumatized children of dissociative/traumatized caregivers will be delineated, along with the importance of team work and the ethical, confidential, and practical limitations this often entails. Clinical examples and case studies will be utilized throughout the day as means to address practical therapy issues, conundrums, and considerations, including those brought up by participants. List three common issues that complicate the treatment of children and teens with complex trauma and dissociation. Identify four ways to improve attachment in children and teens with complex trauma and dissociation.»» Describe five strategies for utilizing language and communication in the treatment of traumatized children and teens FINAL CONFERENCE PROGRAM & PROCEEDINGS

23 PRE CONFERENCE INSTITUTE 1 Room: McLean LEVEL: INTRODUCTORY (02-007) Treating Dissociative Identity Disorder Kevin J. Connors, MS, MFT, Primary Presenter; Lynette S. Danylchuk, PhD, Co-Presenter Increasingly, clinicians are beginning to recognize that many of their clients have histories of complex and chronic abuse. They are confronted with dissociative defenses and, ultimately, may realize that one or more of their clients is struggling with Dissociative Identity Disorder. The lack of training in undergraduate and post graduate education to address these not uncommon disorders results in therapists feeling unprepared and overwhelmend.to help their most wounded clients. Unfamiliar with the diagnosis, clinicians struggle to support their clients through a complex array of intra-psychic dynamics, overwhelming emotions, and distorted beliefs that generate internal storms and external anguish. Clients lives are marked by constant crisis, unremitting self-mutilation, and repeated threats of suicide. They come labeled as problematic, oppositional, manipulative, or worse- as treatment failures. This workshop synthesizes state-of-the-art knowledge about complex posttraumatic stress disorder, attachment theory, and dissociative defenses, as well as often overlooked but equally critical issues of power, control and shame. Positive reframing of client reactions from oppositional or manipulative through an empathic attunement to the nature of their defenses, the history of their abuse, and the direction of their healing empowers therapists to formulate effective and nuanced treatment plans. Focusing on clinical concerns and conflicts, common in the first two stages of treatment, the therapist is challenged to advance treatment by exploring what is being expressed through the therapeutic relationship. The therapist is challenged to communicate in ways and on levels where language often fails. The therapist is challenged to guide the client through new ways of thinking and perceiving. Evaluate and identify clients with complex trauma histories and dissociative defenses. 8:00 AM 5:00 PM Mentor Books Bookstore 10:00 AM 10:30 AM Room: Jefferson Foyer ASCH Training Break - Refreshment 10:00 AM 10:30 AM Room: Arlington Foyer Break - Refreshment 12:00 PM 1:00 PM Room: Arlington Foyer ASCH Training Lunch (provided) 12:00 PM 1:00 PM Room: Arlington Foyer Lunch (provided) 2:30 PM 3:00 PM Room: Jefferson Foyer ASCH Training Break - Refreshment 3:00 PM 3:30 PM Room: Arlington Foyer Break - Refreshment THURSDAY, MARCH 30 Delineate how complex trauma and dissociation complicate treatment and describe appropriate & effective treatment strategies to increase client safety and stability. Delineate the Three Stages of Treatment and describe goals, objectives and treatment strategies appropriate to each FINAL CONFERENCE PROGRAM & PROCEEDINGS 23

24 FRIDAY, MARCH 31, 2017 FRIDAY, MARCH 31 7:30 AM 8:30 AM Room: Arlington Registration Registration Desk Open for Pre-conference Only 8:00 AM 5:00 PM Mentor Books Bookstore 8:00 AM 5:00 PM Room: Jefferson LEVEL: INTERMEDIATE ASCH Intermediate Hypnosis Training - Continued 8:30 AM 4:30 PM CONCURRENT PRE CONFERENCE SESSIONS PRE CONFERENCE INSTITUTE 7 Room: Manassas LEVEL: INTRODUCTORY (03-004) Caboose No More: The Association of Dissociation Is the Engine of EMDR Therapy Sandra Paulsen, PhD, Primary Presenter EMDR therapy is recognized as an effective treatment for PTSD, but is challenging with complex PTSD and dissociation. EMDR therapy training typically address dissociation as an afterthought or caboose. This workshop presents dissociation as the engine behind EMDR s associative processing, integrating with dissociation and adaptive information processing theories. Although not training participants to conduct EMDR, it offers a rapprochement between these two approaches from theory to practice. It integrates somatic, ego state and other preparations for trauma processing within a neurobiological framework. It also discusses the role of fractionation and other attenuating maneuvers for successful processing trauma with dissociative clients. PRE CONFERENCE INSTITUTE 6 Room: McLean LEVEL: INTERMEDIATE (03-005) Back to the Future: Rediscovering the Past to Improve Treatment Results in DID and Allied Dissociative Conditions in the Present Richard P. Kluft, MD, PhD, Presenter This workshop will reach back in time and teach methods of treatment for dissociative disorder patients that were used with great success before they were largely superceded by approaches that are currently in vogue, but which have not demonstrated superior effectiveness. The goal is to help today s clinicians further expand their skill sets and enhance their expertise in assisting their patients by availing themselves of an armamentarium of approaches associated with the highly successful treatments of the past that has been largely dismissed since the advent of the memory wars and the rise of alternative approaches. Contemporary emphasis on neuropsychophysiology, attachment, relational trauma perspectives, progressively blurring the boundaries between complex dissociative disorders and expanded paradigms of posttraumatic stress disorder, and on a proliferation of newer modalities and approaches (e.g., body-oriented treatments), notwithstanding their merits, have detracted attention from the fact that chronic complex dissociative disorders were being treated quite effectively before these models and contributions were on the scene. While the efforts of Brand and her colleagues have demonstrated that efforts to treat Dissociative Identity Disorder are generally helpful rather than hurtful, they also demonstrate a counterexpectational finding: the frequency of psycholytic outcomes, those that result in the cessation of the condition being treated, is far lower among patients treated by contemporary panels of expert therapists than the frequency of successful integrations had been in therapies employed prior to the changes in direction, purportedly improvements, enumerated above (e.g., Coons, 1986; Kluft, 1984, 1986, 1993). This workshop will direct considerable time to working toward integration, a process and outcome that has received little attention in the contemporary study of the dissociative disorders. Identify and describe in brief the 8 phases of standard EMDR therapy Describe two potential barriers to adaptive resolution of memories in using EMDR therapy with dissociative clients Identify two strategies for improving reprocessing with dissociative clients Prerequisites: 1) Basic familiarity with trauma and dissociative disorders; and 2) having taken a basic/introductory course in hypnosis. The ethical principles of the American Society of Clinical Hypnosis stipulate that advanced hypnotic techniques can be taught only to those who have already taken a basic/ introductory course in hypnosis FINAL CONFERENCE PROGRAM & PROCEEDINGS

25 List the characteristics of classic modern era DID treatment. Describe four pathways to the integration of alters and their characteristics. List twenty rationales for working directly with alters. PRE CONFERENCE INSTITUTE 8 Room: Alexandria LEVEL: INTERMEDIATE (03-006) Understanding and Working with Chronic Shame Martin Dorahy, PhD, DClinPsych, Primary Presenter; Richard A. Chefetz, MD, Co-Presenter Shame and responses to it, are ubiquitous in trauma-related disorders like dissociative identity disorder. This workshop examines the complexities and challenges of identifying and working with shame in the treatment of complex trauma and dissociative disorders. The first section will conceptualize shame, examine healthy and pathological manifestation of it, responses to it, it s erosion of self, and the emerging research findings within the complex trauma and dissociation literature. These foundations will path the way for exploring treatment perspectives and challenges including the corrosive impact of shame on the therapeutic relationship, the important of noting the presence of shame in trauma narratives, and the processing of shame in trauma work, or dealing with it before trauma narration. Identify the difference between shame and other selfconscious emotions. Describe the impact of shame on the therapy process. Express a working understanding of dealing with shame in the therapeutic space. PRE CONFERENCE INSTITUTE 9 Room: Rosslyn I LEVEL: ADVANCED (03-007) Working Through Trauma: Process and Pitfalls with Complex Trauma and Dissociative Patients John A. O Neil, MD, FRCPC, Primary Presenter; Su Baker, MEd, Co-Presenter The three-phase approach to the treatment of complex posttraumatic and dissociative disorders is well accepted. This workshop focuses on Phase 2. The three-phase approach developed especially in response to premature treatment approaches that proved to be countertherapeutic. Phase 1 involves stabilization through establishing safety and reducing symptoms, a phase that received too little attention in earlier decades (80s, 90s). Since then, Phase 1 has been much explored and presented, and Phase 2 has been relatively neglected. This workshop focuses on the principle tasks of Phase 2: working through, and integration. Various modes of therapeutic interaction will be outlined: the default therapeutic encounter; communicating through the host to his or her others ; meeting with others in person; and facilitating meetings of host and others in their shared hypnotic internal space or landscape their inscape e.g. through George Fraser s dissociative table technique. Symptoms tell a story. Once the story is told, the symptom is no longer needed. Translating a symptom into a story is most often done using a screen: the symptom is put on the screen, the images are put into words. This may be done live in the office, or in the inscape. Symptoms may be positive : something which should not be there, such as a flashback, nightmare, sensation, voice, affect, action, seizure, suicidal impulse; or negative : something missing which should be there, such as amnesia, analgesia, emotional blunting, depersonalization, derealization, etc. The symptom may be the subject s own, or an intrusion from one of his or her others. There are many paths to integration. Every patient improvises the manner of his or her own repeated doubling into DID, and so the paths to integration will differ from patient to patient. Twins are common, and likely candidates. Once freed from time traps, arrested self states can age spontaneously. When any two states agree to integrate, a temporary fusion may be tried; if this fails, then more working through is needed, but the states will still share more attributes as a result. When temporary fusions succeed, then there is nothing to undo. Ultimate integrated fusion is DID cured; and time for Phase 3. Clinical vignettes will illustrate all the technical issues, and these will be both verbal and through videos of selected sessions. The workshop will terminate with a Q&A period. FRIDAY, MARCH 31 Organize their therapeutic approach to ensure the safety of both patient and therapist. Identify the source of a symptom and to translate the symptom into a coherent narrative. Arrange for the successful integration of self states FINAL CONFERENCE PROGRAM & PROCEEDINGS 25

26 10:00 AM 10:30 AM Room: Jefferson Foyer ASCH Training Break - Refreshment 3:00 PM 3:30 PM Room: Arlington Foyer Break - Refreshment FRIDAY, MARCH 31 10:00 AM 10:30 AM Room: Arlington Foyer Break Refreshment 12:00 PM 1:00 PM Room: Arlington Foyer ASCH Training Lunch (provided) Supported by: TherapyNote 12:00 PM 1:00 PM Room: Arlington Foyer Lunch (provided) Supported by: TherapyNote 2:30 PM 3:00 PM Room: Jefferson Foyer ASCH Training Break - Refreshment 5:00 PM 7:00 PM Location: INTERNATIONAL SPY MUSEUM (participants meet in hotel lobby by 4:30pm) Scavenger Hunt at the International Spy Museum Supported by: Sheppard Pratt Health System and the Trauma Disorders Program at Sheppard Pratt Participants will be put into teams of 6-7 and compete against each other as they answer questions, find a dead-drop, decipher an encrypted message, and bug other teams. Prizes will be awarded to the winning team. 6:00 PM Dinner on your Own Pre-Conferences end today. Join us on Saturday Night for the Annual Awards Dinner and Entertainment. 6:00 PM 10:00 PM Room: Arlington Foyer/Registration Registration Desk Open/Exhibitor & Poster Set-up FINAL CONFERENCE PROGRAM & PROCEEDINGS

27 SATURDAY, APRIL 1, :00 AM 8:00 AM Room: Arlington Foyer Exhibitor & Poster Set-up 7:00 AM 5:00 PM Room: Arlington Registration Registration Desk Open 7:30 AM 8:00 AM Room: Arlington Foyer Coffee & Breakfast Pastries 7:45 AM 8:00 AM Room: Arlington Ballroom Salons III-IV Conference Attendee Orientation 8:00 AM 8:30 AM Room: Arlington Ballroom Salons III-IV Opening - Welcome Remarks 8:30 AM 10:00 AM PLENARY 1 Room: Arlington Ballroom Salons III-IV LEVEL: ALL (04-005) Introduction to the Neurosequential Model of Therapeutics: Using a Neuroscientific, Developmentally Appropriate Treatment Approach in Clinical Work Bruce D. Perry, MD, PhD, Primary Presenter The development of a young child is profoundly influenced by experience. Experiences shape the organization of the brain which, in turn, influences the emotional, social, cognitive and physiological activities. Insights into this process come from understanding brain development. Based on a neurosequential understanding of brain development, the Neurosequential Model of Therapeutics (NMT) is a developmentally sensitive, neurobiologically-informed approach to clinical problem solving that integrates core principles of neurodevelopment and traumatology to inform work with children, families, and the communities in which they live. This session will provide an overview of key principles of neurodevelopment, review key functions of the brain, and outline the hierarchy of brain development. From there, Dr. Perry will describe how the NMT approach can help professionals determine the strengths and vulnerabilities of a child and create an individualized intervention, enrichment, and educational plan matched to his/ her unique needs. Provide an overview of key principles of neurodevelopment crucial for understanding the role of experience in defining functional and physical organization of the brain. Describe the emerging clinical and research findings in maltreated children that suggest the negative impact of abuse, neglect and trauma on brain development Outline the clinical implications of a neurodevelopmental approach to child maltreatment 10:00 AM 10:30 AM Room: Arlington Foyer Break - Refreshment Supported by: Psychiatric Institute of Washington 10:00 AM 10:30 AM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters 10:30 AM 12:00 PM CONCURRENT SESSIONS 90MIN WS 1 Room: Arlington Ballroom Salon II LEVEL: INTERMEDIATE (04-009) Are Autohypnotic Defenses the Sole Etiological Mechanism of the Dissociative Disorders? John A. O Neil, MD, FRCPC, Chair; Paul F. Dell, PhD, ABPP, Primary Presenter In the 1980s and 1990s, many clinicians in the dissociative disorders field thought that DID and other major dissociative disorders were caused by high hypnotizability. Some still believe this. Current researchers and theorists, however, seem to have left this idea behind. Most agree that severely dissociative patients are typically quite hypnotizable, but the hypothesis - that high hypnotizability (plus repeated trauma) is the generative mechanism of the dissociative disorders has few strong advocates today. In this Forum Discussion, I will explain (1) SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 27

28 SATURDAY, APRIL 1 why I think it was a mistake to abandon the high-hypnotizability hypothesis, (2) why the high hypnotizability hypothesis gives us a more natural and more complete explanation of the dissociative disorders, and (3) why the posttraumatic model explains some features of DID, but is ultimately a very attractive red herring for understanding the dissociative disorders. Finally, I will show that the high hypnotizability hypothesis provides a richer and less constraining model of the dissociative disorders than does structural dissociation, and a more complete nosology of the dissociative disorders than does DSM-5. Recognize the fundamental importance of spontaneous hypnosis. Explain why the dissociative symptoms of DID are motivated, not involuntary. Explain why trauma does not cause dissociative disorders. 90MIN WS 2 Room: Arlington Ballroom Salons III-IV LEVEL: INTERMEDIATE (04-008) Clinical Application of the Neurosequential Model of Therapeutics Bruce D. Perry, MD, PhD, Primary Presenter The Neurosequential Model of Therapeutics (NMT) is a developmentally sensitive, neurobiology-informed approach to clinical problem solving. NMT is not a specific therapeutic technique or intervention. It is an approach that integrates core principles of neurodevelopment and traumatology to inform work with children, families and the communities in which they live. This clinical approach helps professionals determine the strengths and vulnerabilities of the child and create an individualized intervention, enrichment and educational plan matched to his/her unique needs. The goal is to find a set of therapeutic activities that meet the child s current needs in various domains of functioning (i.e., social, emotional, cognitive and physical). Illustrate clinical problem-solving through the lens of the Neurosequential Model of Therpapeutics. Demonstrate the application of the NMT assessment process including an examination of past and current experience and functioning in order to estimate the timing and severity of developmental risk that may have influenced brain development. Describe and illustrate the NMT mapping process which helps identify various areas in the brain that appear to have functional or developmental problems in order to help guide the selection and sequencing of developmentally sensitive interventions. 90MIN WS 3 Room: McLean LEVEL: INTRODUCTORY (04-012) How to Use the Dissociative Disorders Interview Schedule Colin Ross, MD, Primary Presenter The Dissociative Disorders Interview Schedule DSM-5 Version (DDIS) is a structured interview that diagnoses the DSM-5 dissociative disorders plus somatic symptom disorder, major depressive disorder, and borderline personality disorder. As well, it inquires about childhood physical and sexual abuse, substance abuse, psychotic symptoms, ESP/paranormal experiences and past psychiatric history. The DDIS has been shown to be valid and reliable and is included in the American Psychiatric Association s Handbook of Psychiatric Measures. The DDIS is usually administered along with the Dissociative Experiences Scale (DES). Attendees will be shown examples of data from DDIS research studies and then will be taught how to administer the DDIS; they will be provided with copies of the DES, the DDIS and its scoring rules. This includes a consent form for the DDIS. The DES and DDIS are public domain documents and can be used without permission. The DDIS takes minutes to administer and can be used in any setting. After thousands of administrations to clinical and nonclinical samples, the author has encountered no severe adverse reactions to using the DDIS. Describe epidemiological research data on the Dissociative Disorders Interview Schedule. Describe clinical uses of the Dissociative Disorders Interview Schedule. Administer the Dissociative Disorders Interview Schedule. 90MIN WS 4 Room: Jackson LEVEL: INTERMEDIATE (04-011) Reducing Dissociation with Systemic Interventions in Children Arianne Struik, MA, Primary Presenter Many chronically traumatized children live in remote areas without access to specialized trauma treatment. Local practitioners need to be generalists and their isolated position often withholds them from taking the risk of opening up trauma. They do not want to wake up sleeping dogs. These children lack resources to travel for a lengthy specialized trauma-treatment but are too unstable for short-term treatment. The Sleeping Dogs model combines attachment work and systemic interventions by local practitioners, teachers, school FINAL CONFERENCE PROGRAM & PROCEEDINGS

29 psychologists, child protection workers, residential staff or foster-carers, supported and guided via phone or Skype with short-term trauma treatment. Four EMDR sessions are planned within one week for which either the child or the therapist, after combining the treatment of a few children, travels. If needed an additional week is planned. Following, the trauma therapist offers long-distance support to the local network to integrate changes and promote further strengthening of attachment relationships. This treatment is not perfect, but just good enough to help these children to process some of their most disturbing traumatic. This presentation is illustrated with case examples from the treatment of traumatized and dissociative children living in foster families and residential homes in remote areas of Australia and Europe. Recognize the powerful effect of systemic interventions.. Plan systemic interventions with dissociative children. Plan the outline of a phased long-distance treatment for the target group. 90MIN WS 5 Room: Jefferson LEVEL: ADVANCED (04-010) Somatoform Dissociation: The Gateway to Frozen States and Terriitories Charles H. Rousell, MD, Psychiatrist, Primary Presenter Physical, psychological and sexual trauma during critical stages of a child s development can create a division of the individuals personality into dynamic subsystems or territories. These subsystems are mediated by psychoform and somatoform action systems which dissociate from the evolving functional personality. Physical, psychological and sexual assaults on the child drive these threat mediated dissociated states or parts into the foreign territories of the mind and phobically exile them from the functioning child. The most deeply dissociated states are frequently created by freeze and submission experiences and require active search and discovery therapeutic techniques to bring them in from the wastelands of the mind. Personification and integration of these dissociated states is essential to resolve the plethora of perplexing somatosensory experiences and disconnected action systems which interfere with these patients relationships and which fragment sustained action behaviors required for building stable and secure lives. Through clinical case presentations interactive discussions and video segments of patients in treatment, this workshop will demonstrate how to reduce the phobic avoidance of the functional personality; journey into distant mental territories and actively seek exiled threat-driven states enabling a more complete integration of these disconnected subsystems and mental territories. Identify dissociative subsystems in patients with puzzling somatoform symptoms. Utilize specific therapeutic techniques to discover foreign territories of the mind and search for exiled frozen and submission states or parts. Apply the therapeutic methods in this workshop to empathically integrate these foreign mental territories and the states that inhabit them into the executive functioning personality. 90MIN WS 6 Room: Madison LEVEL: INTRODUCTORY (04-013) The Comprehensive Resource Model - Bridging Neuroscience and Psychotherapy for the Treatment of Complex Trauma Frank M. Corrigan, MD, FRCPsych, Primary Presenter; Lisa Schwarz, MEd, Co-Presenter The Comprehensive Resource Model (CRM) is a neurobiologically-based treatment model which facilitates healing of traumatic experiences by bridging the deepest, most traumatised aspects of the person and their brain to the healthiest parts of the Self. This bridge catalyzes the mind/ body to safely access emotional trauma memories by utilizing layers of internal resources built from attachment neurobiology, breathwork skills, somatic resources, connection to the natural world, toning and sacred geometry, and from one s relationship with self, intuition, and higher consciousness. The sequencing and combination of these resources, and the eye positions that anchor them, provide the opportunity for fear responses to be dismantled while the client is fully aware and present momentto-moment. CRM allows individuals to orient fully towards the most frightening material, accessing and clearing the origin of the split second moments of survival threat and intolerable affects, sourced in the midbrain and driving defense responses, which lead to pathological dissociation, life-interfering symptoms, and addictions. Stabilization, processing, and integration are done simultaneously. Clearing trauma residues from the nervous system opens the way for positive affect, healing neuro-plasticity, and personal expansion, whether seen as spiritual or otherwise, which is separate from one s history of pain and woundedness. Summarize the clinical case conceptualization of CRM.. Describe the neurobiology of trauma in the context of the theory and practice of the Comprehensive Resource Model.»» Explain the hypothesized neurobiological mechanisms utilized during the use of layered, internal resources in CRM, through which therapeutic change occurs during trauma processing. SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 29

30 SATURDAY, APRIL 1 PANEL 1 Room: Arlington Ballroom Salon I LEVEL: ALL (04-014) Are All Kinds of Dissociation Related to Trauma? Andreas Laddis, MD, Chair; Marilyn Korzekwa, MD FRCPC, Co- Presenter; Kathy Steele, MN, CS, Co-Presenter; Martin Dorahy, PhD, DClinPsych, Co-Presenter The phenomenon of DID-like dissociation has been rightly understood as a psychological mechanism of coping with traumatic danger. Consequently, the mere presence of DID implicates caretakers in the sufferer s childhood for traumatic betrayal and abuse, even in the absence of patients memories of such behavior or other proof of it. The correlation between DID-like dissociation and traumatic childhood has been a precious finding of our research; therefore, it became the object of the memory wars. In trying to understand the nature of dissociation, our field has expanded study to various other phenomena that could be generically called dissociative, notably depersonalization, flashbacks and inordinate selfabsorption. The generic meaning of dissociation is that the person experiences two incongruous mental representations of reality (including one s own activity) at once. The trend has been to explain all these phenomena psychodynamically, in terms of selective inattention to pain or distress. This trend entails the risk of watering down the correlation between DID-like dissociation and trauma, because we cannot find empirical support for a correlation of generic dissociation and trauma. The panel will discuss the literature and their clinical experiences regarding the mechanisms and functions of various kinds of dissociation. Name 3 possible mechanisms of dissociation. Describe the psychodynamics of self-hypnotic dissociation. Describe the psychodynamics of depersonalization. SYMPOSIUM 1 Room: Alexandria LEVEL: ALL (04-015) The Clinical Dynamics of Dissociative Perpetrator Introjects Ralf Vogt, PhD, Primary Presenter; Kevin J. Connors, MS, MFT, Co- Presenter; Irina Vogt, Dipl Psych, Co-Presenter; Richard A. Chefetz, MD, Discussant SPIM 30 is a unifying treatment model combining different strands of psychoanalysis, the latest research into psychotraumatology, classic elements of psychotherapy and current body-oriented and neurophysiological theory. It understands the trauma scene as part of an holistic interactional whole. Its specific treatment settings enable the stepwise externalization of the internalized. Describe the theory of perpetrator introjection, recognize the bridges between clinical phenomenology (SPIM 30) and the latest neurophysiological research (Polyvagal Theory). To learn to assess the effectiveness of differentiated treatment settings. Delineate different roles that internal perpetrator states represent. Recognize the role of pain dissociation in competitive sports at an early age. (04-017) Case Study of a Female Client with Childhood Trauma from High Performance Sports Training Irina Vogt, Dipl Psych, Speaker This case study discusses the treatment of a client, a former competitive diver, whose ability to dissociate from pain is of particular interest. As treatment progressed, a childhood event causing lasting hip damage was acknowledged. In response to this injury, it becomes essential to place special emphasis on the effects of the external and internal dynamics between the client s trainer, trainer introject, and the traumatized child. The client s adult inability to deal with relationship conflict as a result from being traumatically exposed to competitive sports training at an early age and the subsequent dysfunctional relationship between coach and athlete will also be examined. (04-018) Who Is the Big, Bad Wolf? Understanding and Treating Internal Abusive Self-States Kevin J. Connors, MS, MFT, Speaker Arguably one of the two most prevalent dissociative self-states is the abusive alter. The angry, hostile, self-hating, self-harming self-state that sits across from you, spitting venom and vitriol, threatening destruction and sometimes death on your patient. This presentation explores the relational roles and often overlooked inherent values of the abusive alter. Distinguishing their role in the intrapsychic community is critical to determining how to address and resolve the many therapeutic crises they trigger. A key to understanding their role within is to examine their role without, by exploring the dynamics of the members of the dysfunctional family of origin. Another integral element to approaching treatment with these self-states is to explore their role in relationship to others in the world. Essential to developing genuine therapeutic responses is to understand their destructive behaviors from a different lens. What is the value of their behavior? How does their behavior or their way of being serve to protect the personhood of the patient? From these vantage points, treatment strategies can be delineated that avoid pitfalls of power struggles and build collaborative relationships that redefine power and control to facilitate healthy growth FINAL CONFERENCE PROGRAM & PROCEEDINGS

31 (04-019) Working with Perpetrator Introjects by Using the Hoop-setting of SPIM 30 Ralf Vogt, PhD, Speaker The author of the SPIM 30 model will provide an overview of the key theoretical building blocks that constitute normal, neurotic, and dissociative internalizations of interpersonal experience. Perpetrator introjection is explained as a result of the traumatic transaction between violator and victim, covering three distinct phases, which, as will be discussed, appear to overlap with the Polyvagal Theory developed by Porges (2009). The theory, as will be shown, has derived a range of therapy settings that can be applied in practice. A case example utilizing a so-called statehoop-setting will illustrate their effectiveness. PS 1 Room: Arlington Ballroom Salon VI LEVEL: ALL Paper Session 1 Institutional / Societal/ Collective Trauma and Dissociation Chair: Christa Krüger, MBBCh, MMed(Psych), MD, FCPsych(SA) PS 1.1 (04-020) Institutional Betrayal and American Psychological Association Complicity in Torture Ruth Blizard, PhD, Primary Presenter How was the American Psychological Association (APA), a liberal organization with high ethical standards, transformed into an authoritarian culture that actively assisted in torture? The first ethical principle is to do no harm, yet APA has a long history of collaboration with the military, including research on harsh interrogation. Currying favor with the Department of Defense to maintain financial support for research may account for some of the corruption. However, this form of institutional betrayal is similar to oppressive political movements and religious cults, in which traumatizing, narcissistic leaders manipulate information to distort members perception of abuse. Traumatizing, malignant narcissists identify with the aggressor, dissociating and externalizing their own needs for attachment and dependency. They often feel compelled to reenact the abuse they were subjected to by subjugating and torturing someone else. To justify their actions, perpetrators may use paradoxical double-speak and confusion techniques to induce dissociative trance logic in bystanders and victims, which undermines their sense of reality and trust in their own perceptions. This process of distorting the meaning of torture and creating paradoxical, protector/perpetrator roles for psychologists was begun by the Bush administration and continued by APA Ethics Director, Steven Behnke, and other officials. Identify paradoxical double-speak. Define traumatizing, malignant narcissism. Describe how psychologists consulting on the process of torture is an ethical conflict. PS 1.2 (04-021) Gender Role Stress Among College Students in Turkey: The Role of Society, Culture, and Era Vedat Sar, MD, Primary Presenter; Anil S. Kacar, Co-Presenter; Can M. Kilciksiz, Co-Presenter Gender Role Stress (GRS) seems to play a significant role in problems of intimacy including gender-based violence in extreme conditions. The aim of this study was to compare fears related to GRS in North America in the early 1990 s with those in contemporary Turkey. Participants (n=502) were recruited from college students in Istanbul by invitation. Among them, 366students classified their gender as female, 110 as male, and 26 as gender-queer or did not want to disclose. All participants completed the GRS Questionnaire on a web-based application. The five-factor solutions derived from the GRS questionnaire in the present study differed considerably from those obtained in the original one. The Turkish female population reported`feminine fears of abandonment-loneliness-insecurity, being physically unattractive-unpopular, assertiveness, unemotional-hypersexual relationships, and being sexually avoidant. The Turkish male population reported `masculine fears of subordination, sexual inadequacy, performance failure, vulnerability, and nurturance. Building pairs on the domains of security, power, hierarchy, rigor, and reproductivity, these fears constitute properties of the `sociological self (Sar & Ozturk, 2007) which incorporates societal expectations at an individual level. They seem to be oriented towards survival rather than to genuine interpersonal contact. Thus, all feminine and masculine fears may potentially interfere with intimacy. Identify components of gender role stress. Identify fears related to gender role stress. Identify cultural components of gender role stress. PS 1.3 (04-022) Intersections of Individual and Collective Trauma and Loss Diya Kallivayalil, PhD, Primary Presenter Politically motivated violence, persecution, and torture affect a growing number people and communities worldwide. Some estimates indicate that over half a million survivors now live in the United States. As a profession, the impact of collective violence - endless war, forced migration, traumatic loss and the human rights abuses that occur in these contexts have never been more clear. Larger numbers of patients impacted by such violence find their way to our offices and to our care. Many practitioners feel at a loss to intervene when the violence, loss and displacement have been pervasive. These patients are also coping with numerous post-conflict psychosocial stressors such as housing, language and health care barriers, as well as traumatic grief, many of them having lost family members to targeted and untargeted killings. Further, collective violence can obscure earlier traumatic experiences that patients have experienced such as childhood sexual abuse and these SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 31

32 personal traumas are exacerbated by more recent ones, leading to a complex symptom picture, both medically and psychiatrically. This talk will address the impact of collective violence: the various manifestations of PTSD and complex PTSD, the psychic injuries of torture and prolonged sexual violence, and common somatic presentations. This talk will also enumerate the nature of traumatic grief when one has lost family members to large scale violence and displacement. PS 2 Room: Arlington Ballroom Salon V LEVEL: ALL Paper Session 2 Self/ Identity and Dissociation - Normal and Pathological Chair: Adah Sachs, PhD SATURDAY, APRIL 1 Describe the factors that distinguishes political and/or collective trauma from other types of trauma and violence Identify the nature of traumatic grief following homicide and/ or a traumatic loss from community violence Enumerate clinical approaches to treating patients impacted by community and/or political violence and displacement PS 1.4 (04-023) The Pharmaceutical Industry, the American Psychiatric Association and Marginalization of Trauma and Dissociative Diagnoses Ruth Blizard, PhD, Primary Presenter In the late 1970 s, the American Psychiatric Association (ApA) colluded with the pharmaceutical industry to medicalize psychiatric disorders in order to imply that diagnoses had reliability and validity. In contrast to DSM II, DSM III described disorders solely in terms of observable symptoms, without discussing trauma, family dysfunction, or social inequities as causes of psychological distress and dysfunction. This had the effect of invalidating research and treatment of abuse and interpersonal violence. The pharmaceutical industry mounted a public relations campaign to convince the professionals and the public that mental illness was caused by a chemical imbalance, implying that drugs were the treatment of choice. Pharmaceutical companies funded research on drug efficacy, selectively reporting only positive results. Medication was defined as the standard of care for anxiety, mood and psychotic disorders. Post-traumatic and dissociative disorders were marginalized, PTSD was only included in DSM III after intense lobbying by Viet Nam veterans. Insurance companies began refusing to pay for psychotherapy, since medication was cheaper. DSM-III, IV and 5 created more and more diagnoses, devoid of any connection to experience of stress and trauma, creating further confusion and doubt among the professionals and the public as to the harm caused by trauma. Distinguish between disorders defined as medical vs posttraumatic. PS 2.1 (04-024) A Review of 80 Studies on Dissociative Experiences and Dissociative Disorders in College Populations Mary-Anne Kate, MSc, MSc, Primary Presenter This review examines research conducted in university populations to ascertain the prevalence of dissociative experiences and Dissociative Disorders in college samples around the world, and explores the evidence supporting both a traumatic and sociocultural etiology. The findings indicate that dissociation and Dissociative Disorders are a global, not just a Western or North American, phenomenon. Dissociative Disorders are found to be related to sexual abuse, particularly severe abuse, occurring against a backdrop of family dysfunction and emotional abuse; dissociation is linked to a wider range of childhood abuse, traumatic and stressful experiences. A strong relationship between dissociation and fantasy proneness is clearly apparent, although no evidence was found to indicate that fantasy is a primary etiological factor in dissociation. The relationship between fantasy proneness and dissociation is found to be complex with both factors being closely related to psychopathology, and both being recognized coping mechanisms in response to trauma, stress and isolation. The review suggests that future studies would benefit from examining the role of attachment and family environment, the dimension of fantasy proneness while controlling for psychopathology and trauma, and using an instrument that is more predictive of a Dissociative Disorder diagnosis in a college population than the DES. Identify factors associated with dissociation that are generally overlooked, including a negative family environment and personal characteristics such as resilience.. Discuss potential explanations for the close relationship between fantasy proneness and dissociation, including factors that suggest dissociation has a traumatic and iatrogenic aetiology.»» Describe the international prevalence of dissociation and Dissociative Disorders in college populations. Describe three ways that pharmaceutical research results were misreported. Describe how defining psychological distress and dysfunction as mental Illness can disempower sufferers and interfere with active participation in psychotherapeutic treatment FINAL CONFERENCE PROGRAM & PROCEEDINGS

33 PS 2.2 (04-025) Applications of Dissociation in the Mainstream Wendy Lemke, MS, Primary Presenter Mental health professionals are often unaware of how mainstream dissociation actually is because clinical psychology often focuses on pathological dissociation and related disorders. The purpose of this paper is to bring more attention to dissociation utilized in everyday life including the concept of normal multiplicity. By understanding the nature of dissociation and our own multiplicity we can learn to utilize these concepts to enhance functioning in every day aspects of life or as we say, in the mainstream. Dissociation is a normal ability for which we all have the capacity. If you listen to conversations and/ or interviews with individuals, you will often hear references to other aspects of self, including their voices within. This paper includes quotes from athletes, performers, and authors that help illustrate mainstream dissociative phenomena along with strategies based on dissociation to enhance functioning. We all dissociate, commonly as a defense but also for differentiation, or to enhance a performance such as actors, musicians, or athletes demonstrate. An awareness of these processes can not only help us understand others but can also be utilized to assist us in managing our own various states for optimal functioning. Recognize mainstream dissociation utilized in mainstream conversation, writing, and/or interviews.. Describe how dissociation can be utilized for performance enhancement. Explain strategies for utilizing dissociation and normal multiplicity to enhance individual functioning. PS 2.3 (04-026) Injury, Surgery, and Dissociation Paula Thomson, PsyD, Primary Presenter The relationship between orthopedic injury, surgery, and dissociation remains under-researched. In this IRB approved study, participants (n = 40) with pathological levels of dissociation ( 20 on the DES-Taxon) were compared to a group with lower levels of dissociation (n = 291). Group differences for dissociation and past traumatic events were examined between participants who experienced orthopedic surgery (n = 76) versus those with no surgical history (n = 253). Measurement instruments included the Questionnaire Regarding Health, Adverse Childhood Experience, Cambridge Depersonalization Scale, Dissociative Experience Scale-II (DES-Absorption and DES-Taxon), and the Traumatic Events Questionnaire. The data was entered into SPSS 22. Multivariate analyses of covariance (with age and gender as covariates) and stepwise regression analyses were calculated. The results indicated that the pathological dissociation group had more injuries, traumatic events, able to ignore pain and felt that their body did not belong to them. Likewise, the group of participants who had orthopedic surgery had more injuries and ignored pain. Elevated depersonalization and increased past traumatic events predicted 9% of the variance for injury rate. This study demonstrates that elevated dissociation and past traumatic events are related to increased incidence of injuries and orthopedic surgery. Identify the effects of dissociation and past trauma, including childhood adversity, on orthopedic injuries. Describe differences between dissociation measured on the DES-T (taxon) and the Cambridge Depersonalization Scale. Recognize major musculoskeletal injuries. PS 2.4 (04-027) Dissociation and the Problem of Ontology Bryan Reuther, PsyD, Primary Presenter Since the late 19th century, the term dissociation has been used to cover a variety of phenomena, including daydreaming, somnambulism, depersonalization, derealization, psychogenic amnesia, fugue states, and identity fragmentation. It is no wonder many have argued that conceptual unity has been difficult to achieve, rendering the term vague and imprecise (Cardeña, 1994; Frankel, 1994; Dell, 2009). What makes this especially challenging is the many different terms used to refer to what is being dissociated. These terms include some kind of division/disruption/discontinuity or lack of integration in consciousness, personality, memory, identity, etc. While dissociation undoubtedly depicts marked variations in human psychological life, it also cuts much deeper that is, to the nature of human being or ontology. In this paper, I argue that the conceptual problems with dissociation are ontological, specifically related to unevaluated ontological assumptions made by various these psychological terms used to refer to what is being dissociated. In other words, I contend theories of dissociation are ontologically naïve. Does getting a clear sense of the current ontological assumptions of theories of dissociation help in better understanding the phenomena, or will we need another ontology to do the work? Identify at least three different types of dissociation. Identify at least three different definitions of dissociation. Identify at least one problem with the ontological naivete of dissociation. 12:00 PM 1:30 PM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters 12:00 PM 1:30 PM Lunch (on Your Own) SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 33

34 SATURDAY, APRIL 1 12:00 PM 1:30 PM Room: Fairfax Boardroom Professional Training Program Faculty Lunch (by invitation) 12:00 PM 1:30 PM Room: Rosslyn Student and Emerging Professional Lunch Supported by: Sheppard Pratt Health System and the Trauma Disorders Program at Sheppard Pratt Calling all students and emerging professional! The SEP Committee invites you to learn more about new opportunities to become involved in ISSTD and network with distinguished ISSTD members. These seasoned professionals will share their experiences in the industry and answer your questions. Lunch will be provided. 1:30 PM 5:00 PM CONCURRENT SESSIONS 180MIN WS 1 Room: Arlington Ballroom Salon V LEVEL: INTERMEDIATE (04-035) Cultural Competency in Service Delivery to the LGBTQ Community Elizabeth Toledo, LCSW, Primary Presenter The recent attacks at the Pulse nightclub in Orlando, Florida makes this presentation a much needed tool in service delivery to the Lesbian, Gay, Bisexual, Transgender and Queer community. The homophobia that this community experiences when they seek out services in well-meaning but not culturally competent agencies. further traumatizes this already severely traumatized and oppressed community. This is workshop seeks to assist individuals as well as agencies measure their progress or lack of progress along the LGBTQ cultural competency continuum. Once this is identified then agency and individual practitioners can better address how to move forward on the continuum to become a provider that can truly claim to creating a safe haven for the LGBTQ patient. 180MIN WS 2 Room: Manassas LEVEL: INTRODUCTORY (04-032) OMG!!! I Can t Believe I Said (Did) That! Working With and Through Our Errors with Complex Trauma and Dissociative Clients Su Baker, MEd, Primary Presenter It is the fifth of the evening, each one just a little more desperate. This time she describes the blood trickling down her already-scarred arm. I write back I remind her of the techniques, all the alternatives that she and I have meticulously written down, for these bad times. She thanks me and the s stop, or so I think. I go to bed, and the next morning there are three more s, with more descriptions. I begin to write to tell her that I had gone to bed, didn t get them until this morning, I am sorry, etc., when it occurs to me that I am being sucked into something that I know is an error. And I know that I am not the only one. Why is it that seasoned, well-trained therapists lose their way with dissociative clients? What are the psychological mechanisms that underlie our actions? What can we do with and about them? This master class has two sections, the first is an exploration of the psychodynamics of transference, countertransference, projective and introjective identification, enactments and the unthought known in the treatment of dissociative disorder clients, illustrated with case examples. These dynamics will be discussed as methods of communicating the most primitive of experiences of multiply abused people and our errors will be explored as means of responding to these often-desperate pleas for understanding. The second part of the class will be a consultation clinic, where students will explore their thoughts, feelings, and actions that result in their OMG!!! I can t believe I said (did) that, in order to better understand and communicate with their clients. Define and illustrate the psychodynamic concepts of transference, countertransference, projective and introjective identification, and enactment. Discuss the utilization of psychotherapeutic errors to further therapy with dissociative disorder clients.»» Apply the utilization of enactments and countertransference with material from their own cases. Identify service delivery competency as it relates to Lesbians, Gay, Bisexual and Transgender (LGBT) people in need of Trauma treatment.. Identify how homophobia, transphobia, sexism and other gender/sexual identity oppressions are used by systems and individuals. Determine where their organizational structure, their engagement abilities and their services/activities/interventions are in the Cultural and Linguistic competency continuum, as it relates to Lesbians, Gay, Bisexual and Transgender (LGBT) people FINAL CONFERENCE PROGRAM & PROCEEDINGS

35 180MIN WS 3 Room: Arlington Ballroom Salon I LEVEL: INTRODUCTORY (04-033) Stabilizing Adolescents with Dissociative Disorders Frances S. Waters, LMSW, DCSW, LMFT, Primary Presenter; Adrian Stierum, MD, Co-Presenter Traumatized and dissociative adolescents presents many challenges, particularly due to their precarious developmental stage of being on the verge of adulthood and influenced by peers, but still dependent on adults. Often they are victims of early and prolonged abuse with numerous diagnoses, and failed treatments and placements. They often have a high co-morbidity of aggression, self-harming behaviors, sexual and other types of compulsions, eating disorders, substance abuse, and severe attachment impairments. They can resemble a presentation that is similar to traumatized adults with dissociation. This workshop will present the underlying dynamics related to dissociative adolescents high comorbidity, the influence and roles of selfstates, severe affect and behavior dysregulation, interpersonal disturbances, and low self-esteem. Focus will be on creative stabilization interventions to manage the high comorbilidty, including, substance abuse issues, self-harming and aggressive behaviors, compulsions, eating disorders, and attachment impairments. A description of the appropriate use of medication and specific guidelines for dissociative youths, including risks, will be described. Clinical vignettes, DVDs and artwork will depict creative and innovative stabilization techniques for this high-risk group. Describe common underlying dynamics and relationship to comorbidity. Apply iintervention strategies to help stabilization dissociative adolescents. Discuss risks and appropriate utilization of medication. 180MIN WS 4 Room: Arlington Ballroom Salon VI LEVEL: INTERMEDIATE (04-034) Tools for Treating DID from the Outside In and from the Inside Out: Enhancing Safety and Effectiveness in Hypnosis and the Recreation of Self Model of Human Systems Richard P. Kluft, MD, PhD, Primary Presenter; Catherine G. Fine, PhD, Co-Presenter; Stephanie Fine, Co-Presenter; Hedy A. Howard, MD, Co-Presenter Hypnosis is an iconic method for working (metaphorically) from the surface to the depths of the human mind. It usually is focused on the exploration of the past. The Recreation of Self Model proposed by John Eisman is a present-focused, bodybased, neuroscience-based approach designed to support the development of profound changes in their perceived sense of well-being and effectively managing their selfhood in relation to others from a place of compasssion and wholeness. It has areas of ovelap with ego-state approaches, mindfulness and acceptance based approaches, body-based approaches, as well as clinical hypnosis. Rather than pursuing an either/or approach, it will study aspects of both models as they may be used with patients suffering complex trauma and/or dissociative disorders. It will discuss obstacles often encountered in the use of clinical hypnosis despite the high hypnotizability of most dissociative patients, and address difficulties experienced in the induction process. All too often clinicians have difficulty using hypnosis effectively, and resign themselves to making use of their patients spontaneous trance and autohypnotic phenomena. (Dr. Kluift) Furthermore, this workshop will approach how to restore patients to baseline alertness before terminating psychotherapy sessions. (Dr. Howard) In addition, this workshop will introduce participants to body-focused methods useful for Stage 1 or the Safety Stage of trauma treatment, prior to and during respites from more direct trauma therapy. The potential of Eisman s Recreation of Self Model in helping trauma patients will be explored. (Dr. S. Fine) Finallly, An integrated overall perspective that embraces hypnosis, traditional trauma therapies, ego state therapy, EMDR, and more process oriented approaches will be presented, demonstrating their confluence in addressing trauma as conceptualized in Braun s (1988) BASK Model. (Dr. C. Fine) SATURDAY, APRIL 1 List three reasons to prioritize relational over technique considerations in determining how to use hypnosis with the traumatized. List five considerations in deciding how to individualize a hypnotic induction. Describe the components of the Howard Alertness Scale FINAL CONFERENCE PROGRAM & PROCEEDINGS 35

36 SATURDAY, APRIL 1 180MIN WS 5 Room: Alexandria LEVEL: ADVANCED (04-036) Working with Positive Emotion and Experience in the Treatment of Chronic Trauma Kathy Steele, MN, CS, Primary Presenter; Dolores Mosquera, Psy, Co-Presenter Therapeutic work with positive emotion and experience is often overlooked in psychotherapy, where the emphasis is usually focused on helping the patient regulate and work through negative emotion and traumatic experiences. However, a select few patients may improve with a greater focus on positive experience in the present than on processing traumatic memories. These are powerful resources which promote resilience and regulation when emphasized appropriately. Positive emotion and experience can also be found within traumatic memories and may contain essential therapeutic realizations. There is also a more complex side to some apparently positive emotions when they serve as resistance, such as with idealization of the perpetrator or of the least harmful figure, narcissistic defenses, or the use of happiness as a façade. We will explore ways to identify and create positive emotions in therapy, particularly within the therapeutic relationship. Different aspects of dysfunctional positive affect and experience will also be explored. We will share decision points about when to emphasize and enhance positive emotion, when to target dysfunctional positive affect and experience, how to resolve conflicts between positive and negative emotions about a topic, and when to process negative emotions and grief. Ample cases, including videos will illustrate clinical points. Identify positive affects and experiences as potential treatment resources or targets. Utilize various therapeutic approaches to reduce or eliminate the negative effects of positive emotion and experience when they are associated with avoidance or traumatic relationships. Describe three ways positive emotions and experiences can be fostered in highly traumatized clients. 1:30 PM 3:00 PM CONCURRENT SESSIONS 90MIN WS 7 Room: Lee LEVEL: INTERMEDIATE (04-037) Assessment and Treatment Strategies and Techniques for Working with Survivors of Ritual Abuse Eileen Aveni, LMSW, LCSW, ACSW, BCD, Primary Presenter; Alison Miller, PhD Psychology - Private Practice, Co-Presenter DID clients from ritual abuse backgrounds can have deliberately created or spontaneously created personality systems. Deliberately created internal systems usually reflect the work of multiple perpetrators coming from large networks of organized abuse. Spontaneously created systems often derive from a single perpetrator or a small perpetrator group where the abuse happens without focused planning. Assessment involves information gathering to determine the client s role level within the perpetrator group, current group involvement, family background, geographical areas where the client grew up, small group vs. network ring of organized abuse, type of alter presentation (chaotic/distressed, active switching, or voices in head), ability to dialogue with parts (front vs. hidden parts), internal structures, types of mind control or programming present, changes in emotional state, and switching during seasonal changes. Treatment techniques discussed will include: what to do in the initial session, teaching inner communication skills, how to keep the client stable, working with reporter and controller parts, and delaying memory work. Therapeutic approaches will be discussed for low functioning and high functioning clients, and clients trained by a specialty cult. Audience participation in role plays will allow participants to enhance their skills and understanding. Describe assessment techniques to determine the type of personality system a client may have.. Describe a treatment strategy for spontaneously created personality systems, and a treatment strategy for deliberately created personality systems.»» Describe three techniques for working with each type of personality system FINAL CONFERENCE PROGRAM & PROCEEDINGS

37 90MIN WS 8 PANEL 2 Room: Jefferson LEVEL: INTRODUCTORY (04-038) Mindfulness as a Rival Brain Activity to Dissociation: Why It s Not Good to Be Aware Inside the Saber Tooth Tiger s Mouth Christine C. Forner, BA, BSW, MSW, RSW, Primary Presenter Dissociation is a common symptom of trauma. There is a large correlation between dissociation and childhood trauma. Dissociation, in the simplest of explanations, is a partial or complete removal of information and awareness. Reasonably, the more trauma a person experiences the more likely dissociation will occur and possibly become a favored coping technique. Mindfulness and mindfulness meditation have become a very common therapeutic tool. Mindfulness is, in the simplest of definitions, the ability to be aware of conscious and unconscious information. Yet mindfulness still seems to elude and be very difficult to use for those individuals who chronically dissociate. The reasons for these challenges reside in the competing functions and purposes of dissociation and the functions and purposes of mindfulness. The traumatic dissociative process is the opposite of the mindfulness process; one is a brain process that increases awareness; the other is a brain process that decreases awareness they are rival brain activities, where dissociation wins every time. Dissociation is about not knowing real danger and pain; it is also involves playing dead in the face of life threatening danger in order to survive. Mindfulness is the highest form of self-knowledge, it is the capacity to know and have understanding of all of one s self. From this perspective it makes sense that it is not good to be aware of things when you are a tiger s mouth. It also makes sense that a mind that is perpetually dissociating becomes phobic of mindfulness. This interactive workshop will demonstrate and discuss what mindfulness is, the role mindfulness plays within interpersonal, secure attachment relationships and how mindfulness meditation practices interplay with the dissociative process. This workshop will also give a comprehensive summary of traumatic dissociation in order to understand the difficulty and possible injurious implications of mindfulness meditation within a dissociative clinical population. Suggestions, alternatives, and creative meditations for dissociative disorders will be offered and demonstrated to assist clinicians to teach a dissociative mind to learn to slowly become a mindful, associated mind. Room: Arlington Ballroom Salon II LEVEL: INTRODUCTORY (04-039) The Tidal Wave Effect: Trauma and Dissociation in the Mainstream A. Steven Frankel, PhD, JD, Primary Presenter; Richard A. Chefetz, MD, Co-Presenter; Philip J. Kinsler, PhD, ABPP, Co- Presenter; Lynette S. Danylchuk, PhD, Co-Presenter; Christy Wise, PsyD, Co-Presenter; Mark E. Roseman, JD, Co-Presenter This presentation addresses vulnerabilities of child abuse survivors who develop highly successful life paths, but whose object choices as adults may have been impacted by child abuse, and who are thus at risk for adult trauma that can be disabling and disastrous. Two such survivors will present their life paths and a panel of senior mental health professionals will discuss achilles heels. object choices, shame and resilience factors that play critical roles in the management of adult trauma. List three resilience factors. Identify three impacts of shame. State two factors describing the impact of child abuse on later object choice. SYMPOSIUM 2 Room: McLean LEVEL: ADVANCED (04-040) New Findings in the Neuroimaging of Dissociation Negar Fani, PhD, Primary Presenter; Lauren A. M. Lebois, PhD, Primary Presenter; Ruth A. Lanius, PhD, MD, Primary Presenter; A.A.T. Simone Reinders, PhD, Primary Presenter; Discussant: Milissa Kaufman, MD, PhD Seminal work has begun to identify cognitive and neural response patterns associated with the phenomenon of trauma-related dissociation. We will present new evidence on dissociative neural intermediate phenotypes consisting of structural, resting state, and task based neuroimaging findings in low vs. high dissociators, including individuals with dissociative identity disorder. SATURDAY, APRIL 1 Discuss the theory behind the rival brain activities of mindfulness and dissociation. Identify the potential emotional, mental and sensory triggers and flooding that can occur with mindfulness practices. Desribe how dissociation decreases human attachments and how mindfulness increases human attachments. Describe new structural and functional neuroimaging findings in the dissociative subtype of PTSD and DID. Compare neuroimaging findings in classic vs. the dissociative subtype of PTSD.»» Identify how dissociation may also be conceived of as a cognitive capacity FINAL CONFERENCE PROGRAM & PROCEEDINGS 37

38 SATURDAY, APRIL 1 (04-041) Neuropsychological Advantages and Hindrances of Dissociation in Trauma: Implications for Neurobiological Models of PTSD Negar Fani, PhD, Speaker The neuropsychological profiles of highly dissociative traumatized people, including patterns of cognition both within and outside of the context of emotion, have not been well-defined, which was the goal of the present study. 121 African-American women aged were recruited from an ongoing trauma study, and completed neuropsychological testing (Penn Computerized Neuropsychological Battery; CNP). Clinical measures administered were: the Multiscale Dissociation Inventory; Childhood Trauma Questionnaire; Traumatic Events Inventory. A subset of participants underwent fmri during performance of an attentional control task (Affective Number Stroop; ANS). Compared to low-dissociative participants, high-dissociative participants exhibited fewer errors on a measure of abstraction/ cognitive flexibility, after adjusting for age and trauma exposure (F1,111=4.64,p=.03), but performed more poorly on a measure of visual memory (F1,111=9.52, p=.003) and made more errors in the presence of trauma-relevant distractors on the ANS (F1,36=4.68, p=.04). Dissociation symptoms correlated negatively with amygdala connectivity to the insula in the presence of these distractors. Dissociation was linked to enhanced executive functioning in a non-emotional context, but also associated with poorer visual memory and attention in the context of traumarelevant cues, accompanied by disrupted connectivity in salience and interoceptive brain networks. These findings shed light on the unique neuropsychological signatures of dissociation in trauma. (04-042) Individuals with Dissociative Identity Disorder Outperform Individuals Low in Dissociation on an Attentional Task: Neuroimaging Findings Lauren A. M. Lebois, PhD, Speaker; Milissa Kaufman, MD, PhD, Speaker Neuroimaging data from symptom provocation paradigms in patients with Post-traumatic Stress Disorder (PTSD) have implicated differential brain activity in those with high vs. low levels of dissociative symptoms. However, it is unknown how this differential pattern is associated with performance on less emotionally-charged attentional tasks. We investigated this question in a sample of 28 treatment-seeking individuals with diagnoses of Dissociative Identity Disorder and/or PTSD, and 12 control participants (HCs). In a functional magnetic resonance imaging paradigm, participants completed a challenging attention task: the Multi-Source Interference Task. Trials varied in difficulty. Using a median split of Multidimensional Inventory of Dissociation partially dissociated intrusion scores to create low vs. high dissociation patient groups, preliminary data analyses demonstrated that all participants performed equally on easy trials; however, on difficult trials, low dissociators were least accurate, while high dissociators and HCs performed at the same accuracy rate. Preliminary uncorrected dorsal anterior/mid cingulate cortex (damcc) region of interest contrast analyses of brain activation revealed that high dissociators had more damcc activation on difficult trials compared to HCs, though they performed similarly on the task. These results support the hypothesis that dissociation is a cognitive capacity. (04-043) New Findings in the Neuroimaging of Dissociation Ruth A. Lanius, PhD, MD, Speaker PTSD patients frequently experience hyperarousal symptoms that are accompanied by active fight or flight defensive responses; however, those with the dissociative subtype of PTSD may experience additional passive or submissive defensive responses. The dorsolateral (DL-PAG) ventrolateral (VL-PAG) subregions of the periaqueductal gray play a central role in active and passive defensive responses, respectively. We examined the resting-state functional connectivity of the DLand VL-PAG using a seed-based approach in non-dissociative PTSD patients (n=60), dissociative PTSD patients (n=37) and healthy controls (n=40). All PTSD patients demonstrated extensive DL- and VL-PAG connectivity at rest when compared to healthy controls. While all PTSD patients demonstrated DL-PAG connectivity with areas associated with active coping strategies (e.g. anterior insula; dorsal anterior cingulate), dissociative patients showed greater VL-PAG connectivity with areas associated with passive coping strategies and increased levels of depersonalization (e.g. temporoparietal junction). These findings suggest that PTSD patients may demonstrate greater defensive posturing even at rest, and also those with dissociative symptoms may display unique PAG functional connectivity patterns. Taken together, these findings represent an important first step towards identifying neural and behavioural targets for therapeutic interventions that address defensive strategies in trauma-related disorders. PS 3 Room: Madison LEVEL: ALL Paper Session 3 Remembering and Healing from Trauma Chair: D. Michael Coy, MA, LICSW PS 3.1 (04-044) Repressed Memory vs. False Memory Patricia Zipris, MD, Primary Presenter Sexual abuse and incest are one of the most destructive ways of violence implemented against children. How is this violence expressed by the victims on their future lives and their future relationships? Even if the repressed traumatic memories are not recovered, or are partially recovered, what is their influence on the victims parenthood, behavior and integration into the society? Is it possible for traumatic memories to be repressed for many years and sink to the depths of oblivion until they erupt following a trigger? If so, is the repressed memory kept in its pure form free of distortions and falsifications? Or are tricks of memory the outcome of external implants or selfinduced erroneous reconstructions that create false memories? Discussion of this issue has therapeutic, social and legal implications. On the one hand, we, as therapists must extend our understanding of the subject in order to appropriately and effectively treat the victims. On the other hand, society seeks a just trial, as the judge (to distinguish from the therapist) FINAL CONFERENCE PROGRAM & PROCEEDINGS

39 investigates factual truth.the case presented illustrates the complexity of adult testimony concerning incest that occurred during childhood. Testimony is many years after the incidents took place, under the assertion of awakened repressed traumatic memories. This case was tried in the Supreme Court in Israel in A 26 year-old woman filed suit against her father, whom she claimed indecently assaulted and raped her from age four until age ten. The father stood trial and was convicted. The accused appealed to the Supreme Court, and was acquitted based on reasonable doubt. Describe the complexity of adult testimony concerning incest that occurred during childhood.. Discuss about therapist s interventions in cases of adult testimony concerning incest. Discuss about the validity of recovered traumatic memories memories. PS 3.2 (04-045) Reconnection in Research and Practice: Systemic Constellations and Sense of Community in Psychological Healing Michaelene Ruhl, PsyD, Primary Presenter; Jade Barclay, MCAP, MBA, CSP, Co-Presenter Addiction and other conditions have been recently reconceptualized as a lack of connection, however there is sparse research into the experience of suffering, coping and healing related to connection phenomena. This research was conducted to investigate lived healing experiences of patients using Family and Systemic Constellations. Resulting themes include increased awareness of connection with self and relationships with others and the world: (1) experiences of healing; (2) somatic experiences; (3) experiences of emotion; (4) experiences of connection; (5) changes in perception and understanding; and (6) impact on relationships and self. This study gives voice to Family and Systemic Constellations as a valuable approach to psychological healing and helps clinicians better understand the essence of the challenges of psychological suffering, its impact on the family system and the individual, the clients who are challenged by it, and to inform future psychological treatments. Participants will engage with the core philosophies and practices of this modality and further explore the efficacy of Family and Systemic Constellations in working clinically with individuals and groups. List three psychological benefits reported by patients who experienced Systemic Constellations.. Describe the theoretical background that underpins Systemic Constellation Work. Identify three main components of the Systemic Constellations method. PS 3.3 (04-046) Disruptions of Sense of Self in Trauma: Conceptualizations and Treatments Elizabeth Alire, BS, BA, MA, Candidate, Primary Presenter; Louis K. Moser, BA, MA Candidate, Co-Presenter Dissociation, resulting from organic or psychological trauma, often involves a disruption of an individual s sense of self. Significant study into the nature of the self has been completed, yet a well-delineated consensus has yet to be reached. A review of historical and current conceptualizations of senseof-self is presented, including cognitive, phenomenological and Buddhist theories. Reasons will be explored for the lack of comprehensive care available to many clients who experience sense-of-self disruptions, including the preeminence of the medical model, stigmata surrounding such disruptions, and the absence of agreed-upon terminology with which clients may communicate their phenomenological experiences to care providers. Preventative first-aid procedures will be suggested that might prevent or mitigate serious long-term damage when sense-of-self disruptions are indicated by a trauma. Finally, current treatments will be presented, including narrative and phenomenological modalities. Discuss various concepts of the phenomenology of self as presented throughout history. Share the stories they encounter with others who are experiencing disruptions of sense of self. Apply first-aid techniques to their practice with traumastricken individuals. PS 3.4 (04-047) ACE, Equity & Intervention: A Trauma- Informed Approach In College Mental Health Jim Helling, MSW, LICSW, Primary Presenter; Genevieve Chandler, PhD, RN, Co-Presenter First generation students of color from underprivileged socioeconomic backgrounds are overrepresented among NCAA Division I athletes, particularly in the high-visibility, revenue producing sports of football and basketball. The combination of high rates of exposure to childhood adversity and lower than average utilization of psychological health resources on campus leaves these young adults at particular risk of high emotional, social, behavioral and developmental challenge. In this presentation, an innovative effort to use trauma-informed practices and develop a trauma-informed system of care to better serve this population is described. In a satellite clinic of a college counseling center embedded in the Department of Athletics, universal Adverse Childhood Experiences screening has been added to the pre-participation sports physical examination required of all NCAA athletes. Systemic changes in outreach, education, support, skills training and treatment designed to meet the identified need for resilience-based, trauma-informed intervention within this population are reviewed. Preliminary data on changes in utilization of support and SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 39

40 treatment services among diverse student-athlete populations are reviewed, along with data on rates of extreme stress exposure, and results of pilot implementation of a group-based, culturally-attuned, resilience-focused intervention approach. Describe the ACE Questionaire as a useful tool in assessing the psychosocial health needs of US college athletes.. Describe the basic role that mindfulness plays in our human attachment system. Describe how dissociation usurps the neurobiological process of mindulness. Discuss how dissociation is an opposite brain function of mindfulness. SATURDAY, APRIL 1 Distinguish the unique challenges to meeting the psychosocial health needs of US college athletes from underprivilged backgrounds. Identify three resilience based interventions that are consistent with a trauma-informed system of care for US collegiate athletes. 3:00 PM 3:30 PM Room: Arlington Foyer Break - Refreshment 3:30 PM 5:00 PM CONCURRENT SESSIONS 90MIN WS 9 Room: McLean LEVEL: INTRODUCTORY (04-049) Dissociation, Mindfulness and Creative Meditations Christine C. Forner, BA, BSW, MSW, RSW, Primary Presenter In this 90 minute workshop participants will learn about the connection and disconnection between dissociation and mindfulness. This workshop will cover an in-depth discussion of what mindfulness is, with an emphasis on mindfulness as part of our human attachment system. A brief discussion on the neurobiology of mindfulness and the positive outcomes of mindful practices will also be discussed. This workshop will also look at dissociation from a neurobiological perspective in order to highlight the rival and opposite brain functions of dissociation and mindfulness. By considering the neurobiological purpose of mindfulness and the neurobiolgical purpose of dissociaiton, a practice of meditation can be developed to help dissociative clients eventually achieve mindfulness. This workshop will be a practical training to help clinicians utilize a creative meditative practice to assist dissociative clients eventually learn to be mindful. By using specific techniques and brain strengths of the dissociative clients, many people with dissociative disorders can learn to meditate. This workshop will include step by step instructions of creative meditation practices to help foster healing. 90MIN WS 10 Room: Jackson LEVEL: INTERMEDIATE (04-050) Why You Really Need Training in Clinical Hypnosis: A Pitch for Obtaining Clinical Hypnosis Training Utilizing Didactic and Experiential Means Reinhild Draeger-Muenke, PsyD, LMFT, Primary Presenter Formal training in clinical hypnosis is considered vital to offer state of the art treatment to individuals who have utilized spontaneous trance states to cope with the sequelae of traumatic experiences. In order to provide helpful and calming experiences, even when unfamiliar with clinical hypnosis, clinicians offer guided imagery or mindfulness meditation/ mindfulness based stress reduction, only to be surprised by the unexpected occurrence of unpleasant and unhelpful spontaneous trance states in the context of these methods considered benign and healing. This workshop will offer clinicians not yet trained in, but curious about, clinical hypnosis an introduction into the nature of clinical hypnosis and trance. Clinicians will learn to recognize spontaneous trance states and their underlying causes, and be invited to experience how to methodically enter, utilize, and exit a light trance state. Through this workshop, clinicians will achieve a better understanding of the power of focused imagination and trance, and of the ways clinical hypnosis beneficially harnesses these human capacities in the treatment of trauma and dissociation. Define what clinical hypnosis is and is not. Identify spontaneous trance states. Name three ways to identify level of alertness FINAL CONFERENCE PROGRAM & PROCEEDINGS

41 90MIN WS 11 Room: Lee LEVEL: ADVANCED (04-051) Working Through the Traumatic Memories of Mind-controlled Clients Alison Miller, PhD, Primary Presenter In the second stage of therapy, survivors of organized abuse involving mind control have to confront the traumatic memories which caused their dissociation. Because such survivors usually have a structured personality system, work with the traumatic memories can be pursued in a systematic way. This workshop will cover such issues as: deciding whether and when to pursue memories, dealing with flashbacks, choosing memories to work with, planning memory work, finding alters who hide parts of memories, involving all alters who have parts of a memory, dealing with emotions and bodily sensations during memory work, getting the story clear, and cognitive processing of what has been discovered when a memory has been reconstituted. Describe a method of closing down a memory flashback. State the criteria for a client s readiness to pursue work with traumatic memories. Describe an effective strategy for selecting memories to process. SYMPOSIUM 3 Room: Arlington Ballroom Salon II LEVEL: INTERMEDIATE (04-052) Are DID Patients as Suggestible and Fantasy-prone as the Fantasy Model Proponents Say They Are? The Answer According to Comparisons of DID Patients, Actors Simulating DID, PTSD patients, and Healthy Controls Bethany Brand, PhD, Primary Presenter; Aliya R. Webermann, MA, Primary Presenter; A.A.T. Simone Reinders, PhD, Primary Presenter; Chair The Trauma Model of dissociative identity disorder (DID) posits that DID is etiologically related to childhood traumatization. In contrast, the Fantasy Model posits that DID can be simulated. This study compares matched groups [DID/PTSD patients (n = 33) and (simulating) controls (n = 32) on psychological Trauma and Fantasy measures. (04-053) Can DID Patients Be Distinguished from Professional Actors Imitating DID, Patients with PTSD, and Healthy Controls? Bethany Brand, PhD, Speaker If the Trauma Model is correct, DID patients should score higher on trauma related measures (e.g., dissociation, anxiety, sleep difficulties, psychotic symptoms, trauma exposure, etc.) than actors imitating DID, PTSD patients, and healthy controls. That is precisely what we found: the DID group scored higher than the other groups on trauma-related measures, generally followed by the PTSD group, then the actors and controls. Thus, there was a trauma-exposure related continuum of severity across the groups and measures with the most traumatized individuals (i.e., DID group) generally having the highest scores. The DID group was not more suggestible or fantasy-prone, nor did they generate more false memories, compared to the other groups. These findings strongly challenge the core premises of the Fantasy Model of DID and consistently support the Trauma Model of DID. (04-054) Further Evidence Supporting the Trauma Model of DID: Responding to Challenges from Fantasy Model Authors Aliya R. Webermann, MA, Speaker In this final presentation we address concerns by Fantasy Model (FM) authors raised in a comment to the Editor about our study. The FM authors suggest additional analyses to address the possibility of participants over-reporting on the Structured Inventory of Malingered Symptomatology (SIMS), a measure of psychological malingering. In the first analysis, participants scoring above a cut-off on the SIMS (indicating potential malingering) were removed, and even with the reduced sample size, findings continued to support the Trauma Model: those with DID and PTSD were significantly higher on measures of dissociation and trauma compared to those with simulated DID and healthy controls; additionally, there were few group differences in malingering and no group differences in fantasy proneness. In the second analysis, we controlled for potential malingering using another method, and the DID group continued to score significantly higher on dissociation and trauma measures as compared to the PTSD, healthy control, and simulated DID groups; and again, there were no group differences in fantasy proneness. Taken together, the original study combined with the additional analyses provide consistent and strong support for the Trauma Model. Both the original and additional analyses challenge the validity of the Fantasy Model. SATURDAY, APRIL 1 Explain the Trauma and Fantasy Model of dissociation. Describe how empirical data obtained from a range of questionnaires including both Trauma Model and Fantasy Model measures informs on the etiology of dissociation. Evaluate evidence which supports the Trauma Model of DID FINAL CONFERENCE PROGRAM & PROCEEDINGS 41

42 SATURDAY, APRIL 1 PS 4 Room: Jefferson LEVEL: ALL Paper Session 4 Shame and Dissociation Chair: Paula Thomson, PsyD PS 4.1 (04-055) Pervasive Shame in Complex Trauma: An Ecological View Peitao Zhu, MA, Primary Presenter Shame is a self-conscious emotion that serves developmental and social purposes. It is subjectively experienced as painful, small, inhibited and exposed. Recent studies in complex trauma have suggested that shame plays a central role in the prediction, maintenance, and exacerbation of posttraumatic symptoms. In fact, researchers have proposed that complex PTSD is a shame-based disorder. On the other hand, shame, for decades, has been largely ignored, avoided or minimized in clinical practices and research literature. Shame has been systematically silenced in modern Western culture so that it is almost invisible in daily conversations and social occasions. This presentation, from an ecological framework, proposes that the pervasive yet unspoken shame is the key to understanding the debilitating effects of complex trauma and its increasingly perplexing symptoms manifestations. Through shame, survivors of complex trauma interact with multiple ecological factors in a bidirectional fashion. Clinical implications and future research directions will be discussed. Recognize the central role of shame in complex trauma. Identify shame-related factors in client s ecological systems. Apply shame-informed treatment into their clinical practice. PS 4.2 (04-056) Gender Role Stress Among College Students in Turkey: The Role of Childhood Trauma, Attachment, and Shame Vedat Sar, MD, Primary Presenter; Can M. Kilciksiz, Co-Presenter; Anil S. Kacar, Co-Presenter This study inquires about potential relations of Gender Role Stress (GRS) to developmental traumatization, attachment, and shame among young adults in Turkey. A group of college students (n=502) was recruited by invitation. Among participants, 366students classified their gender as female, 110 as male, and 26 students as gender-queer or not willing to make a declaration about their gender. All participants filled the GRS Questionnaire, the Childhood Trauma Questionnaire, the Relationship Styles Questionnaire, and the Experiences of Shame Scale. For both masculine and feminine fears, GRS was predicted by shame which was associated with childhood trauma and/or negative self and other. Feminine fears of abandonment and assertiveness and all masculine fears were affected by childhood trauma and disturbances of attachment. Being negatively correlated with shame, perception of positive self alleviated the feminine fears of assertiveness and abandonment. While these fears were affected by childhood trauma and insecure attachment, feminine fears related to sexuality were not. Masculine fears of nurturance and vulnerability were negatively associated with secure attachment. Fear of vulnerability was associated with fearful attachment. There was no relationship between attachment styles and masculine fears of sexual inadequacy, subordination, and performance failure. Sexual abuse was associated with masculine fear of subordination. Describe the links between shame, attachment, and childhood trauma and gender role stress. Differentiate the links between shame, attachment, childhood trauma and feminine and masculine gender role stress. Disucss the common links between shame, attachment, childhood trauma in both feminine and masculine gender role stress. PS 4.3 (04-057) Alternatives to Self Harm - An Introduction to an Innovative Approach to Reducing Harm and Shame in Trauma and Dissociative Clients Who Self Harm Diane Clare, BA, MA (Hons), Dip. Clin. Psych., AFBPsS, MNZAP, Primary Presenter This paper outlines the Alternatives to Self Harm Program (A.S.H.), designed by Diane Clare. Consequent to trauma, people can seek ways of regulating distress through self-harm, commonly in the context of dissociative states. In forensic and mental health services, Clare found attitudes of negativity, bewilderment and disgust expressed by professionals in response to self-harm. Such reactions can stigmatise, shame and increase the risk of harming. Dialectical Behaviour Therapy and STEPPS (Systems Training in Emotional Predictability and Problem Solving) though effective, are not universally accessible and do not target self-harm specifically. As self-harm can be therapy interfering, a pre-treatment program to target self-harm is recommended. Clare developed an easily learned and costeffective approach to apply across all skill levels. Drawing on evidence based material, she designed an innovative and respectful way to effectively help to reduce self-harm and related shame. A.S.H. incorporates the evidence base and Clare s APEX model: Attitude, Purpose, Emotional First Aid Kit and the X-Factor (a self-contract), which are tailored to the person s needs. The paper will introduce participants to this model and describe work to date in groups in the UK and single therapy applications in New Zealand FINAL CONFERENCE PROGRAM & PROCEEDINGS

43 Describe the four components of the APEX model underpinning the Alternatives to Self-Harm approach. Identify attitudes about self-harming that are more likely to shame and attitudes about self-harming that enable the person who self-harms to consider alternative ways of coping. Gain an overview of how to collaborate with a client to identify the purpose of their self-harming. PS 4.4 (04-058) Exploring Dissociative Processes and Regulating Shame in Group Therapy with Female Survivors of Childhood Sexual Abuse Grace Tomas-Tolentino, PhD, Primary Presenter In this paper, I provide a conceptualization of shame and dissociation in the context of attachments, including those formed in the group therapy setting. Shame that arises from the traumatic experience of childhood sexual abuse is at the core of work with survivors. Dissociative processes, which are consequential to such experiences and are intrinsically tied to the survivor s attempts to manage shame, are a crucial part of what is examined in group therapy. This paper is derived primarily from the presenter s work with survivors of childhood sexual abuse in the context of group therapy and highlights this treatment modality s unique role in the healing process for survivors. The community of group therapy, where survivors can feel heard, attuned to, and validated, can be a powerful adjunct to individual work with survivors. Relational difficulties and affective dysregulation, which are anchored in shame, further validate the historicity of the impact of childhood sexual abuse in survivors. The ultimate reparative goal of treatment is to dissipate shame, which is attainable only in the context of attachments. Because dissociative processes appear to make attachments impossible, addressing such processes and their role in the maintenance of shame is invaluable. Describe the role of shame and dissociation in attachments in survivors of childhood sexual abuse.. Explain attempts at regulating shame in female survivors of child sexual abuse in group therapy. Illustrate the role of group therapy in the treatment of survivors of childhood sexual abuse. 5:00 PM 6:30 PM Room: Arlington Foyer Final Poster Judging Hour Poster presenters available in the poster exhibit area to meet and discuss their work with judges. Posters will be displayed throughout the day for judges to review. Winner will be announced at the Awards Dinner. (# 1) Creativity and Dissociation Jonathan M. Cleveland, PhD Over the past decade, there appears to have been a growing interest in the nonpathological manifestations of dissociation. Perhaps owing to the impetus of Lisa Butler s influential 2006 article, there has been an increase in efforts to establish and measure the relationship between dissociation and putatively positive phenomena such as creativity (Perez-Fabello, & Campos, 2011), musical experiences (Van Heugten Van der Kloet, Cosgrave, Merckelbach, Haines, Golodetz., & Lynn, 2015), and hypnosis (Cleveland, Korman, & Gold, 2015). In the present study, the author will explore the relationship between creativity, as measured by the Torrance Tests of Creative Thinking - Figural (Torrance, 2010); state dissociation, as measured by the State Scale of Dissociation (Kruger & Mace, 2002); and belief in one s capacity to dissociate, as measured by the Dissociative Ability Scale (Fischer, Johnson, & Elkins 2013). Preliminary findings will be discussed, contrasting a nonclinical group (undergraduate psychology students) with a clinical group (outpatient mental health clinic). Distinguish between pathological and nonpathological dissociation. Identify established applications of nonpathological dissociation. Evaluate research suggesting a connection between creativity and dissociation. (# 2) Healing the Invisible Wound : Early Attachment Trauma (EAT) as the Basis for the Development of Dissociation, and Healing Strategies. Doris D hooghe, BA As dissociation and maltreatment have been marginalized in the early twentieth century, the necessity to highlight early attachment trauma (EAT) as a hidden epidemic imposes itself. Recent research supports the hypothesis that early attachment experiences are linked to dissociation. Therefore, it is crucial to install the significance of these experiences in mainstream psychology. To understand the underlying mechanisms of dissociation, we have to approach dissociation within the context of EAT. EAT is invisible and is related to the quality of parenting, e.g., sensitive psychobiological attunement, accessibility, etc. It is these early attachment failures, resulting in different insecure attachment styles, which set the stage for dissociation. We could consider attachment disorders as dissociative disorders with a negative impact on the development of a coherent self, and on resilience against later trauma and stress. Infants, as a result of insecure attachment experiences, could internalize non-integrated internal working models of their relationships with caregivers and about themselves. Dissociation could thus be seen as a lack of integration and a failure in organizing multiple and incongruent models of the self and the other. Dissociation also has various neurobiological consequences. As the literature suggests, secure SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 43

44 SATURDAY, APRIL 1 attachment underlies the development of the right hemisphere and thereby EAT influences the neurobiology of dissociation. Healing strategies should include:preventive work, with the presentation of a parent-training program, including therapy with the caregivers to heal their own unresolved attachment related trauma(s). Treatment strategies based on the therapist-client dyad for achieving attachment security will be demonstrated. Participants will be able to identify the relationship between early attachment trauma and the development of dissociation. Participants will be able to theorize the neurobiological consequences of dissociation. Participants will be able to integrate the presented healing strategies into their practice. (# 3) Building Hope and Resiliency in Trauma Treatment: A Punk Rock Approach to Therapy Jessica Drass, MA, ATR-BC, PhD Candidate Punk culture emphasizes a quest for authenticity, and art therapy informed by punk ideology can be a way to build resiliency and hope in trauma treatment. The literature has shown that instillation of hope is associated with a greater chance of recovery for patients with a history of trauma. The presenter will share case examples of how punk rock ideology can be incorporated into a traditional treatment setting using a DBT model. Punk rock art therapy can be a way to create a culture of connection that helps combat the sense of loneliness so often driving patients maladaptive behaviors, while also building resiliency and instilling hope through core concepts of collapse of hierarchy, search for authenticity and understanding, deconstruction/reconstruction, and empowerment through a DIY mindset. In DBT the skill of Alternate Rebellion can help cope with urges and to satisfy the innate desire for rebellion. Punk rock art therapy aligns with this concept as a safe way to rebel against authority and conformity. This presentation will illustrate how patients can use art therapy to imagine a place that looks beyond the difficulties of the present moment and re-write their personal narrative. Define Punk Rock Art Therapy. List three ways punk rock culture builds hope and resiliency. Describe two examples of how to incorporate Punk Rock Therapy into traditional treatment settings. (# 4) Trauma-Focused Somatic Based Intervention for Latino Children: A Pilot Study Anne S. Farina, MSW, LCSW Background: The aim of this study was to examine the effectiveness of a somatic-based intervention designed to address trauma, anxiety, and depressive symptoms in Latino children who have experienced trauma. Method: A total of 24 children and adolescents fully completed the trauma-informed treatment at a community-based clinic during the course of the project and follow-up. The average length of time children received treatment was 12 weeks. Participants completed baseline standardized measures for psychosocial functioning, depression, anxiety, emotional regulation and trauma and the same measures at the conclusion of treatment and 3-month follow-up. Paired t-tests were used to compare the pre-, post-, and follow-up data Results: Children and their caregivers reported significant decreases in trauma symptoms, problematic behaviors, anxiety symptoms, depressive symptoms, and an increase in emotion regulation skills. Discussion: Somatic Soothing shows potential in decreasing trauma, depressive, and anxiety symptoms in Latino children who have experienced trauma. Due to the limited language proficiency and high prevalence of trauma in immigrant and refugee children, this is potentially a promising practice for these children. Randomized, controlled trials are suggested to further test the efficacy of this trauma-focused, somatic based intervention. Describe the unique mental health needs of Latino children and adolescents. Describe the aims of somatic based interventions in the treatment of trauma. Identify specific outcomes achieved from the use of a somatic based intervention for this pilot study. (# 5) Want to Get Lunch?: Maintaining Boundaries in the Therapeutic Relationship Eileen Griffin, MS, PhD Candidate; Melanie Soilleux, MPsy A major challenge in treating adults with a history of childhood abuse is maintaining appropriate boundaries and managing countertransference reactions. Child abuse is often perpetrated by or in the presence of caregivers, the people who are most responsible for a child s safety (Lawson, Davis & Brandon, 2013). The child experiences the parent s failure to provide security and well-being (Knox, 2003), which then affects the child s ability to develop a stable sense of self and appropriate boundaries. Thus, adults with a history of childhood trauma are often still trying to manage conflicts in earlier stages of development around issues such as autonomy, initiative, and intimacy (Herman, 2015, p. 52), which has implications for how patients manage adult relationships with others. Those with childhood trauma often pull individuals in their adult lives to provide a new, compensatory experience of attachment (West, 2013). This can feel potent in the therapeutic relationship and cause a number of reactions in the therapist. This poster explores the maintenance of appropriate boundaries in therapeutic relationships with adult patients who have experienced significant childhood trauma. Specific psychotherapy case examples are provided, with considerations on countertransference reactions, common challenges in working with trauma survivors, and recommendations for self-care. Recognize the common countertransference reactions in working with trauma survivors. Identify boundary challenges and interpret their reactions to clinical cases. Apply self-care strategies FINAL CONFERENCE PROGRAM & PROCEEDINGS

45 (# 6) Sexual Abuse by Parents: Differences in Graduate Students Perceptions of Maternal and Paternal Behaviors Christine Hatchard, Clinical PsyD; Amanda Aynes, BA Candidate; Richard Felicetti, BA Candidate; Genesis Gonzalez, BA Candidate; Juliana Thomas, BA Candidate The current study examined social work and mental health counseling graduate students perceptions of sexually abusive behaviors as a function of the sex of the parent and the sex of the child. Vignettes illustrating different forms of sexual abuse were written for the study and rated by 118 participants on a Likert point scale with different parent-child pairs (motherdaughter, mother-son, father-daughter, father-son) substituted into the vignettes as the only difference between groups. Twoway between subjects ANOVAs revealed that sexually abusive behaviors by mothers were perceived as less abusive to child victims (F (1, 118 = 5.37, p <.05) than the same sexually abusive behaviors committed by fathers. Additionally, sexually abusive behaviors by mothers towards daughters were perceived as the least abusive (F (1, 118 = 7.75, p <.01), the least criminal (F (1, 118 = 8.83, p <.01) and the least damaging (F (1, 118 = 4.35, p <.05), as compared to the other 3 groups. Results suggest that perceptions of sexual abuse may be influenced by participants perceptions of sex and gender, and that training in identifying and understanding victims of sexual abuse may be an area of growth for graduate programs. Define sexual abuse in comprehensive terms to include both overt and covert behaviors perpetrated by either a a male or female against a male or female victim. Explain how gender bias and stereotypes may prevent the identification of mother-daughter sexual abuse in forensic and clinical settings. Describe strategies in forensic and clinical settings that can increase the rate of identification and intervention. (# 7) The Fear Response in Dissociative Identity Disorder: An Acoustic Startle Response Study Isabella Kahhale, BS Candidate, Presenter Authors: Lauren A.M. Lebois, PhD; Cara Bigony, BA; Jonathan Wolff, BS; Sherry Winternitz, MD; Kerry J. Ressler, MD, PhD; Milissa Kaufman, MD, PhD The overgeneralization of conditioned fear and the impaired ability to extinguish fear are potential mechanisms underlying alterations in arousal and reactivity associated with traumaspectrum disorders. One way to measure fear processing is the acoustic startle response (ASR), a muscular reflex to auditory stimuli. Classic/re-experiencing Post-traumatic Stress Disorder (PTSD) is associated with an exaggerated ASR and a failure to extinguish the fear response in ASR paradigms. To date, one study has examined ASR and pathological dissociation; dissociation was associated with an attenuated ASR. We aim to replicate and extend these findings in an ongoing crossdiagnostic study of women with histories of childhood abuse, Dissociative Identity Disorder, and/or the dissociative subtype of PTSD (preliminary N= 13; age M= 45.58). Participants completed a self report battery and an ASR paradigm measuring facial electromyography, heart rate, and skin conductance. All participants reported both high levels of arousal-based symptoms and pathological dissociation (PTSD Checklist for the DSM-5 E:M= 12.67,SD= 3.92; Multidimensional Inventory of Dissociation V6:M= 51.03,SD= 19.33). ASR data will be discussed. Our findings will help provide a basic physiological understanding of the fear response in DID, informing treatment development to manage physiological symptoms. Describe the Acoustic Startle Reflex (ASR) task and why it is utilized in studying fear-based disorders. Identify the key differential ASR findings between PTSD and PTSD Dissociative Subtype. Compare self-reported arousal-based symptoms of participants with DID to the physiological ASR data. (# 8) A Meta-Analysis Study of Predictors of Disaster Victims Post-traumatic Stress Response Based on an Ecological Model Nabin Lee, MS, PhD Candidate, Presenter Authors: Kisun Sim, Hyunnie Ahn The objective of this study is to classify relevant factors of disaster victims posttraumatic stress response(ptsr) systematically using an ecological model. To this end, this study is a meta-analysis of 87 studies published between 2005 and 2015 on a topic of disaster victims PTSR. Factors associated with PTSR were derived and classified into sublevels of an ecological model: individual system, microsystem, and exosystem. Then, we investigated what predictors were more strongly related with the PTSR. According to results on effect sizes by ecological system and factor group separately for different types of disaster, PTSR for natural disasters were best related with the order of micro, exo, then individual system, and PTSR for man-made disaster were better related with micro and individual systems than the exosystem. The results of comparison of effect sizes between factor groups showed that effect size of factors associated with structure and functions within family was greatest for natural disasters, whereas the effect size of exposure level factor group was greatest for man-made disasters. In addition, in both natural and man-made disasters, stressors caused in family and social relationships after disaster and secondary stressor factor groups were major predictors of victims PTSR. Classify related variables of disaster victims posttraumatic stress response systematically using an ecological model. Discuss effect size of the three ecological models»» Discuss interventions for disaster victim s psychological recovery. SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 45

46 SATURDAY, APRIL 1 (# 9) Support/Process Groups for PTSD and Addictions/Community Judy McLaughlin-Ryan, MFT Group psychotherapy and twelve-step group psychotherapy, as an adjunctive to overall psychological treatment for those patient s with Post-Traumatic-Stress-Disorders and Addictive Disorders, has been shown to contribute to a more positive treatment outcome. Research based rationale for group psychotherapy are based on regulation theory, attachment theory, and neurobiological theory, with a focus on interactive behaviors which diminish the symptom of isolation. Dysregulation of affect and state prohibits closeness to others and increases symptom clusters of PTSD and Addictive Disorders. Due to the high levels of co-morbidity, the necessity of addressing dyregulation of affect and state with both disorders is key. While there are treatment challenges of high risk addictive behaviors occuring with this patient population, research supports increased positive treatment outcomes when socialization and affiliative behavior occurs. Isolation as a symptom of PTSD is prevalent. Most PTSD and Addictive symptoms lead to isolation, which only causes further problems with intimacy and overall development. In order for regulatory skills to occur, and in order to enhance neurobiological development group participation is key. Case examples will illustrate the dyadic efficacy of group psychotherapy, along with current supportive research and theory. Identify, listing whether true or false, whether the three areas of affective state regulatory goals, when treating PTSD are as follows: The patient s ability to self-regulate, utilize and understand interactive affective and state regulated secure attachment building, and ongoing moving towards groups and dyadic secure attachments to secure sustained decrease of symptoms. List at least three qualities of dysregulation of affect, for those who are diagnosed with PTSD, with 11 per cent accuracy. (Some are the emotions of fight resulting in heightened rage or anger, flight while experiencing feelings of leaving, and uncontrollable fear and terror). List at least three qualities (out of many) of dysregulation of state, for those who are diagnosed with PTSD are the physiological dysregulation. (May include increased heart rate, still freeze response, and or sweating). (# 10) Differences in Social Sharing and Community Resilience after Disaster among Social Empathy Latent Classes Moonkyung Min, MS, PhD Candidate, Presenter Authors: Heejeong Moon; Hyesun Joo, PhD; Hyunnie Ah, PhD The purpose of this study was to investigate social empathy in a Korean sample, extending the traditional concept of empathy through understanding the context, and examining group differences among the social empathy latent classes according to its five subscales (i.e., affective response, selfother awareness, perspective taking, emotion regulation, macro perspective taking). Specifically, we concentrated on differentiating the level of social sharing and community resilience (i.e. leadership, collective efficacy, preparedness, place attachment, social trust) on the impact of disaster on the whole society. The Survey was conducted among 1147 Korean respondents in their 20s to 50s eight months after the Sewol Ferry accident, and 1000 people who experienced the accident indirectly were included in the analysis, As a result of the latent class analysis, three social empathy classes were identified : (a) low social empathy group (b) middle social empathy group (c) high social empathy group. In addition, using ANOVA and MANOVA, significant class differences were found in all variables, suggesting that the low social empathy group was lower than middle and high social empathy groups. Results indicate several ways to facilitate social empathy and recovery from the disaster. Investigate how social empathy, which extended the traditional concept of empathy through understanding the context appears in Korean sample. Describe group differences among the social empathy latent classes according to its five subscales (i.e., affective response, self-other awareness, perspective taking, emotion regulation, macro perspective taking). Explain differences in the level of social sharing and community resilience (i.e. leadership, collective efficacy, preparedness, place attachment, social trust) on the whole society. (# 11) Social Network Analysis of a Cooperation Network among Disaster Support Systems -Focused on the Sewol Ferry Accident in South Korea Jiwon Min, MS, PhD Candidate, Presenter Authors: Kisun Sim, PhD Candidate; Soosang Lee; Hyunnie Ahn, PhD The Sewol Ferry accident in April, 2014 had a significant impact on Korean society. In response to the national-scale disaster, there are limitations to what a single institution can do to facilitate the effective recovery of society. Previous studies also indicated that it is important to establish cooperative networks of various resources from a local community where a disaster has occurred and the private and public sectors. Therefore, the present study aims to analyze the cooperative relations between 38 organizations who participated in psychosocial support activities after the Sewol Ferry accident. Results from Social Network Analysis(SNA) showed that 38 disaster support institutions generally formed low-levels of cooperative relationships after the Sewol Ferry Accident. Specifically, the degree and effectiveness of cooperation between the institutions were found to be lowest in terms of human resources. In comparison, cooperation was found to be relatively high with respect to information/data transfer. In addition, the major players in this network were mainly public institutions, while private sector or local community organizations were somewhat limited in their ability to mobilize support. The clinical implications of support systems for disaster victims were drawn and discussed in the cultural context FINAL CONFERENCE PROGRAM & PROCEEDINGS

47 Describe how disaster support systems cooperated each other after Sewol Ferry Accident in South Korea. Discuss cultural differences in disaster responses between U.S. and South Korea. Identify his or her role as a mental health service provider in psychosocial recovery from disaster. (# 12) The Impact of Collective Trauma on Indirectly Exposed People: The Role of Social Empathy on Social Sharing and Event Centrality Moonkyung Min, MS, PhD Candidate Collective trauma affects all members of the society even if they are not involved in the event directly. Although previous studies mainly focused on the victims, or the professional helpers, we focused on the impact of collective trauma in relation to social empathy among people indirectly exposed to the Sewol Ferry accident in Korea. We hypothesized that macro perspective taking (MPT) which is a key component of social empathy, will mediate the associations between interpersonal empathy and social sharing, as well as event centrality. Furthermore, we hypothesized that those relationships will differ between those who experienced trauma and the non-trauma experienced group. A sample of 1147 Koreans completed questionnaires assessing the variables, and only those who were exposed to the Sewol Ferry accident indirectly (e.g., watched on the news) were included for the analysis. As a result, the Structural Equation Modeling analysis indicated that MPT mediated the relationship between interpersonal empathy and social sharing fully, as well as event centrality partially. However, the multigroup analysis indicated that those associations emerged for the trauma-experienced group only. Results suggest that social empathy carried out the role of commemorating the event, especially in a collective trauma situation, by facilitating reflection on one s own experience and positioning. Explain how collective trauma affects all members of the society even if not involved in the event directly. Recognize the role of social empathy in collective trauma situation by facilitating the reflection on one s own experience and positioning. Discuss how previous trauma experience makes differences in response to collective trauma. (Craig, 2009). Poor interoceptive awareness (IA), or the ability to perceive internal body states, may underlie dissociative symptoms and alexithymia (Seth, 2013). Recent work on IA suggests its importance in developing body awareness and ownership, self-identity, emotional and self awareness (Craig, 2009; Pollatos, Kirsch, & Schandry, 2005). This research aims to understand the link between interpersonal trauma, knowing the body and knowing the self in terms of IA and emotional awareness. IA, as measured by the Heartbeat Detection Task (HBD; Schandry, 1981) was expected to predict an increase in self-reported dissociative experience and alexithymic symptoms and be related to exposure to different types of trauma. Our findings suggest that experiencing interpersonal violence may lead to reduced IA, as determined by a prolonged HBD task (55 seconds), r=.551, p=.017, which implies that interpersonal trauma holds effects not only within the interpersonal relationship but also for intrapersonal functioning. Explain the role of interoceptive awareness in individuals who have experienced trauma. Assess IA as they relate to different trauma exposures. Identify the extent of IA in traumatized individuals. (# 14) The Unstable and Intense Relationship Between Dissociative Disorders and Borderline Personality Disorder Sanjana Ramaswamy, Brad Foote, MD Foote et al. (2008) found that dissociative disorders (DD s) and borderline personality disorder (BPD) were the two strongest predictors of chronic suicidality in psychiatric outpatients, and after co-entering the two diagnoses in a regression analysis, found that the comorbid DD accounted for the high suicidality in patients with BPD. In an attempt to replicate and expand the results of this previous study, the current study includes a much larger group of patients, who completed a number of self-report measures and participated in a structured diagnostic interview. 325 psychiatric outpatients were interviewed in an IRB-approved research protocol; 108 met criteria for BPD and 101 for a DD, with an extremely high degree of overlap between the two groups. We compare these groups with regard to demographics, suicidality, non-suicidal self-injury, trauma history, comorbidity, post-traumatic stress disorder and a number of other measures. The two groups are found to be similar on many measures, but a few striking differences are noted, especially with regard to the prevalence of non-suicidal self-injury. SATURDAY, APRIL 1 (# 13) Keeping the Heart in the Mind: Dissociative Symptoms and Interoceptive Awareness in Victims of Interpersonal Violence Nadia Nieves, MA, PhD Candidate; Kellie Ann Lee, BA, MA Candidate Authors: Steven Freed, MA; Lina Ledvin; Wendy D Andrea, PhD Research suggest that individuals who are unable to accurately integrate information coming from within and outside the body to establish a material me in an environment that is separate from the body may result in alexithymic symptoms Describe the relationship between dissociative disorders, borderline personality disorder, and suicidality. Recognize the substantial comorbidity of dissociative disorders and borderline personality disorder.»» Compare and contrast dissociative disorders and borderline personality disorder FINAL CONFERENCE PROGRAM & PROCEEDINGS 47

48 SATURDAY, APRIL 1 (# 15) Trauma Practice: Preliminary Analyses of Pilot Data of a Tri-Phasic Treatment Sara L. Rependa, MA, Kristina Cordeiro, BA Hons, Robert T. Muller, PhD, CPsych Authors: Anna Baranowsky, Anna Kozina We performed preliminary analyses on data collected during a controlled pilot study with follow up. The treatment model is a tri-phasic trauma therapy conducted in a multi-site context. Participants were 12 adults in community based private practice settings in Canada. Therapists were Master s and Doctoral level clinicians, with previous experience working with trauma, as well as training in the Trauma Practice Model. This therapy model includes: Phase 1: Safety and Stabilization; Phase II: Working through Trauma; and Phase III: Reconnection. Measures were given at five time points: 1) Intake; 2) after Phase I; 3) after Phase II; 4) after Phase III and; 5) at a three month post-therapy follow up. Self-report questionnaires evaluated post-traumatic symptomatology, self concept and identity, post-traumatic growth, emotion regulation, therapeutic alliance, self-esteem, and daily functioning. Data are currently being collected. Preliminary analyses of the study s pilot data are presented. List the different P\phases that compose the therapy model Trauma Practice. Describe the preliminary data outcome findings. Identify what data findings were significant for change in post-traumatic symptomatology. (# 16) Themes of Betrayal in Autobiographical Narratives in Relation to Current Abuse and Quality of Life in Adult Women with HIV Elizabeth G. Ruffing, MTS, MA Experiences of betrayal recounted in autobiographical narratives of HIV+ women were investigated in relation to current abuse and quality of life. Betrayal was defined as betrayal trauma (BT; trauma inflicted by a trusted other) or non-abuse-betrayal (NAB; trusted individual not living up to expected role, e.g. exploitation, abandonment, infidelity). Ninety-eight HIV+ women (91% African-American, mean age=45 years) from the Chicago Women s Interagency HIV Study provided narratives about three significant life turning points. Narratives were reliably coded for BT and NAB episodes per life stage (childhood/ adolescence/adulthood). Health-related quality of life (HRQOL) was measured with the Medical Outcome Study (MOS-HIV; Bozette, et al., 1995), and recent abuse (RA, yes/no) was selfreported. 75% of participants recounted at least one betrayal episode (42% BT, 60% NAB; 29% both). Controlling for current age and income, multiple and logistic regressions indicated that childhood/adolescent BT and NAB each significantly predicted lower HRQOL (β=-.22, p <.05; β=-.31, p <.01). Adolescent BT significantly predicted adulthood BT (β=.24, p <.05), adulthood NAB (β=.21, p <.05), and likelihood of RA (β=1.82, p <.05). Adulthood NAB, but not adulthood BT, significantly increased the likelihood of RA (β=2.62, p <.01). The relationship between betrayal and current abuse and HRQOL is a new contribution that could benefit treatment design. Describe effects of a history of betrayal (both trauma and non-trauma related betrayal) on recent abuse and healthrelated quality of life in adult HIV+ women. Integrate knowledge of how the life stage at which betrayal occurs impact quality of life and recent abuse. Identify how qualitative research on betrayal using autobiographical narratives can inform trauma focused treatment programs for HIV+ women. (# 17) The Effect of Secondary Trauma Care on Professional Quality of Life among Mental Health Professionals Responding to the Sewol Ferry Disaster Kisun Sim, PhD Candidate Authors: Nabin Lee, PhD Candidate; Hyesun Joo, PhD; Hyunnie Ahn, PhD When a disaster occurs, mental health professionals are brought in and provide psychosocial service to trauma survivors. However, they also become vulnerable to negative effects of secondary trauma after disaster intervention. Therefore, the purpose of this study was to examine the professional quality of life among mental health service providers responding to the Sewol Ferry disaster and to identify effective secondary trauma care strategies for reducing secondary traumatic stress. The Sewol Ferry disaster in April of 2014 is considered to be one of the biggest tragedies in South Korean society. To this end, data was collected from mental health workers, and 69 professionals who participated in disaster activities were used in final analysis. Results from multiple regression analyses revealed that setting appropriate psychological boundaries contributed to reduction of the level of secondary traumatic symptoms. Institutional-level secondary trauma management was effective to reduce the risk of burnout. Finally, meaning making of their work was effective in enhancing compassion satisfaction for professional. Findings shed new light on the influence of organizational-level care on disaster mental health professionals and importance of macro approaches to provide secondary trauma care. Based on these results, implications for mental health care and organizational policy are discussed. Describe professional quality of life among mental health professionals who participated in psychosocial support activities after the Sewol Ferry disaster. Identify effective secondary trauma care strategies after controlling the individual and contextual factors.»» Discuss implications for disaster mental health care and organizational policy FINAL CONFERENCE PROGRAM & PROCEEDINGS

49 (# 18) Location, Location, Location: Geographical Heat Maps as Critical Components of Climate Surveys of Campus Sexual Assault Alec M. Smidt, MS, Presenter Authors: Marina Rosenthal, MS; Jennifer Freyd, PhD We examined the utility of using geographical heat maps in conjunction with traditional self-report questionnaires when studying the climate of campus sexual violence. Current research on campus sexual violence focuses on incidence and prevalence rates, victim/perpetrator demographics, and outcomes of victimization. However, no studies have examined where e.g. actual buildings and housing facilities incidents of sexual violence occur. 6,000 randomly-selected students (4,000 undergraduate students and 2,000 graduate students) were recruited via from a large university in the Pacific Northwest. From that pool of 6,000, 1,556 participants completed the entire study; of those 1,556 students, 1,334 participants satisfied data integrity safeguards and had their responses included for analysis. We will present four geographical heat maps that display the location and relative intensity (i.e., number of incidents) for 1) sexual harassment of students by faculty/staff, 2) sexual harassment of students by other students, 3) sexual violence (e.g., sexual assault, attempted/completed rape), and 4) dating violence (e.g., physical violence perpetrated by a romantic partner). These heat maps will be discussed in relation to the overall trends in victimization captured by this study. Implications for prevention and intervention strategies and information on how to incorporate this method will be discussed. Identify patterns in the locations of sexual violence on college campuses. Identify particular groups which may be at greater risk of sexual violence. Describe the utility of geographical heat maps in understanding trends of sexual violence victimization on college campuses. (# 19) Trigger Warning: Effects of Content Warnings on State Anxiety Alec M. Smidt, MS, Presenter Author: Jennifer Freyd, PhD We examined the effects of different types of content warnings (sometimes referred to as trigger warnings ) accompanying either neutral or emotionally-charged stimuli on state anxiety levels. Participants were recruited from a pool of undergraduates enrolled in introductory psychology courses at a large Pacific Northwestern university and were divided into one of six conditions in a 3 (content warning type; no warning, Content warning: Rape, or Trigger warning: Rape ) x 2 (neutral or emotionally-charged stimulus). The neutral stimulus was a video depicting a man and a woman interacting in an office setting, and the emotionally-charged stimulus was a video depicting a man sexually assaulting a woman; the man and woman were the same across both the control and experimental stimuli. This poster will discuss the results of a 2 x 2 ANOVA (dichotomizing the content warning type into warning or no warning ) to determine if there is a) a main effect for stimulus type (neutral or emotionally-charged), b) a main effect for warning type (warning or no warning), and c) an interaction between stimulus type and warning type; main effects and the interaction will be discussed in terms of the effects on participant state anxiety. Identify different types of content warnings used before viewing emotionally-charged or neutral stimuli. Identify the main effects and interaction of content warning type by stimulus type. Use the presented information in their own clinical and academic work. (# 20) Trauma-Informed Care for Women in Correctional Settings: Challenges and Benefits Leah Taylor, MS Previous researchers have reported on the high prevalence rate of prolonged childhood trauma in the lives of inmates along with its numerous long-term effects on adaptive and healthy functioning (Covington & Bloom, 2007; Heckman, Cropsey, & Olds-Davis, 2007; Levenson, 2014). While experiencing childhood trauma alone significantly interferes with healthy development, clinical observation suggests that the presence of childhood trauma along with an invalidating home environment has the most harmful impact due to the lack of teaching and modeling of healthy and adaptive coping skills (Gold, 2010). Researchers have identified childhood trauma as key factor in the developmental pathway to a criminal lifestyle and that number of arrests are positively correlated to an abuse history (DeCou, Lynch, DeHart, & Belknap, 2016). Survivors of prolonged childhood trauma are overrepresented in our inmate population, yet the adverse psychological impact of these experiences is not addressed in prisons (Covington & Bloom, 2007; Messina, Grella, 2006; Levenson, 2014). Lengthy prison sentences are being distributed with the expectation that serving time will result in an inmate reentering society as an effective, law-abiding adult. This outcome is expected without anyone addressing or treating the underlying causes of criminal behaviors during incarceration. This paper will address the need for appropriate and safe individualized trauma-informed care for incarcerated women with a history of prolonged child abuse. A literature review will be conducted in order to evaluate the promises and challenges of providing trauma informed care in correctional settings and to explore the effectiveness of existing programs. Due to inmates being a vulnerable population and prisons being an unsafe and triggering environment, the writer will address any special needs and considerations of providing trauma-informed care within this setting. The Contextual Model of complex traumatization (Gold, 2000) will be explored as a potentially fitting approach for treating trauma within this setting. Lastly, this literature review will include examples of specialty trainings that exist for correctional staff that aids in developing a safer and less triggering environment for all inmates and staff. SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 49

50 SATURDAY, APRIL 1 Describe the role of attachment style in adult criminal behavior Evaluate the current system in place to treat female offenders with complex trauma histories Apply Herman's Three-Phase Model and Gold's Contextual Model for female offenders within a correctional setting (# 21) Negative Parental Treatment of the Singled-Out Child: A Predictor of Chronic Non-Suicidal Self Injury Michelle T. To, MD; Brad Foote, MD The phenomenon known as negative parental differential treatment (PDT), wherein patients describe receiving harsher parental discipline and less parental love than their siblings, has been commonly reported by clinicians. The participants in our IRB approved study were 325 patients consecutively admitted to an inner-city hospital-based outpatient psychiatric clinic. Participants completed self report measures and structured interviews for trauma, PDT, self-harm, and diagnoses including borderline personality disorder, posttraumatic stress disorder (PTSD), and dissociative disorders. Of these 325 patients, 211 indicated that they had at least one sibling and responded to questions about PDT. Among the respondents, 78 (37%) reported presence of negative PDT in their childhood. A Chisquare test for independence indicated a significant association between negative PDT and chronic non-suicidal self injury (NSSI), χ (1, n=211) = 11.59, p = Negative PDT was the strongest predictor of chronic NSSI when compared to the 5 classic domains of childhood abuse. In addition, negative PDT was a strong predictor of a diagnosis of borderline personality disorder. Negative PDT was significantly associated with diagnoses of dissociative disorders and PTSD, although to a lesser extent than other domains of childhood abuse. Describe the prevalence of negative parental differential treatment. List at least 3 types of psychopathology associated with negative parental differential treatment. Describe how negative parental differential treatment compares to other domains of childhood abuse in the etiology of chronic non-suicidal self injury. treatment after many years of therapy; showing consistent improvement in the later years. Positive and negative effects from exposure to severe trauma coexist in this individual. She shows elements of PTG on three of the five factors of PTG (Personal strength, new possibilities, life appreciation). There is no change in the interpersonal relations and the spirituality factors. The patients has successfully integrated a long and severe history of trauma; obstacles to the process of growth are also presented. In conclusion, PTG elements can be identified in a severely traumatized individual; there is a need for systematic, quantitative research regarding the process of PTG in individuals with DID. Describe Posttraumatic growth (PTG) and its five factors. Analyze the PTG concept in terms of its five factors (personal strength, life appreciation, new possibilities, spirituality, interpersonal relations).. Illustrate the subjective experience of a person with complex DID who shows behavioral and verbal elements of PTG. (# 23) Clergy Knowledge of Trauma and Intervention with Rural Churchgoers Anna W. Vandevender, MS; Ruth Riding-Malon, PhD Clergy often serve as frontline helping professionals within their community, placing them in a position to respond to events that could evoke symptoms of posttraumatic stress in their congregation. While the use of mental healthcare has increased in urban areas, research indicates rural residents continue to rely heavily on clergy. The pursuit of clergy support represents aspects of rural culture and other marginalized populations, such as racial minorities, including the role religion and faith may play in the lives of trauma survivors, the long-term relationships between clergy and members of their congregations, limited access to mental health professionals in service shortage areas and financial limitations, and mistrust toward the mental health field. This qualitative study sought to capture the understanding and types of support clergy members provide to rural residents who have experienced trauma. Findings indicated themes of distrust of mental health professionals, misunderstanding of the roles of psychologists, and a lack of support for clergy working with trauma survivors. Responses also highlighted concerns related to racial trauma and tensions within the immediate community and society at large. Implications for collaboration between mental health professionals and rural clergy are discussed. (# 22) Posttraumatic Growth in Dissociative Identity Disorder Marie Torres, MEd, PhD This is a clinical case presentation of a person exposed to severe psychological trauma, whose verbalizations and behavior show elements of Posttraumatic Growth (PTG). PTG is the positive change resulting from exposure to trauma. This patient s diagnosis is complex Dissociative Identity Disorder (DID). The patient has progressed through the stages of List the factors contributing to severe resource limitations in mental health service shortage areas. Describe three types of support rural clergy bring to trauma treatment.»» List possible reasons members of racial minorities refuse mental health services in rural areas, choosing instead to rely on clergy FINAL CONFERENCE PROGRAM & PROCEEDINGS

51 (# 24) Healing Factors and a Model of Psychotherapy For Individuals with Complex Trauma in Childhood: The Client s Perspective Agnieszka Widera-Wysoczanska This research concerned the factors influencing changes in 132 women and 58 men (average age: 31.7) during psychotherapy for after complex familial interpersonal trauma involving emotional, physical, sexual or substance abuse. Identification of healing factors allow establishment of a more effective recovery process, and effective determination of objectives, principles, methods and stages. Participants completed an Abuse Questionnaire and Intimate Situations Questionnaire, to obtain information concerning types of trauma experienced, its duration and the perpetrators. A structured interview was conducted to define problems, pathological mechanisms, patients goals, factors affecting recovery, and the changes that were achieved. The pathological mechanisms of functioning and factors strengthening and hindering the healing process are explained in detail. Some of these include the perception of the group and the therapist, giving new meaning to the past, identifying with the stories of other people, dealing with stressful situations, relationships with people from outside the group, and planning for the future. Particular attention was paid to the importance of admitting to being the perpetrator of violence, if applicable. A model of psychotherapy, taking into account these factors will be discussed in detail. Analyze and identify factors accelerating and hindering therapy. Plan goals and therapy milestones that enhance the healing process. Determine the structure of the therapy stages tailored to the needs of individuals. (# 25) Childhood Abuse Predicts Complex Dissociative Symptoms in Adult Women with Post-Traumatic Stress Disorder: Diagnostic Implications Jonathan Wolff, BS Increased interest in dissociative symptoms such as depersonalization and derealization has led to the designation of a dissociative subtype of PTSD in the DSM-5. Clinically, individuals with PTSD may report a broader range of dissociative symptomatology than accounted for by this subtype. Our goal was to investigate this issue empirically in a cross-sectional sample of adult women with PTSD (CAPS-5) and histories of childhood abuse, and healthy controls (N = 62). We completed linear regression analyses with the Childhood Trauma Questionnaire (CTQ) total score and the Multidimensional Inventory of Dissociation (MID) depersonalization, derealization, and mean pathological dissociation scales. The CTQ total score significantly predicted adulthood depersonalization (RF(1,60)=32.61,p</em> <.001,b=.54, t(60)=5.71,p</ em> <.001), derealization (RF(1,60)=15.84,p</em> <.001,b=.41, t(60)=3.98,p</em> <.001), and mean MID scores (RF(1,60)=42.71,p</em> <.001,b=.52, t(60)=6.54,p</em> <.001). These results demonstrate that childhood abuse predicts a broad range of complex dissociative symptoms in adulthood, and highlight the importance of comprehensive assessment for dissociation in PTSD research and treatment. Describe how the Multidimensional Inventory of Dissociation (MID) is a comprehensive measure of dissociation. Discuss how the CTQ predicts various dissociative symptomatology. Identify the importance of comprehensively assessing for dissociative symptoms. 5:00 PM 6:45 PM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters 6:15 PM 7:00 PM Room: Arlington Foyer President s Reception (included in Full Conference Registration) Come mingle with colleagues, new and old, and visit with exhibitors. Use your drink ticket for a glass of beer or wine. Cash bar available (No credit cards or checks please.) 7:00 PM 10:00 PM Room: Arlington Ballroom Salons III-IV Awards Dinner/ Entertainment (included in Full Conference Registration) Following the President s Reception, come enjoy dinner with your colleagues and make new friends too! Annual Awards presentation ceremony followed by music and dancing! And the annual Students attending will have the chance to grow their library via the Student Book Giveaway Drawing. Cash bar available (No credit cards or checks please.) Eat! Drink! Socialize! Get to know peers! Be Merry! SATURDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 51

52 SUNDAY, APRIL 2, :30 AM 8:30 AM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters 10:00 AM 10:30 AM Room: Arlington Foyer Break - Refreshment 7:30 AM 10:30 AM Room: Arlington Registration Registration Desk Open 10:00 AM 10:30 AM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters SUNDAY, APRIL 2 8:00 AM 8:30 AM Room: Arlington Foyer Continental Breakfast 8:00 AM 10:00 AM PLENARY 2 Room: Arlington Ballroom Salons III-IV LEVEL: ALL (05-004) LIVESTREAM SESSION: The Borderline Question Julian Ford, PhD, Co-Presenter; Warwick Middleton, MB BS, FRANZCP, MD, Co-Presenter; John A. O Neil, MD, FRCPC, Moderator; Dolores Mosquera, Psy, Co-Presenter This interactive panel discussion regarding The Borderline Question commences with short presentations by panel members, all of whom have done research and written on issues involving borderline personality disorder in the context of complex trauma/dissociative disorders. These multiple perspectives on contemporary issues incorporate a historical perspective on the evolution of the borderline construct, leading into the Moderator asking specific questions of the panel regarding issues raised. This is followed by the general audience being invited to contribute questions or comments. Identify one primary similarity and one primary difference between borderline personality disorder and complex PTSD. Appreciate that while borderline personality disorder (BPD), is often seen in those who meet diagnostic criteria for dissociative identity disorder, this is by no means an inevitable association and indeed BPD may on occasions be seen in individuals with no apparent childhood history of severe trauma/neglect. 10:30 AM 12:00 PM CONCURRENT SESSIONS 90MIN WS 12 Room: Lee LEVEL: INTERMEDIATE (05-007) Addressing Pervasive Shame in Complex Trauma Peitao Zhu, MA, Primary Presenter Recent studies in complex trauma have suggested that shame plays a central role in the prediction, maintenance, and exacerbation of posttraumatic symptoms. In fact, researchers have proposed that complex PTSD is a shame-based disorder. On the other hand, shame, for decades, has been largely ignored, avoided or minimized in clinical practice and the research literature. Shame has been systematically silenced in modern Western culture so that it is almost invisible in daily conversations and social occasions. This workshop, informed by an ecological framework, proposes that addressing the pervasive yet unspoken shame is crucial in working with survivors of complex trauma. Verbal, non-verbal and paralinguistic cues for shame are identified and connections between shame and various symptom manifestations are conceptualized from multiple theoretical orientations. Clinical implications will be discussed and practical strategies for incorporating shame-informed treatment will be highlighted. Recognize the central role of shame in complex trauma. Identify shame-related factors in client s ecological systems.»» Integrate shame-informed treatment into their clinical practice. Track the evolution of the borderline construct through earlier concepts incorporating views of overlapping symptoms of psychosis and neurosis, though debates about the nature of personality disorder and whether such conditions are best conceptualized dimensionally rather than by selected diagnostic criteria, through to an appreciation of how the term borderline can have perjorative contexts FINAL CONFERENCE PROGRAM & PROCEEDINGS

53 90MIN WS 13 Room: Arlington Ballroom Salon I LEVEL: INTERMEDIATE (05-008) Does This Mean I Liked It?: Victim Arousal in Sexualized Violence Andrew G. Pari, MSW, LCSW, Presenter Arousal during sexual assault is possibly the most devastating aspect for the survivor. It is rarely discussed in the literature and often not addressed clinically at all. It leads to lower levels of reporting than already exist for rape survivors due to prevailing myths of what it means to orgasm in an assault. Survivors experiencing arousal/orgasm during sexual abuse/assault raises many treatment implications. Symptom sequelae involving dissociation, guilt, shame, cultural views of this phenomenon, partner rejection, and self-injury increase as barriers to healing. The presenter will address the myths and prejudice towards these victims, discuss the neurobiology that drives arousal during sexual violence, and provide psychotherapists with treatment tools to address the trauma of arousal. New data demonstrating arousal in sexual violence and the trauma it causes will be reviewed. Identify the biological and psychological underpinnings of sexual arousal and response during rape/sexual assault. Identify three common myths to better support victims through treatment and the legal system. Differentiate inhibited from dis-inhibited behaviors in sexual assault survivors. 90MIN WS 14 Room: Alexandria LEVEL: INTRODUCTORY (05-009) Six Relational Crises Philip J. Kinsler, PhD, ABPP, Primary Presenter Each phase of the treatment of complex traumatic disorders presents relational challenges. We will discuss two such challenges that typically present in each of the three stages of the consensus trauma treatment model. In Stage One, there is The Opening Gambit, where the client and clinician negotiate the treatment contract, and where setups can occur that will, of necessity, derail the treatment further along. Some time after this is resolved, there is The First Crisis, in which the boundaries, relationship, and solidity of the therapist are tested. Phase Two presents two typical emotional/relational developments, which can occur in either order. These are The Destabilizing Rage often followed by The Empty Depression. In Phase Three, after the general completion of the working through of trauma in phase two, we are typically faced by The Devastated Life Rebuilding, and if this is successful, Terminating the Therapy Without Destroying It s Work. We will discuss theoretical and clinical perspectives on how to work through each crisis and save some time for the audience to discuss relational treatment questions. Recognize the emergence of predictable relational crises. Perform successful psychotherapy during the predictable relational crises. Analyze their approaches to relational crises and modify these if necessary to increase their effectiveness. 90MIN WS 15 Room: McLean LEVEL: ADVANCED (05-010) Solving Special Dynamic Effects in State Work with Dissociative Clients Ralf Vogt, PhD, Primary Presenter The workshop will start by outlining the key theoretical pillars underpinning the SPIM 30 treatment of dissociative patients, which are necessary for working with states. It will then briefly touch upon its kinship with concepts developed by Kluft, Putnam, Van der Hart, Nijenhuis and Steele in order to contextualize it as a treatment model. The heart of the workshop will contain a methodical exposition of a so-called hoop setting for therapeutic dialogue. A wide variety of case examples will illustrate its practical use for proficient and experienced therapists. The atmospheric representative function of the hoop enables both childlike victim states and extremely aggressive perpetrator introject states to comprehend psychodynamic internal regulation as a whole and to find stepwise solutions. Describe the methodical implications of dissociative state theory for therapeutic dialogue. Identify the right therapy setting for different dissociative diagnosis types. Devise different state hoop settings for different conflict constellations. 90MIN WS 16 Room: Arlington Ballroom Salon II LEVEL: INTERMEDIATE (05-011) It Hurts so Good: Understanding & Transforming Self-harm Naomi Halpern, CQSW Grad. Cert. Human Rights, Primary Presenter Self- harm serves many functions. In the dissociative identity disorder client, different parts will self-harm for different reasons. In the supermarket of choices to manage feelings, memories, disconnect or reconnect, self-harm is an effective consumer choice. The dilemma for the client is it hurts so good. Like alcohol or drugs, self-harm works instantly. Selfharm is generally carried out in secrecy, accompanied by feelings of self-loathing. The client carries not only the physical scars but feelings of shame, fear of rejection and a sense of SUNDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 53

54 SUNDAY, APRIL 2 powerlessness to resist overwhelming urges. Self-harming behaviour can also generate strong reactions in the therapist. Unchecked countertransference can lead to unproductive rescue attempts, pushing a client beyond their window of tolerance and activating Karpman s triangle. Fear of, or actual rejection by the therapist may result in self-harming behaviour going underground. The consequence may be an escalation of the behaviour and more serious injury. This workshop will explore the function of self-harm, assessment, and the process of the therapist learning to tolerate self-harming behaviour, while the client safely learns new strategies to remain present to painful feelings and reality. Identify the various functions of self-harm. Identify apply the self-harm loop to explore and understand self-harming behaviour. Identify formulate strategies to work within the window of tolerance with self-harming behaviour. 90MIN WS 17 Room: Manassas LEVEL: INTRODUCTORY (05-012) What Youth Say About Their Own Experience of Resourcing: Twelve Essential Elements Rochelle Sharpe Lohrasbe, PhD, RCC, Primary Presenter Gleanings from a descriptive, phenomenological, and psychological inquiry where youth attending tri-phasic trauma treatment were interviewed about their resourcing experience are presented and integrated into therapeutic practice. The results revealed a basic structure in the resourcing experiences of the youth participants which was comprised of 12 constituents: (a) perceived attitude of the therapist, (b) personal and contextual relevance, (c) currency, (d) choice and control, (e) calming, (f) unsticking, (g) experiential, (h) triumph, (i) internal ease, (j) needing a guide, (k) naming the resource, and (l) betterment. The findings contribute to an understanding of the resourcing experience of youth in trauma therapy by adding the client s voice to the therapeutic process. Results are presented against developmental theory and provide clues to increase relevancy and efficacy of resourcing efforts, whether they are in service of Phase 1 or Phase 2 trauma treatment. Suggestions for clinical practice and further research are presented. PANEL 3 Room: Arlington Ballroom Salons III-IV LEVEL: ALL (05-013) LIVESTREAM SESSION: Therapy in an Unsafe World: The Impact of Terrorism on Clients and Therapists Joan A. Turkus, MD, DLFAPA, Co-Presenter; Billie A. Pivnick, MD, MD, Co-Presenter; Kathy Steele, MN, CS, Chair We live in a world that is not always safe. There are no international borders to terrorism and threats. With terrorism increasingly at the forefront of the news, and with ever more restrictive policies to contain terrorism, we are faced with the threat of unrest and violence in a highly conflicted world. Even without close contact with acts of terror, there is the trauma of the violence in the media itself, which creates a heightened state of arousal and stress for all of us. And there are drumbeats, political and otherwise, that egg on our fear. Then, how do we help highly traumatized clients experience safety, when we cannot promise it, and as importantly, do not feel it ourselves? As therapists, how do we cope with the daily onslaught of fear and anxiety from external threats (real or perceived) without becoming fearful, defensive, or hopeless? Our panel will begin with essential background and facts about terrorism and share the transformative lessons gained in psychological consultation to the 9/11 Museum in New York City, applying what has been learned to the holding environment of the therapy space. We will discuss coexistence with the existential issues of our times in the therapy room and beyond while maintaining balance and hope. There will be time for comments and questions from the audience. Distinguish the current terrorism threats from those of the past. Describe the transformative lessons gained in working on the creation of the 9/11 Museum in New York City.»» Explain the risks of prolonged exposure to terrorism in the media. Name at least one benefit of a qualitative research project. Name 2 antecedent elements to a resourcing session. Describe at least 2 essential elements of a resourcing session, according to the study s participants FINAL CONFERENCE PROGRAM & PROCEEDINGS

55 SYMPOSIUM 4 Room: Arlington Ballroom Salon V LEVEL: ALL (05-014) Patient Safety and Quality of Life: Updates from the Treatment of Patients with Dissociative Disorders (TOP DD) Network Study Hugo Schielke, PhD, Primary Presenter; Bethany Brand, PhD, Primary Presenter; Chair; Aliya R. Webermann, MA, Co-Presenter; Patricia Abduragimova, MA Candidate, Co-Presenter; Shaina A. Kumar, MA, Co-Presenter; Amie Myrick, MS, LCPC, Co-Presenter The TOP DD Network study launched in September 2014 to assess whether a web-based intervention alongside psychotherapy was more effective for DD patients than psychotherapy alone. The papers in this symposium examine participant symptom changes, safety, and quality of life after one year in the study. Describe which symptoms showed improvement over time for DD patients receiving a psychoeducational web-based intervention as an adjunct to their individual psychotherapy. Summarize what quality of life looks like for those participating in the TOP DD Network Study, including general quality of life and personality, romantic relationship, friendship, vocational, and physical health. Compare criminal behavior among those with DDs and those with other mental illnesses. (05-015) Mental Illness and Violent Behavior: The Role of Dissociation Patricia Abduragimova, MA Candidate, Speaker; Aliya R. Webermann, MA, Speaker Many stereotypes and misconceptions exist regarding the role of mental illness in crime and violence, and high-profile atrocities bring discussions of mental illness into the public sphere. Studies at the intersection of mental illness and violence have found elevated psychopathology among violent offenders, and also elevated rates of both crime and victimization among those with mental illness. Although dissociative disorders are at the center of many inaccurate media portrayals, especially those involving violence, they are rarely included in studies of violent behavior and crime. The present study assessed recent criminal justice involvement among 242 patients in the TOP DD Network study via patient reports, and whether criminal behavior could be predicted by patient self-reported symptomatology and trauma. Recent criminal justice involvement was low; 13% reported police contact, and 5% reported a recent court case, although neither necessarily tied to criminality, but only 3% reported chargee, 1.8% reported fines, and 0.6% incarcerations, and no one reported convictions or probations. Symptoms did not predict recent criminal behavior, with the exception of PTSD predicting recent police contact, but this finding did not remain after adjusting for an inflated alpha. The implications of these findings, and future directions for research, are discussed. (05-016) Trauma Exposure, Psychiatric Symptoms, Self-compassion, and Shame: Are They Related Among Dissociative Disorders Patients? Allison Schuck, BS Candidate 2017, Speaker Trauma exposure in childhood and adulthood has been consistently associated with later Dissociative Disorders (DD) and PTSD. However, the connection between trauma exposure and other psychiatric symptoms and outcomes has not been well explored among this population. The present study aims to explore relationships among childhood and adult trauma exposure and their association with self-compassion, shame, and a variety of psychiatric symptoms among TOP DD patients using therapists and patients reports. (05-017) Preliminary 12-month Progress Report: Patient Safety, Functioning, and Symptoms After a Year in the TOP DD Network Study Hugo Schielke, PhD, Speaker The TOP DD Network Study is investigating whether a webbased psychoeducation program, in conjunction with individual psychotherapy, helps dissociative disorder (DD) patients develop and maintain safety more effectively than individual psychotherapy alone. This program aims to enhance DD patients ability to establish and maintain safety by: 1) teaching patients healthy coping skills for managing DD symptoms and unsafe urges; 2) improving patients ability to recognize, adaptively regulate, and make healthy use of their emotions; and 3) decreasing trauma-driven distortions in patients perceptions of themselves and others in order to reduce shame and enhance self-compassion. This presentation will describe Network study participants progress at the 12-month milestone. Progress comparisons will include changes in suicidal and self-harm behaviors, suicide attempts, and a variety of symptoms. (05-018) Quality of Life in Patients with Dissociative Disorders: The Role of Posttraumatic Stress and Dissociative Symptoms Amie Myrick, MS, LCPC, Speaker; Shaina A. Kumar, MA, Speaker Patients with dissociative disorders (DD) struggle with complex and chronic symptomatology that impact their abilities to experience and enjoy life to its fullest potential. In this paper, we report on the extent to which TOP DD patients find their lives to be meaningful and the implications of these perspectives. Additionally, their therapists perspectives of patients personality, romantic relationship, friendship, vocational, and physical health are considered. Analyses examining the relationships between quality of life variables and concurrent levels of posttraumatic stress and dissociative symptoms are discussed, as are the applications of these findings to clinical practice. SUNDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 55

56 SUNDAY, APRIL 2 PS 5 Room: Jefferson LEVEL: ALL Paper Session 5 Parenting, Attachment and Dissociation Chair: Richard Hohfeler, PsyD PS 5.1 (05-019) Fear of Connection - The Origins of Traumatic Disappointment in Clients with Disorganized/Preoccupied Attachment Style Orit Badouk-Epstein, UKCP registered psychotherapist & supervisor, Primary Presenter As with all insecure attachment styles, the clinical work with preoccupied clients often entails the gathering of internal and external records of the cumulative traumatic events and dysregulating experiences, sustained early on in life by their caregivers These experiences give rise to forces that interfere with the client s movement towards mental wellbeing. The journey I embark upon with my preoccupied clients, therefore, is not so dissimilar to the one I have with all my other clients, but one that more painfully confronts the clients' need to mourn their relentless disappointment in their wistful searching and yearning for the ideal caregiver. We also need to pay attention to clients' vested interest empowered by a protective need to keep things exactly as they have always been, and by doing so, feeling helplessness and indecisiveness and sitting on the fence. In doing so, the client is not fully aware of his/her need to constantly recreate the past in the present. This presentation is meant to shed some light on the work with these clients and share some effective ways of overcoming their feeling of being stuck in relentless hope. Describe an attachment perspective into clinical work with a client with DID. Describe a relational perspective working with complex trauma. Describe classification of disorganised/preoccupied attachment. PS 5.2 (05-020) The Relationship Between Parental Support, Parent Emotional Reaction, and Parenting Stress with Children s Posttraumatic Stress Symptoms Following Traumafocused Cognitive Behavioral Therapy Julie Cinamon, MA, Primary Presenter The current study examined the reciprocal relationship between three parental factors (parental support, parent emotional reaction, parenting stress) and child symptoms of posttraumatic stress (PTS) related to trauma. Method: 115 children and their non-offending caregivers were referred for trauma assessment and treatment. Parents completed the Parental Support Questionnaire, Parent Emotional Reaction Questionnaire, and the Parenting Stress Index. Child symptoms were assessed with parent report on the Trauma Symptom Checklist for Young Children and child report on the Trauma Symptom Child Checklist at pre-assessment, pre-therapy, post-therapy, and 6-month follow-up. Results: No relationship was found between parental support and child symptoms. Parental support did not predict child symptoms. Parent emotional reaction, parent depression, and parenting competency were related with child symptoms in a reciprocal fashion. Parent emotional reaction predicted child PTS. Conclusion:Parent emotional reaction emerged as a key indicator of child PTS. This may be due to a spill-over effect of parents emotions on their children. By assessing parent emotional reaction, clinicians can identify important areas for intervention, break down the parents emotional barriers, and allow space for positive change in parental support. Apply research findings in their clinical practices. Describe the effect of parent emotional reaction on children s improvement in posttraumatic stress symptoms following assessment and treatment for trauma. Explain the reciprocal parent-child relationship within the context of trauma treatment. PS 5.3 (05-021) Characteristics of Play Between Parents with Borderline Personality Disorder Traits and Their Children: Impact on Intergenerational Transmission, and Applications for Attachment Focused Parenting Treatments Janet Lee-Evoy, MD, Primary Presenter; Kristina Cordeiro, BA Hons, Co-Presenter; Robert T. Muller, CPsych, PhD, Co-Presenter; Diane Philipp, MD FRCP(C), Co-Presenter Parents with Borderline Personality Disorder (BPD) often experience difficulties with parenting. This is frequently related to histories of complex interpersonal trauma. Parenting problems can lead to disruptions within the parentchild attachment relationship that negatively impact child development. Attachment focused parent-child interventions have been recommended as possible courses of treatment. This exploratory study examined how parents with BPD traits and their children engage in these treatments. The study used a mixed-methods design. Semi-structured interviews were conducte with clinicians who use attachment-based parenting interventions. Additionally, using a case-series design, data were collected via retrospective chart review, comparing families where a parent had BPD traits and a history of interpersonal trauma, with those where parents did not. Data collection and qualitative analysis for this study are ongoing. Our presentation will focus on identified patterns of interaction between parents with BPD traits and their children, the challenges engaging parents with BPD in treatment, as well as preliminary findings regarding treatment progress and outcomes FINAL CONFERENCE PROGRAM & PROCEEDINGS

57 Identify common parenting challenges experienced by parents with BPD or complex trauma disorders. Compare patterns of interaction between families where a parent has BPD or a complex trauma disorders, and those where parents do not. Describe how families, where a parent has BPD or a complex trauma disorder, engage in attachment based parenting interventions. PS 5.4 (05-022) Nonverbal Behavioral Coding of the Adult Attachment Interview (NBC-AAI) Kristina Cordeiro, BA Hons, BA Hons, Primary Presenter; Mirisse F. Foroughe, PhD, CPsych, PhD, CPsych, Co-Presenter; Robert T. Muller, PhD, CPsych, PhD, CPsych, Co-Presenter We have developed a novel, nonverbal behavior coding tool for use with the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1985). Verbatim responses on the AAI are traditionally used in order to determine an individual s attachment status based entirely on verbal content. However, nonverbal behaviors are clinically informative, particularly in relation to strong emotions. Nonverbal behaviors during the AAI may elucidate an individual s emotional response to particular interview items, not captured by examining verbal content alone. An individual s behavior during the AAI may be indicative of his or her anxiety and discomfort with attachment-related memories, often shedding light on a history of intrafamilial trauma. This paper presentation will introduce and demonstrate a novel coding tool for the AAI. Higher occurrences and particular patterns of nonverbal behaviors indicative of discomfort (e.g., increased looking away, increases in nervous shifting, arm crossing, etc.) have been observed more often in individuals with a history of intrafamilial trauma. Clinical and research implications will be discussed. Validation of the coding tool is in progress, and preliminary data will be presented. Identify key nonverbal cues for identifying parent distress during the Adult Attachment Interview. Appraise nonverbal cues in relation to attachment-related memories and unresolved intrafamilial trauma. Recognize how parents behavior during the Adult Attachment Interview is influenced by their caregiving burden in relation to their child s mental health difficulties. PS 6 Room: Jackson LEVEL: ALL Paper Session 6 Borderline Personality Disorder, Psychosis, PTSD and Dissociative Disorders: Quantitative Approaches Chair: Martin Dorahy, PhD, DClinPsych PS 6.1 (05-023) What Kinds of Parent-Child Dynamics and Experiences of Maltreatment During Childhood Best Predict Dissociation and Dissociative Disorders in Australian College Students, Outpatients and Inpatients? Mary-Anne Kate, MSc, Primary Presenter Three hundred students and staff of an Australian university completed a questionnaire assessing dissociation (Multidimensional Inventory of Dissociation), adult attachment style (Relationship Questionnaire), experiences of childhood maltreatment (revised Betrayal Trauma Index), and dynamics between themselves and their parents during their childhood (Parent-Child Dynamic Questionnaire). Three factors alone predicted 60% of dissociation in females the number of different types of physical mistreatment endorsed; the overall score negativity of parental role in, or reaction to, the mistreatment (i.e. whether they failed to protect, blamed, enabled, incited, or perpetrated the mistreatment); and the total number of times sexual mistreatment was experienced. This paper compares the college population findings to two clinical groups 22 outpatients being treated for a Dissociative Disorder, and 12 inpatients in a specialist psychiatric unit for treating trauma and dissociation to explore similarities and differences in exposure to particular adverse childhood experiences and environments. Recognise the specific types of childhood maltreatment associated with dissociation, which may assist participants in identifying children at risk of developing a Dissociative Disorder and children and adults with a Dissociative Disorder. Identity the types of parent-child dynamics that create, contribute, or moderate dissociative symptoms and recognise the importance of the parents role and/or response in relation to the maltreatment experienced. SUNDAY, APRIL 2»» Recognise the similarities and difference between experiences that lead to dissociative experiences and those that lead to a Dissociative Disorder FINAL CONFERENCE PROGRAM & PROCEEDINGS 57

58 SUNDAY, APRIL 2 PS 6.2 (05-024) Problematic Borderline Traits Are Not Predictive of a Dissociative Disorder Diagnosis Christa Kruger, MBBCh, MMed(Psych), MD, FCPsych(SA), MBBCh, MMed(Psych), MD, FCPsych(SA), Primary Presenter Purpose: The relationship between borderline personality disorder(bpd) and dissociative disorders has been studied frequently, but not using logit models. We investigated whether problematic borderline traits predict a dissociative disorder(dd). Methods: Psychiatric in-patients (n=116; mean age=35; F:M=1.28:1) completed dissociation and trauma scales. DD diagnoses were confirmed by multidisciplinary team diagnosis or administering SCID-D to high dissociators. Problematic borderline traits (average BPDIndex of 17 items in Multidimensional Inventory of Dissociation(MID)) indicate a subset of BPD patients who exaggerate/falsify symptoms or trauma history to get sympathy/attention. Logit models examined whether BPDIndex predicts diagnostic grouping of patients under DD (n=16) or not (n=100). The TRAUMA-T factor of the Traumatic Symptom Inventory-2 and the Post-traumatic Checklist score(pcltot) were included as potential moderators. Findings: BPDIndex was not a significant predictor of a DD (p=0.24), with/without controlling for TRAUMA-T and PCLtot, despite their moderate association with BPDIndex (r=0.62; r=0.58). BPDIndex does not influence the odds of DD diagnosis (odds=0.974; 95% CI= ). Conclusions: The study did not provide statistical evidence of a close relationship between problematic borderline traits and DDs. Clinicians should not equate BPD with DDs in psychiatric patients. Identify problematic borderline traits. Distinguish between borderline personality disorder and dissociative disorders. List psychiatric disorders in which dissociative symptoms are often found. PS 6.3 (05-025) Schneiderian First Rank Symptoms Significantly Predict a Dissociative Disorder Diagnosis Christa Krüger, MBBCh, MMed(Psych), MD, FCPsych(SA), Primary Presenter Purpose: The contribution of dissociation to psychosis has been studied frequently; not vice versa. We investigated whether Schneiderian first rank symptoms(frs) predict a dissociative disorder(dd). Methods: Psychiatric in-patients (n=116; mean age=35; F:M=1.28:1) completed measures of dissociation, FRS and general psychological distress(gpd). DD diagnoses were confirmed by multidisciplinary team diagnosis or administering SCID-D to high dissociators. These FRS were recorded in the Multidimensional Inventory of Dissociation(MID) and an average score obtained for 35 relevant items: Voices arguing, voices commenting, made feelings, made impulses, made actions, influences on body, thought withdrawal, thought insertion. A global severity index(gsi) of GPD was obtained from the Symptom Checklist 90 Revised(SCL-90-R). Logit models examined whether FRS predict diagnostic grouping of patients under a DD (n=16) or not (n=100), controlling for GSI. Findings: The severity of FRS significantly predicted a DD (p=0.0002), controlling for GSI, the latter moderately associated with FRS (r=0.56). FRS more than doubled the odds of DD diagnosis (odds=2.089; 95% CI= ; correct classification rate 87.1%). Conclusions: The study provides convincing evidence that FRS are closely related to DDs. FRS should alert clinicians to consider DDs in differential diagnosis of psychiatric patients. Identify first rank symptoms as predictors of a dissociative disorder. Describe the relationship between dissociation and psychosis. List psychiatric disorders in which dissociative symptoms are often found. PS 6.4 (05-026) Assessment of Complex Dissociative Phenomenology in Women with Post Traumatic Stress Disorder: Investigating the Issue of Cross-measure Validity Matthew A. Robinson, PhD, Primary Presenter Trauma-spectrum and dissociative disorders are receiving growing clinical and research attention. The latest revision of the Diagnostic and Statistical Manual (DSM-5) includes the option to specify when dissociative symptoms co-exist with a diagnosis of Post-Traumatic Stress Disorder (PTSD). This change draws valuable attention to dissociative symptomatology; however, cross-measure diagnostic validity requires further investigation. Forty-five treatment-seeking women with self-reported histories of childhood abuse completed diagnostic assessments including the Clinician Administered PTSD Scale (CAPS-5), Structured Clinical Interview for DSM-IV Dissociative Disorders, Revised (SCID-D), and Multidimensional Inventory of Dissociation (MID). All 45 women met criteria for PTSD on the CAPS-5. Results for 32 participants showed consistency across assessment tools such that 7 met criteria for PTSD only, 5 met criteria for the dissociative subtype of PTSD only, and 20 met criteria for the dissociative subtype of PTSD and a dissociative disorder on both the SCID-D and MID. Results for the remaining 13 participants were inconsistent across assessments; 4 met criteria for a dissociative disorder on the SCID-D or MID but did not meet criteria for the dissociative subtype of PTSD and 9 had discrepant results across assessments. Findings underscore the need for nuanced assessment of complex dissociative phenomenology in PTSD FINAL CONFERENCE PROGRAM & PROCEEDINGS

59 Identify frequently used diagnostic assessment tools for measuring trauma-related and dissociative symptoms. Describe differences and similarities between diagnostic assessment tools for measuring trauma-related and dissociative symptoms. Compare the effectiveness of diagnostic assessment tools in accurately measuring trauma-related and dissociative symptoms. 12:00 PM 1:30 PM Lunch (on Your Own) 12:00 PM 1:30 PM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters persons hear voices who do not have a psychotic diagnosis, or even any diagnosis at all. But are these the same types of voices? At the same time, persons diagnosed with dissociative disorders frequently hear voices, representing dissociative parts of their personality, and are sometimes misdiagnosed with schizophrenia because of this. Are these experiences similar to the voice hearing experiences in other groups? These questions will be addressed through a review of recent literature. Many clinical approaches to hostile or critical voices focus on attempting to eliminate the voices, typically by taking medication, or not paying attention to them, through various distraction techniques. Problems with these strategies are that they often don t work, and they involve avoiding issues or emotions the voice represents. Our approach to working with voices emphasizes instead trying to understand their function and the meaning behind their disruptive behaviors, and change the person s relationship with their voices. Case examples will be used to illustrate this approach. 12:00 PM 1:30 PM Room: Alexandria Child and Adolescent SIG Lunch (bring Your Own Lunch) 12:00 PM 1:30 PM Room: Manassas RA/MC SIG Lunch Meeting (bring Your Own Lunch) 12:00 PM 1:30 PM Room: McLean Creative Arts SIG Lunch (bring Your Own Lunch) 1:30 PM 5:00 PM CONCURRENT SESSIONS 180MIN WS 6 Room: Arlington Ballroom Salons III-IV LEVEL: INTRODUCTORY (05-032) LIVE STREAM SESSION: The Nature of Auditory Verbal Hallucinations: Understanding and Working with Persons Who Hear Voices, Regardless of Their Diagnosis Andrew Moskowitz, PhD, President, European Society for the Study of Trauma and Dissociation (ESTD) Primary Presenter; Dolores Mosquera, Psy, Co-Presenter For many decades, the experience of hearing voices has been closely associated with the diagnosis of schizophrenia. In recent years, however, it has become increasingly clear that many Describe important similarities and differences between voice hearing experiences in persons with psychotic disorders, dissociative and posttraumatic disorders, and no psychiatric diagnosis, along with relevant clinical implications. Allay the person s initial worries and concerns through addressing the fears of the voices, dealing with underlying traumatic experiences and providing appropriate psychoeducation. Utilize guidelines for promoting integration from the beginning of treatment, and for dealing with hostile or threatening voices, along with destructive or selfdestructive commands or impulses. 180MIN WS 7 Room: Alexandria LEVEL: ADVANCED (05-033) Supervising Complex Trauma Cases to Foster Personal as Well as Professional Growth Steven N. Gold, PhD, Primary Presenter; Amy E. Ellis, PhD, Co- Presenter; Nicole Sciarrino, MA, MS, Co-Presenter; Kelly Araujo, PsyD, Co-Presenter; Bryan Reuther, PsyD, Co-Presenter Treating complex trauma cases requires a level of developmental attainment that encompasses an extensive capacity for emotional regulation, interpersonal flexibility and skill, and conceptual sophistication. Supervision of these cases, therefore, is most effective when it promotes personal as well as professional development. Based on the premise that most complex trauma survivors present not only with trauma-related difficulties, but also with gaps and warps in development resulting from having grown up in a deficient family environment, Contextual Trauma Therapy aims to foster adult development as well as trauma resolution. Such an approach to supervision necessitates, above all, an organically evolving supervisory relationship that parallels the development-promoting aspects of Contextual Trauma Therapy. This approach deemphasizes pathology and inadequacy, and instead focuses on problemsolving, existing capabilities and potential for growth. The SUNDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 59

60 SUNDAY, APRIL 2 Contextual Trauma Model of Supervision works from a three component framework analogous to that employed in Contextual Trauma Therapy: a collaborative relationship; supervisor-guided practical skills transmission, and superviseeguided case conceptualization. This presentation will identify means of fostering personal as well as professional development in supervisees, with illustrations provided via a discussion between a late career psychologist and former trainees at various points in their careers. Describe and explain the three components of the Contextual Model for Supervision. Integrate an understanding of the Contextual Model for Supervision as it applies to clients. Apply at least two skills aimed at de-emphasizing trainee inadequacy and simultaneously emphasizing trainee competence and skills. 180MIN WS 8 Room: Arlington Ballroom Salon V LEVEL: INTRODUCTORY (05-034) The Treatment of Adolescents with Complex Trauma and Dissociative Disorders Robert B. Slater, LCSW-R, Primary Presenter This workshop will explore many of the developmental impacts that occur as a result of traumatic stress in childhood and the impact this has on the adolescent that is simultaneously coping with complex trauma and dissociative experiences and trying to manage adolescence. The presenter will utilize the BASK model for exploring these dissociative experiences and how our current understanding of neurobiology affects these responses to trauma and to current problems. Practical ways to normalize, stabilize and positively impact these neurological adaptations such as intense emotional outbursts, amnestic episodes, flashbacks, phobic avoidance of emotional states, numbing and effectively negotiating with aspects of the self that may resist treatment will be explored and specific case material will be utilized as examples that allow for a change from crisis oriented coping to a more unified and cohesive approach to living. Discussion of various treatment settings (school, private, residential treatment) and how these impact the delivery of treatment will also be examined. Identify 3 developmental changes in the brain that are linked to a lack of integration and the development of dissociative states. Identify at least 3 forms of intervention that will decrease dissociative behavior and increase internal awareness. Distinguish at least 4 therapist characteristics that will access the capacity of traumatized adolescents to actively participate in the therapeutic process. 180MIN WS 9 Room: Arlington Ballroom Salon VI LEVEL: ADVANCED (05-035) When Words Are Not Enough: A Graphic Narrative Approach for Treatment of PTSD Tally Tripp, MA, MSW, ATR-BC, Primary Presenter; Linda Gantt, PhD, ATR-BC, Co-Presenter This course teaches an integrated set of techniques and methods that can be used to bring about rapid and lasting treatment for post-traumatic stress disorder. The procedures can be applied individually and in groups. The first objective of treatment is to process and integrate the verbal and nonverbal trauma narratives without reliving the trauma, which is accomplished by graphic narrative processing and representation. The second objective of reversing dissociation uses the externalized dialogue individually or in groups to repair traumatic dissociation. Participants will learn the essential tasks of trauma therapy and how to treat post-traumatic stress disorder by the use of two art therapy based procedures: the graphic narrative and the externalized dialogue. The training is appropriate for non- art therapists and will include hands-on experience working with art and narrative processes. List the six phases of the instinctual trauma response in humans. Conduct the art based graphic narration for narrative trauma processing. Conduct an effective procedure for diminishing posttraumatic dissociation. 1:30 PM 3:00 PM CONCURRENT SESSIONS 90MIN WS 18 Room: Lee LEVEL: INTERMEDIATE (05-036) Symptoms and Treatment History of 70 Children Abused in a Child Pornography Ring Joyanna Silberg PhD, Primary Presenter; Richard J. Loewenstein, MD, Co-Presenter; Judith Gerstenblith, Co-Presenter This presentation will describe the symptom presentation of 70 children presumed to have been abused in an organized child pornography ring. The treatment protocol used for these children, many of whom showed severe dissociative symptoms will be presented. The challenges of working with this population, including political and public relation challenges, will be discussed with an opportunity for the audience to discuss these findings, and offer solutions for improving widespread knowledge about this form of abuse FINAL CONFERENCE PROGRAM & PROCEEDINGS

61 Identify the four most common symptoms seen in a cohort of children abused in a pornography ring. Describe how attachment to a caregiver can facilitate healing from abuse outside the family. Identify three barriers to the exposure of this kind of criminal enterprise and accessibility of appropriate treatment. 90MIN WS 19 Room: Arlington Ballroom Salon I LEVEL: INTERMEDIATE (05-037) Consultation Clinic: The Treatment of DID with Personality Disorder (Axis II) Comorbidity Peter A. Maves, PhD, Primary Presenter; A. Steven Frankel, PhD, JD, Co-Presenter The difficulties of treating complex trauma and dissociative conditions produce numerous times of confusion, uncertainty and lack of clarity about effective treatment approaches. When Axis II comorbidity is added, treatment considerations become even more difficult. After an overview discussion of personality disorder issues, including assessment and identification of Axis II comorbidity, participants will be invited to discuss treatment and management issues they encounter in their practice settings. Treatment strategies will be discussed along with the unique transference and countertransference circumstances that arise in treating this population. The resistance points and treatment impasses which are a frequent part of the treatment will be identified and suggestions will be shared. Participants should disguise their clinical material so as not to compromise patient/client privacy and the workshop will not be taped. Identify a range of personality disorders comorbid with dissociative conditions. Organize treatment approaches for comorbid personality disorders and dissociative conditions. Share information and treatment approaches for personality and dissociative disorders. 90MIN WS 20 Room: Jackson LEVEL: INTERMEDIATE (05-038) My Dirty Little Secret: Suicidality Saved My Life Understanding the Paradox of Coping Mechanisms When Working with Survivors of Childhood Abuse and Neglect Joanne Zucchetto, MSW, LICSW, Primary Presenter; Simone Jacobs, MSW, LCSW-C, Co-Presenter Main stream mental health literature is rich with research, analysis, and techniques for managing the difficult symptoms of those who have been traumatized. This presentation will demonstrate that rather than manage these behaviors, clinicians need to view current symptoms from their original state; that is, when the client was a child, trying to survive. Using case examples, the presenters will illustrate how helping clients to see through the eyes of a child, is a transformative experience. Symptoms such as suicidality, self-harm, persistent depression and anxiety come to be viewed as helpful coping skills developed at an early age, when the options for survival were limited. When seen through this lens, symptoms are honored and respected, and clients begin to see themselves as human beings who fought, and continue to fight, for the right to live, in spite of surface appearances. This presentation will demonstrate how seeing symptoms through the eyes of a child helps keep the therapeutic process moving in a way that benefits both clients and clinicians. Participants will leave with practical explanations, specific techniques, and tools for working with traumatized clients. Identify and describe specific complex defense mechanisms utilized by survivors of childhood familial abuse. Explain how these defense mechanisms operate to protect survivors from both knowledge of the abuse, and the overwhelming emotions related to the abuse, in order to survive.»» Apply this information to improve best practices when working with survivors of abuse. SUNDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 61

62 90MIN WS 21 Room: McLean LEVEL: ADVANCED (05-039) Second Phase Treatment of DID, Part 1: When Is the Client Ready? Willa R. Wertheimer, Director: ISSTD, President: ISSTD-NWIG, Primary Presenter; Edward Groenendal, MA, LCPC, Co-Presenter This workshop will explore the neuropsychological changes that take place throughout phase one and phase two treatment of DID and their manifestations in the therapy room. Special emphasis will be made on the dawning of sense of self, selfreflection and insight, applying both neurological data and Self Psychology Theory. With a combination of lecture and dramatized vignettes, therapists will learn how to identify and assess these changes when considering client readiness to begin work with traumatic memories, the major thrust of phase two work. Several tools and guidelines will be utilized to facilitate the assessment of client functioning and therapeutic progress, along with the implementation of The Self-Reflection and Insight Scale, to indicate client readiness to move forward to phase two treatment planning. politically-charged professional schisms and personal attacks (e.g., the picketing of therapists offices, orchestrated media defaming). The crux of these battles revolved around the ability of the human cognitive system to forget and then later remember memories of earlier abuse. Events from this time period are easy to avoid, on account of the pain, anger, shame, grief and anxiety they stir. Yet, leaving dormant this time period robs ISSTD of a signal point in its history. This panel draws together four leading speakers who in different ways are intimately familiar with memory wars, through lived experience and study. They will address an array of questions relevant for the impact of the memory war on ISSTD at the current time. Identify the impact of the memory wars on ISSTD and treatment for complex dissociative disorders. Describe what was learned from the events of this time period including what has changed in the treatment of complex trauma disorders and what has not. Express how the legacy of the memory wars should be remembered and become a non-forgotten period in the ISSTD s history. SUNDAY, APRIL 2 Apply The Self-Reflection and Insight Scale, and Progress in Treatment Questionnaire and interpret results as it applies to entering phase two memory work. Identify and describe self-reflection and insight, as it pertains to working with dissociation and readiness to address traumatic material. Identify neurologic changes in the limbic system and right orbitofrontal cortex correlated with phase one accomplishments of increased affect regulation and the developing sense of awareness, respectively. PANEL 4 Room: Arlington Ballroom Salon II LEVEL: ALL (05-040) Lest We Forget, The Legacy of the Memory Wars on ISSTD: What We Learned, Lost and Already Knew Martin Dorahy, PhD, DClinPsych, Chair; Richard P. Kluft, MD, PhD, Primary Presenter; Warwick Middleton, MB BS, FRANZCP, MD, Co-Presenter; Christine A. Courtois, PhD, ABPP, Co-Presenter; Thomas G. Carlton, MD, Co-Presenter Commencing in the early 1990s and continuing with ferocity for much of that decade, the so-called memory wars had a marked impact on the ISSTD, its members, the therapeutic community treating complex trauma disorders, and society at large. During this time period (and to some extent after it), standard professional debate about the existence of child abuse, organized perpetrator abuse, dissociative disorders, and the nature and dynamics of traumatic memories moved from conferences and the pages of journals to court rooms, PS 7 Room: Jefferson LEVEL: ALL Paper Session 7 Intimate Relationships and Dissociation Chair: PS 7.1 (05-041) Social Work and Trauma: The Dynamic Process of Social Support Described by Intimate Partner Violence Clinicians Denise Michelle Brend, BA, MSW, Primary Presenter Purpose: To better understand how social workers, who are routinely exposed to secondary and shared trauma, experience workplace social support. Methods: Interpretive Phenomenological Analysis grounded this study. First-hand accounts of interpersonal relating among social workers working in the field of intimate partner violence were elicited. Seventeen hours and twenty-five minutes of taped interviews were collected. Data was also collected using Livescribe technology to identify embodied reactions observed by the interviewer, and emotional or embodied reactions felt by the interviewer during the interviews. Transcriptions were analyzed using NVivo Findings: Highly descriptive accounts of the nature of human professional interaction among social workers, their colleagues, supervisors, administrators, boards of directors and community partners emerged. The participants described how these interactions impacted them both personally and professionally. They also demonstrated their personal coping mechanisms within the interviews and discussed strategies that they found either harmful to, or helpful for their well-being. Conclusions: FINAL CONFERENCE PROGRAM & PROCEEDINGS

63 Professional relational experiences had powerful impacts on the wellbeing these social workers. Various elements of a dynamic interactional process were described. Elements included experiences that would promote, short circuit or mediate the participants perceived experience of interpersonal support within their professional relationships. Develop a greater understanding of the potential for workplace relationships to impact the personal well-being of clinicians and the quality of care that they offer. Expand their understanding of social support to include professional relationships. Identify interpersonal behaviours in the clinical workplace that may promote their personal well-being. PS 7.2 (05-042) Mechanisms of Underground Resistance: Patterns of Dissociative Behavior Among Homeless Domestic Violence Survivors Carolyn S. Stauffer, PhD, Primary Presenter This presentation identifies five distinct patterns of dissociative behavior exhibited in the life-story interviews of eight homeless females who were survivors of sexual or domestic violence. Conducted in the Shenandoah Valley of Virginia, these interviews offer a fascinating look at the micro-politics of dissociation enacted by survivors in response to traumatic abuse. Using a qualitative approach, the presentation employs narrative and performative analysis grids to investigate the patterns of traumatic dissociation rendered by participants. Building on feminist epistemologies, survivors narratives are analyzed in terms of their psychological responses to structural, disciplinary and hegemonic forms of violence. The findings of the study suggest that dysregulation exhibited among the study s participants in the following formats: serial acts of evasion, false-compliance, feigned ignorance, hyper-surveillance and identity disruption. By means of decoding these behaviors as covert forms of defiance, these women s narratives challenge standard definitions of complicity in response to the personal and structural violence they have experienced. As mediums for both survival and sabotage, these survivor s actions were found to enact the logics of dissociative disorder as a platform for their subversive agency. Identify five patterns of dissociative behavior typical of a sample of indigent domestic violence survivors. Recognize three forms of structural violence that frequently impact on the psychological health of indigent domestic violence survivors. Explain how the intersectional identities of indigent domestic violence survivors can be a source of cognitive dissonance and/or a positive resource for psychological health. PS 7.3 (05-043) The Many Faces of Sex Trafficking the Interplay Between Sex Trafficking, Mind Control and Ritual Abuse Eileen Aveni, LMSW, LCSW, ACSW, BCD, Primary Presenter In exploring the mental health needs of victims of human trafficking, questions regarding the best treatment options for this population remain. Limited research has been conducted to understand the mental health conditions and types of trauma that victims of sex trafficking have experienced. Some research defines the link between sex trafficking and dissociation, while other research points to the link between sex trafficking and ritual abuse within family and organized perpetrator groups. Some researchers and survivors testify to the programming aspects of some perpetrator groups whose tactics included ritualized abuse. Discussion will focus on research that has been done so far. Research surveyed will include: why mind control and ritual abuse might be utilized in sex trafficking, treatment issues involved, and what therapists need to know to properly assess a sex trafficking survivor. Comparisons will be outlined for the therapist to determine the types of trauma the survivor may have sustained in order to apply the correct treatment approaches. The need for specific areas of research will be defined to help advance further study into sex trafficking treatment. Describe the dilemma in defining the mental health conditions of sex trafficking victims. Describe at least one piece of research that point to links between sex trafficking and ritualized mind control. Describe three issues involved in assessing a survivor of sex trafficking. PS 7.4 (05-044) Intimate Treason: Healing Trauma for Partners Confronting Sex Addiction Cara Tripodi, LCSW, Primary Presenter The treatment of partners experiencing intimate betrayal will be discussed using a multi-phase approach to healing. The impact of betrayal from sex/love and relationship addiction results in a profound loss of self, insecure relational safety and trauma related symptomatology. Many partners meet criteria for PTSD and without specific partner-focused treatment can feel alienated and lose hope that healing is possible. This presentation will address common trauma responses of those who have discovered that their partner has engaged in egregious, secretive high-risk behavior. I will address the pitfalls that can occur in early treatment with partners and address helpful strategies to best empower therapists in their work with this special population. My social work values, combined with advanced training in addiction and trauma-related therapies have allowed me to develop a best practices model in the treatment of the betrayed partner that leads to effective outcomes for those victimized by another s sexual infidelities. SUNDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 63

64 Assess for the critical needs of partners through trauma and crisis informed interventions while focusing on client stabilization. Evaluate therapist use of self in treating partners facing intimate betrayal. Identify the 3 stages of healing common to the betrayed partner. 3:00 PM 3:30 PM Room: Arlington Foyer Break - Refreshment with the inability to regulate his anxiety. Treatment strategies combine neurobiological, attachment and trauma insights and include body oriented therapy, affect and stress- regulation strategies, restructuring the internal working model, the therapeutic relationship, etc. Recognize, identify and categorize early attachment trauma and recognize the clinical symptomatology of this condition and the relationship with the development of anxiety disorders. Define the developmental impact of early attachment experiences that compromise ongoing psychological and neurobiological growth. SUNDAY, APRIL 2 3:00 PM 3:30 PM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters 3:30 PM 5:00 PM CONCURRENT SESSIONS 90MIN 22 Room: Jackson LEVEL: INTERMEDIATE (05-047) Mom, There s a Monster in the Closet : Linking Early Attachment Trauma to the Development of Anxiety Disorders and Treatment Possibilities Doris D hooghe, BA, Primary Presenter In this workshop I want to broaden the vision on attachment trauma and highlight the importance to acknowledge early attachment trauma (EAT) as a hidden epidemic. The significance of EAT in the development of anxiety symptoms becomes more and more apparent. Recognizing the effect that the quality of the attachment relationship has on the development of a secure attachment bond is important to understand the factors underlying the development of anxiety symptoms. The availability, responsiveness, mentalizing possibilities, etc. of the parent create a secure base from which the child can explore and develop. The absence of those features in the child- parent relationship causes traumatic stress within the child and impacts his psychological and neurological well-being. Insecure attachment influences the neurobiology and results in dissociative processes (hyper- and hypo-aroused) expressed through different types of anxiety disorders. Deriving from neurobiology, there is a clear link between anxiety, depression and aggression. Internal working models rises from insecure attachment and adversely influences the child s capacity to regulate and relate. From an intergenerational point of view, an insecure attachment style of the parent implements the absence of affect and stress regulation capacities and leaves the child Describe factors that contribute to the treatment needs of traumatized children and adolescents. 90MIN 23 Room: Lee LEVEL: INTRODUCTORY (05-048) Maladaptive Daydreaming Evidence for a Pathological Form of Absorption Eli Somer, PhD, Primary Presenter Daydreaming is a common mental activity that can help solve problems, trigger creativity, and inspire great works of art and science. Evidence suggests that some people have a capacity for vivid absorptive fantasy that is experienced with an acute sense of presence. This ability to script an alternate reality that can offer an intense experience appears to be highly gratifying. In fact, the experience seems so rewarding that if curbed, elicits a yearning to resume it that is akin to addiction. For individuals who are coping with past and current distress, life in a fantasized alternate world, seems a soothing, affect regulating alternative. However, when daydreaming becomes compulsive and time consuming, the consequences can be dire: Daydreaming activity can interfere and sometimes even replace real-life social, academic and vocational activities. This workshop will describe the discovery process of a dissociative and addictive mental activity reported in various internet venues by thousands of individuals seeking support and coping advice. The workshop will also offer a review of the latest empirical data collected on the subject. A video clip featuring a testimony of a maladaptive daydreamer will be screened. Articulate the difference between normal and maladaptive daydreaming (MD). Describe the grassroots process that has contributed to the evolvement of the construct of MD. Identify suggested diagnostic criteria for MD FINAL CONFERENCE PROGRAM & PROCEEDINGS

65 90MIN 24 Room: Manassas LEVEL: ALL (05-049) Rational and Irrational Psychopharmacology for Complex Trauma and Dissociative Disorders Richard J. Loewenstein, MD, Primary Presenter This Workshop addresses the role of psychopharmacologic and somatic treatments e.g., electroconvulsive therapy (ECT) in treatment of patients with complex trauma (CT) and dissociative disorders (DD), particularly, dissociative identity disorder (DID). I will overview psychological factors in prescribing medications, incuding. discussion of appropriate target symptoms in psychiatric medication management, and in CT/DD patients. I will discuss specific psychological issues that arise in prescription of medications to CT/DD patients, including informed consent; patients who are phobic of medications, and those who rely too extensively on medications. I will address specific issues in the psychopharmacological management of DID patients. I will discuss collaboration between the psychopharmacologist and the non-medical psychotherapist, and the patient s medical providers. I will address conceptualization of symptoms that are legitimate targets for somatic treatments in CT/DD patients, and those that are more amenable to psychotherapy. This includes discussion of medication for mood disorders, fear and anxiety symptoms, PTSD symptoms, and sleep problems, among others, using the model of shock absorber effects of somatic treatments. I will discuss medication classes that have utility in medication management of this patient population; apparent differential responses to medications of DID self-states; state-dependent medication response; and placebo effects. Describe psychopharmacological and somatic interventions in severely traumatized patients in terms of the shock absorber model. Assess whether medications work or not in severely traumatized patients who often state that my meds don t work. Identify and address concerns about medications of the person with DID, and those of the self states. 90MIN 25 Room: McLean LEVEL: ADVANCED (05-050) Second Phase Treatment of DID, Part 2: Working Through the Trauma Kevin J. Connors, MS MFT, Primary Presenter; Lynette S. Danylchuk, PhD, Co-Presenter Stage Two therapy consists of working through and processing trauma while maintaining stability in life and in the therapeutic relationship. The power of the trauma frequently destabilizes both the client and the therapist, leading to reenactments and experiences of being stuck. The emotional impact of traumatic memory work often overwhelms the client s capacity to maintain connectedness or communicate effectively. Resolution is derailed by the horror of what happened; the complexities of developing mastery lost to the details of the trauma. The therapist is challenged to identify the trauma in a way that advances the therapy by exploring what is being expressed through the therapeutic relationship. The therapist is challenged to be sensitive to the dynamics within the client and within the transference. The therapist is challenged to communicate in ways and on levels where language often fails. The therapist is challenged to guide the client through new ways of thinking and perceiving while balancing neutrality and empathic engagement. The therapist is challenged to be self aware and to self-disclose in a therapeutically appropriate manner.this workshop will identify common Stage Two dilemmas for client and therapist, with examples and suggestions for dealing with those dilemmas in a constructive way. Identify five (5) overarching guidelines that inform trauma treatment. Identify five (5) general precautions that facilitate successful trauma treatment. Describe three tasks inherent to successful trauma memory work. SYMPOSIUM 5 Room: Arlington Ballroom Salon I LEVEL: INTRODUCTORY/INTERMEDIATE (05-051) Treatment of Dissociation Within Prison Walls Kirsten Stach, Diploma, Primary Presenter; Richard Hohfeler, PsyD, Primary Presenter, Chair Modalities of psychodynamically oriented group and individual psychotherapy will be explicated as this perspective is not typically utilized with incarcerated populations. The central role of attachment processes and traumatic re-enactments will be emphasized in understanding the genesis of dissociatively driven criminal behaviors and recovering a more humanized sense of self. Apply individual and group psychodynamic principles in working with traumatized inmate populations. Describe how traumatic re-enactments become manifest in criminal behavior. Apply attachment principles safely within violent individuals. SUNDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 65

66 SUNDAY, APRIL 2 (05-052a) Embracing the Dark Side: Working with the Traumatized Victim Turned Perpetrator with Psychodynamic Group Therapy in a Prison Setting Kirsten Stach, Diploma, Speaker The presenter has worked in three prisons in Germany, conducting group psychotherapy over a period of 5 years. This presentation will describe psychodynamic oriented group work with 12 men, all of whom had committed murder or manslaughter, conducted within a four year time frame. The group was created on the initiative of the inmates who chose the common goal of never using violence again in conflict with others or against any living creature. The group created a strong sense of solidarity and empowerment within a context of physical and emotional safety which resulted in diminishing helplessness, hopelessness, and isolation. It provided a safe training ground for healthier and more constructive human interactions while modeling empathy and genuine human attachment. Within this frame of relational safety, it was possible to address the original traumata suffered, as well as to acknowledge the suffering and horror caused to others, enabling a fair assessment of responsibility and owning of one s guilt. It was discovered that addressing shame was instrumental in allowing the development of genuine human attachment and social connection which then provided the strongest inoculation against re-offending and a firmer foundation for a meaningful life. (05-052b) Case presentation: Individual Psychodynamic Psychotherapy of Dissociatively Based Narcissism in a Prison Inmate Richard Hohfeler PsyD, Speaker This case illustrates how developmental trauma by a narcissistic father resulted in dissociative criminal behavior and opiate addiction. Traumatic re-enactment and dissociative preservation of an idealized object will be discussed as the primary mechanisms for the maintenance of this man s criminality. The utility of dissociative shame/rage states as a defense against shame and object loss will be examined, as will the working through of this defense as mitigating the dissociative re-enactment of traumatizing narcissism. This case study will also illustrate how dissociation can present in an individual with a predominantly hyperaroused orientation. The course of this psychotherapy was conducted in one year s time within a state prison facility. PS 8.1 (05-053) Psychodynamic Psychotherapy with Abused Adults Greg Pearson, PsyD, Primary Presenter The psychodynamic psychotherapy of adults currently experiencing intimate partner violence (IPV) will be presented within an attachment theory framework. After defining various forms of IPV, describing the institutional responses to it, and delineating the special role of the therapist within this helping milieu, clinical case examples will be presented that illustrate specific psychodynamic interventions and their practical and theoretical rationales. Define intimate partner violence (IPV) and to describe its physical and psychological effects on individuals. List institutional responses to helping victims of IPV. Describe and explain the special role of the psychotherapist in the IPV helping milieu. PS 8.2 (05-054) 10-month Follow-up of Highly Dissociative Inpatients in a Trauma Program Colin Ross, MD, Primary Presenter A sample of highly dissociative inpatients in a Trauma Program (N=37) was followed up for 10 months post-discharge. The age range of the participants was years and the average was 45.4 years (SD=9.5); 17 were female and 3 were male (gender was missing for 17); At baseline on the DDIS, 10 met DSM-IV criteria for DID, 17 for dissociative amnesia, 4 for dissociative fugue, 12 for depersonalization disorder, and 7 for DDNOS. The average DES score at baseline was 37.8 (SD=21.9), and 7 were in the dissociative taxon. Baseline and follow-up measures included the DES, the Somatoform Dissociation Questionnaire (SDQ), and the Beck Depresson Inventory (BDI). Measures were repeated at 6 and 10 months post-discharge. The average DES score dropped to from 37.8 to 33.3 at 6 months and 31.1 at 10 months; the SDQ score dropped from 41.4 to 31.6 at 6 months and 32.5 at 10 months; the BDI score dropped from 36.9 to 30.0 at 6 months and 24.7 at 10 months. All scores on all measures at 6 and 10 months were significantly different from baseline using t tests. The data demonstrate overall good outcomes for the sample. PS 8 Room: Jefferson LEVEL: ALL Paper Session 8 Treatment and Outcome of Dissociative Disorders Chair: Kimber Olson, LCSW, BCD, C-ACYFSW Describe the existing treatment outcome literature for dissociative disorders. Describe the principal findings from the present treatment outcome study.»» Describe the key future treatment outcome studies required in the dissociative disorders field FINAL CONFERENCE PROGRAM & PROCEEDINGS

67 PS 8.3 (05-055) Emotion Focused Family Therapy for Intra-familial Trauma: A Randomized Controlled Trial Mirisse F. Foroughe, PhD, CPsych, Primary Presenter; Laura Goldstein, BA Hons, Psych, Co-Presenter Parents with a history of intrafamilial trauma can find it particularly difficult when their own children expereince emotional distress or painful situations. This randomized controlled trial evaluated Emotion-Focused Family Therapy (EFFT), a transdiagnostic intervention supporting parents to take a primary role in their child s recovery from mental illness. The specific goals of the intervention are to equip parents in the treatment domains of recovery coaching and emotion coaching, as well as to process parents maladaptive emotional responses when their own traumatic attachment memories are triggered. Parents of children referred for services were randomly assigned to one of two conditions: 1) a three-month waitlist control group or 2) a two-day, outpatient EFFT caregiver intervention delivered to groups of twenty caregivers at a time. Waitlisted participants were offered treatment in the same EFFT caregiver intervention three months post-referral. One hundred and thirty parents completed the intervention and provided data at pre-intervention and at post-intervention. Through psycho-education, intensive skills practice, and experiential processing of emotion blocks, parents acquired specific strategies for interrupting symptoms of child mental illness in their child. Results indicated that the brief, cost-effective EFFT intervention increased parental selfefficacy in relation to the child s treatment and improved clinical outcomes for children. Name the three domains of intervention in emotionfocused family therapy. Identify the connection between increases in caregiver self efficacy and decreases in caregiver fears. Assess the ways in which caregiver fear and self-blame contribute to behaviors that accommodate and enable the mental health symptoms of their child. PS 8.4 (05-056) Use of Mobile Apps in Client Treatment Kristina Hallett, PhD, ABPP, Primary Presenter An ongoing challenge for clinicians is developing mechanisms to support client engagement and compliance with treatment goals and self-help strategies outside of the therapeutic session. Over 91% of adults in the United States utilize a mobile phone (Campbell, 2015). With the ease and portability of mobile phone and device applications (apps), there is an opportunity to increase supportive interventions for clients for the other 23 hours. Discussion of studies on mobile apps and client interest in utilizing mobile apps as an adjunct to outpatient psychotherapy. The presentation reviews available free apps for client use to assist in monitoring and tracking mood, anxiety, cognitions, stress level, and related areas. This workshop will allow participants to view and practice several multi-use apps, including PTSD Coach, T2 Mood Tracker, ichill, and LifeArmor, among others. In addition, participants will learn and practice several brief self-care interventions (mindfulness, relaxation and chair-based yoga), which clinicians can both share with clients and utilize themselves for self-care. Identify at least three mobile applications for use as adjunctive clinical practice. Demonstrate and apply facility with a variety of mental health mobile applications for self and/or patient use. Practice three brief self-care techniques, including mindfulness, relaxation and basic chair yoga. 5:15 PM 6:15 PM Room: Arlington Ballroom Salons III-IV Annual Town Hall Meeting (All Attendees Invited) 6:15 PM 6:45 PM Room: Arlington Ballroom Salons III-IV ISSTD Business Meeting (Open to ISSTD Members Only) 8:30 PM 10:00 PM Room: Arlington Ballroom Salons III-IV Special Documentary Presentation - The Hunting Ground From the team behind THE INVISIBLE WAR, comes a startling exposé of rape crimes on U.S. campuses, institutional cover-ups and the brutal social toll on victims and their families. Weaving together verité footage and first-person testimonies, the film follows survivors as they pursue their education while fighting for justice - despite harsh retaliation, harassment and pushback at every level. Continuing Education Credits for this film presentation have not been approved. SUNDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 67

68 MONDAY, APRIL 3, :30 AM 10:30 AM Room: Arlington Registration Registration Desk Open 7:30 AM 8:30 AM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters 8:00 AM 8:30 AM Room: Arlington Foyer Continental Breakfast 8:30 AM 10:00 PM Identify how the parent-child attachment relationship may contribute to trauma and dissociation, even in the absence of overt abuse. Explain how the family of origin may either facilitate the development of insecure attachment including disorganized attachment or guard against its occurrence. Describe how the family of creation may either contribute to or interrupt intergenerational cycles of trauma and dissociation. 10:00 AM 10:30 AM Room: Arlington Foyer Break - Refreshment MONDAY, APRIL 3 PLENARY 3 Room: Arlington Ballroom Salons III-IV LEVEL: ALL (06-004) Intergenerational Cycles of Trauma and Dissociation: The Family Context of the Attachment Relationship Pamela C. Alexander, PhD, Presenter The notion of relational trauma is grounded in attachment theory, suggesting that complex trauma emerges in large part from the relationship with the attachment figure. Indeed, research demonstrates that overt abuse is not necessarily even required for disorganized attachment and dissociation to occur. However, the parent-child attachment relationship does not exist within a vacuum. Instead, the family context of this relationship may set the stage for and allow the development of disorganized attachment or alternatively, protect the child from its effects. Reciprocally, an individual s experience of abuse or trauma may have ripple effects on the family of creation as evidenced by intergenerational cycles of trauma. These ripple effects may even be observed in the absence of overt abusive behavior through the mechanism of attachment behavior toward children and partners. One goal of this session is to describe the many ways in which the family affects, is affected by and interacts with the parent-child attachment relationship in the development of intergenerational cycles of trauma and dissociation. Another goal is to explore how the family of origin and family of creation are important potential sources of resilience and healing. 10:00 AM 10:30 AM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Poster 10:30 AM 12:00 PM CONCURRENT SESSIONS 90MIN WS 26 Room: Arlington Ballroom Salon VI LEVEL: INTERMEDIATE (06-007) Differential Diagnosis of Post-traumatic and Dissociative Syndromes and DSM-5 Disorders Ruth Blizard, PhD, Primary Presenter Research and clinical experience have demonstrated the traumatic antecedents of many forms of psychopathology, including mood, anxiety and personality disorders and some forms of psychosis. However, DSM-5 (APA, 2013) says little about the role of trauma, except under Trauma and Stress Related Disorders. Diagnosis can inform treatment by indicating probable causes of distress and dysfunction, rather than just masking symptoms with drugs or temporarily controlling them with behavioral techniques. This presentation will illustrate how trauma can impact functioning and produce symptoms similar to a range of DSM-5 diagnoses that do not currently specify trauma as a risk factor, including borderline personality, substance abuse, and panic disorder. Clinical vignettes will be used to illustrate how to conduct a trauma-informed assessment and arrive at a differential diagnosis between post-traumatic syndromes and disorders that may have a biological basis, such as ADHD, major FINAL CONFERENCE PROGRAM & PROCEEDINGS

69 depression and schizophrenia. Participants will assess which diagnoses seem likely from presenting problems, and modify their evaluation as history and behavioral observations unfold through several sessions. They will discuss how the initial symptom cluster may suggest ADHD, major depression or schizophrenia, whereas further information indicates post-traumatic hyperarousal, hypoarousal and avoidance symptoms, or intrusive symptoms that appear psychotic. Identify key post-traumatic and dissociative symptoms in presenting problems. Recognize post-traumatic and dissociative symptoms in DSM-5 criteria for borderline personality and panic disorders. Differentiate dissociative disorders from schizophrenia. 90MIN WS 27 Room: Alexandria LEVEL: ADVANCED (06-008) Chronic Invisible Illness: Systemic Clinical Constellation Work with Multigenerational Trauma and Ambiguous Loss Jade Barclay, MCAP MBA CSP, Primary Presenter; Michaelene Ruhl, PsyD, Co-Presenter Multigenerational trauma and ambiguous loss are prevalent, but are difficult to work with using conventional psychological paradigms. Systemic Clinical Constellations (SCC) have been used in research and clinical practice to expose systemic trauma, interpersonal and multigenerational themes in a number of chronic invisible illnesses, including chronic fatigue and depression. We will be presenting research findings and giving participants an experiential introduction to SCC practices that can be used in research studies and clinical practice, as well as applications of SCC for therapist self-care. We will also explore concepts from moral injury research, identifying subcategories of PTSD relating to traumatic loss, betrayal and perpetration that commonly arise in systemic, interpersonal and multigenerational themes when working with the SCC approach. Participants will have a basic introduction to Systemic Interviewing (SI), roles in the system, wholeness and parts, and other fundamental constellation practices from the SCC framework. Identify three categories of questions used in Systemic Interviewing (SI). Identify three categories of data revealed by constellations-based research. Describe a chronic individual condition within a systemic multi-generational context. 90MIN WS 28 Room: Arlington Ballroom Salon V LEVEL: INTERMEDIATE (06-009) Psychodynamics of Trauma: Bedrock of Trauma Therapy Joan A. Turkus, MD, DLFAPA, Primary Presenter; Harold S. Kudler, DLFAPA, Co-Presenter The psychodynamics of trauma is the framework, the holding environment, for all trauma therapy, no matter what techniques we have in our toolbox. The psychotherapy of recovery for trauma therapy is complex, as is the complexity of PTSD and Dissociative Disorders. As we wend our way through the journey with our clients, it is important to keep these psychodynamics in mind, to reflect on the underlying psychological sources of symptoms and behaviors. This workshop will first explore our heritage, the history and roots of psychoanalytic thinking, which leads to an understanding of transference and countertransference as well as the paradigm-shift into the concept of a traumatic memory causing symptoms. The continued awareness of transference and countertransference is an essential part of our work; that awareness can further the therapy. Second, we will explore specific psychodynamics of trauma, those in common for all traumatized survivors and those more specific for such symptoms as the ambivalent relationship with abusers and self-injurious behaviors. In addition, the intense transferences and countertransferential reactions, which these clients engender, will be discussed. It is the intent of the presenters that this workshop be informal, with time for questions and answers. Discuss the history of the paradigm-shift into the concept of traumatic memory resulting in symptoms. Explain the importance of an understanding of transference and countertransference in trauma therapy. Illustrate examples of therapeutic interventions, based on the psychodynamics of trauma, that might be used with a chronically suicidal, trauma survivor. 90MIN WS 29 Room: Arlington Ballroom Salon II LEVEL: ADVANCED (06-010) I Think I May Have Dementia : Cognitive Deficits in PTSD Dana C. Ross, MD, MSc, FRCPC, MD, Primary Presenter; Colin Ross, MD, Co-Presenter Patients with a history of abuse frequently report difficulties with cognitive functioning, particularly in the domains of memory and attention. In this workshop the literature related to complex PTSD and cognitive impairment will be reviewed and discussed MONDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 69

70 MONDAY, APRIL 3 with a particular focus on clinically relevant implications. In addition, the under-recognized impact of traumatic brain injury (TBI) from child abuse and domestic violence on cognitive processing, as well as the potential role of TBI in dissociative symptoms will be explored. The importance of recognizing cognitive deficits and the challenges of working with a traumatized client population that may have varying degrees of cognitive deficits will be discussed. This is an interactive workshop that will encourage discussion and reflection on assessment and treatment of complex trauma patients who are experiencing cognitive issues related to their traumatic history. The presenters will discuss the relationship between PTSD and dissociation to set a context for the rest of the presentation, and will also discuss the relationship between abuse-driven cognitive errors and neuropsychological impairment. List 3 cognitive domains that are negatively impacted by PTSD. Explain how a deficit in attention shifting is an important contributor to cognitive deficits in PTSD. Identify 2 ways in which traumatic brain injury may impact the presentation of a patient with dissociative symptoms. 90MIN WS 30 Room: Lee LEVEL: INTERMEDIATE (06-011) Shutdown Dissociation and Treatment Resistant Depression Heather Hall, MD, Primary Presenter Patients with Major Depressive Disorder have an inadequate response to evidence based treatments. The lack of specificity in the DSM 5 diagnostic criteria for Major Depression may create false positives, leading to this variability. Some depressive symptoms may stem from Shutdown Dissociation. Traumatic experiences can elicit responses from two different nervous systems. The first is the fight or flight response, accompanied by increased activity of the sympathetic nervous system. In the second, experiences of extreme fear, with no perceived ability to fight or flee, activate the freeze response, mediated by the parasympathetic nervous system. This results in bradycardia, decreased blood pressure and vasodilatation and consists of functional sensory deafferentation, motor paralysis, alterations of consciousness, and loss of speech perception and production. The disruption of the integrative processes plays a role in the development and maintenance of dissociative disorders. Shutdown dissociation is understood as both an adaptation, enabling survival during a perceived life threatening situation, and a disorder, resulting in fragmentation of past and future memories. Shutdown dissociation should be considered during the evaluation and treatment of trauma related illnesses. This presentation illustrates this concept through a series of clinical cases. Summarize the diagnostic and treatment dilemmas associated with treatment resistant depression. Explain the difference between shut down dissociation major depressive disorder. Describe the risk factors associate with development of shutdown dissociation. 90MIN WS 31 Room: Jefferson LEVEL: INTRODUCTORY (06-012) The Hidden Epidemic of Multigenerational Sexual Abuse and Trauma in Small Town America: Effective Treatment and Policy Implications Lynne H. Harris, MA, MPH, LPC, ATR, Primary Presenter This workshop presents an observed phenomenon of multigenerational sexual abuse and trauma among patients in an outpatient mental health clinic in rural Southeast Georgia. Case studies will be presented to highlight the diagnostic and social breadth of the issue. Statistics from national databases and studies regarding populations with similar socioeconomic and geographic features will be considered and compared to anecdotal evidence. First hand experience of effective treatment methods for trauma and dissociative disorders in this setting will be presented, including the Structural Dissociation Model. We will also look at which Federal and state programs are currently underway that address factors affecting poor outcomes, such as lack of access to treatment and inadequate diagnosis of trauma. We will collaboratively consider the implications for the community and nationally of not addressing the pervasive pattern of unchecked abuse of (primarily) female children in our society. Observations will be shared about the positive ripple effect of healing trauma and dissociative symptoms among even a few people in a small community. Delineate the specific differences in treating trauma and dissociation in rural or small communities vs. larger or urban communities. List at least three methods for effectively treating the neurobiological legacy of childhood sexual abuse in adults.»» Identify advocacy resources, local and national, to promote public education and policy to frame the issue as a public health issue FINAL CONFERENCE PROGRAM & PROCEEDINGS

71 90MIN WS 32 Room: Jackson LEVEL: INTRODUCTORY (06-013) The Interface Among Providers Using Multi-Stage Approaches in Dissociative Treatment (Case Study) Mindy Jacobson-Levy, MCAT, ATR-BC, LPC, Primary Presenter; Jessica Drass, MA, ATR-BC, Co-Presenter The clinical treatment for individuals diagnosed with complex trauma is multifaceted and therefore challenging. For those on the dissociative spectrum there is a tendency to gravitate towards artmaking, as visual narratives bypass a secrecy pact typically designated to verbal communication. In this workshop, the artwork of a client diagnosed with Dissociative Identity Disorder will be utilized to illuminate the importance of authentic communication among clinicians working at various levels of clinical care. The presenters will propose a S.T.R.A.T.E.G.Y. that reinforces team fluidity and provides tools for addressing various challenges that may arise during treatment. The incorporation of the client s art therapy renderings will highlight the value of nonverbal productions in understanding the dynamics of this case. Participants will engage in a brief art experience and discussion to elucidate the potential for the derailment of treatment when foundational and philosophical differences are present across team members. This case typifies the knowledge gap and ongoing taboos that continue to exist concerning dissociative treatment within an expansive healthcare system. Identify three (3) challenges when working with individuals with complex trauma. Identify three (3) ways that art therapy serves as an effective method of treatment for clients diagnosed on the dissociative spectrum. Identify the eight (8) elements of the S.T.R.A.T.E.G.Y system that improve communication across treatment providers. PANEL 5 Room: Arlington Ballroom Salon I LEVEL: ALL (06-014) Trauma and Dissociation in Children and Teens with Gender Issues: A Panel Presentation Frances S. Waters, LMSW, DCSW, LMFT, Chair; Na ama Yehuda, MSC SLP, Primary Presenter; Joyanna Silberg, PhD, Co-Presenter; Frances Doughty, MFT, MFT, Co-Presenter Gender issues in children and teens markedly increase risk of trauma, rejection, shaming, maltreatment, and bullying. The high prevalence of trauma also increases risks for dissociative coping and dissociative disorders in this population. This panel will discuss the clinical relevance of gender issues and influence of dissociation in assessment and treatment of trauma in children and teens who are gay, bisexual, transgender, or do not identify as either gender. The increased vulnerability to trauma that gender non-conformity brings on will be described, along with resulting clinical realities of dissociation, attachment impairments, disavowed parts of self, numbing, acting out, suicidal ideation, social isolation, academic issues, and selfharm that children and teens with gender issues bring into the therapy. Complicating factors and possible solutions in the treatment of trauma and dissociation in children and teens with gender issues will be identified, and ways to work with dissociated self-states, shame, disowning, and attachment risks and disruptions will be suggested. Panelists will look at sociological, psychological, psychotherapeutic, family-dynamics, and clinical perspectives of gender issues and trauma, along with developmental, social communication and coping perspectives. The potentially dissociogenic aspects of cultural, social, and parental/familial rejection will be presented along with possible pathways to their healing. Recognize three trauma risks that are specifically high in youth with gender issues. Identify three complicating factors in the assessment and treatment of dissociation in young persons with gender issues. List sociological, psychotherapeutic, developmental, and clinical perspectives in gender issues and trauma in children and adolescents. PANEL 6 Room: Arlington Ballroom Salons III-IV LEVEL: ALL (06-015) Engaging Hidden Selves in the Dissociative Mind Richard A. Chefetz, MD, Primary Presenter; Richard Hohfeler, PsyD, Co-Presenter; Joanne Zucchetto, MSW, LICSW, Co-Presenter Dissociative processes predict the shape of how a mind hides from itself and challenges a clinician to engage their patient in ways that can sometimes only be sensed rather than immediately observed. What is it that is hiding? Why is it hiding? How does it hide? How can we learn to see what s hidden? And even when we can finally see, then how do we address and engage a mind that prefers invisibility and then create a meaningful process? Using multiple theoretical vantage points from psychotherapeutic traditions, neurobiology, and attachment theory, discussants will work with the material of a detailed case presentation and then open discussion to actively include the audience. After all is said and done, the centrality of the relationship with the patient and a two person model of psychotherapy will be emphasized. MONDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 71

72 Describe a psychodynamic understanding of dissociative process and how to use this understanding to meaningfully engage dissociative patients. Use theories of attachment, affect, and neurobiology of trauma to discern hidden states of a dissociative mind. Utilize a relational model of psychotherapy to find and engage hidden aspects of the dissociative mind. Identify, define and describe the principal diagnostic features of Autistic Spectrum Disorders (ASD). Recognize points of intersection and interaction between complex trauma, dissociation and ASD. Discuss treatment considerations and approaches for the treatment of trauma/dissociation conditions and ASD. MONDAY, APRIL 3 PS 9 Room: McLean LEVEL: ALL Paper Session 9 Medical Issues/ Addiction and Dissociation Chair: Warwick Middleton, MB BS, FRANZCP, MD PS 9.1 (06-016) The Strange Cases of the Dog, Dissociation and Autistic Spectrum Disorders (ASD) in the Night: Considerations and Treatment Methods for Co-existing ASD and Dissociative Conditions Susan Hykes, BA, Primary Presenter; Peter A. Maves, PhD, Primary Presenter It is well-understood that dissociative conditions are difficult to diagnose and differentiate from other psychiatric presentations (Coons, 1984). Dissociative symptomatology requires consistent questioning of personality as a unitary construct (Pearlman & Saakvitne, 1995); awareness that dissociative aspects can be subtle and embedded in broad symptomatic matrixes (Loewenstein, 1991); and dissociative symptoms may play a role in multiple psychiatric conditions (Choe, Kluft, Park, Halm & Jo, 1994). Diagnostic intersections/ overlaps are familiar with dissociative conditions, particularly with personality disorders (Ross, Ferrell & Schroeder, 2014). This presentation will outline the overlay of Autistic Spectrum Disorders (ASD) and dissociative conditions and unique ASD considerations, such as altered social reasoning, varying maturity levels, advanced vocabulary and syntax but impaired communication and emotional control, environmental sensitivities, uneven strengths and deficits, including the presence of fluid multiplicity (Kruger, Sokudela, Motlana, Mataboge & Dikobe, 2007). ASD treatment considerations and approaches will be shown to apply to complex trauma and dissociative treatment conditions in general. Case questions and audience discussion will be encouraged. PS 9.2 (06-017) Ghosts from the Past : Could Dementia Symptoms Be Considered as Dissociative Symptoms Due to Previous Traumatic Experiences? A Pilot Project Doris D hooghe, BA, Primary Presenter The aim of this workshop is to reveal the interrelationship between trauma, dissociation and dementia, and to demonstrate a pilot project based on this vision, running in an elderly home. There is a growing body of research studying the stress-dementia connection. This research proposes that life trauma could precede the appearance of dementia symptoms.,early childhood trauma and disrupted attachment plays a crucial role in the development of dissociative psychopathology. We could consider aging as a threatening condition in which the many developmental changes constitute stressors that make the person more vulnerable for unresolved traumatic experiences to surface. A lot of behavioral, affective and cognitive symptoms in dementia could be labeled as hyper-aroused dissociation, e.g., reliving expressed through dementia as increased physiological reactivity such as wandering, or hypo-aroused dissociation e.g. amnesia expressed through dementia as loss of memory. The pilot project: The mosaic of life is based on a holistic approach blending together the environmental aspects with the interpersonal aspects. The staff is trained in person-centered care, attachment and trauma theory and neurobiological approaches. The team is supported through supervision and intervision, which increases their self-efficacy. The person with dementia receives a tailor made treatment, based on a holistic assessment, consisting of psychobiological strategies, the carer-client dyad, etc. Describe how trauma, dissociation and the symptoms of dementia are interrelated with each other. Define a tailo- made treatment and apply it in work with the elderly.»» Describe how dementia symptoms could be interpreted as dissociative symptoms FINAL CONFERENCE PROGRAM & PROCEEDINGS

73 PS 9.3 (06-018) The Convergence of Childhood Trauma and Dementia: Awakening the Monster - A Bioecological Life-Course Perspective Theory Building Exploration Marilyn Dodd, BAS, MSc, Primary Presenter This bioecological, life-course perspective theoretical exploration, aims to raise awareness of the impact of childhood trauma on survivors who develop dementia later in life. When the ripple effects from childhood trauma and dementia collide, the consequences can be horrific, and yet this area is neglected by both trauma and dementia mainstreams. Children who experience trauma; even severe trauma, can grow old and can develop dementia. When this occurs a lifetime of defences; adaptive and maladaptive, can be destroyed, allowing feelings of fear to emerge or re-emerge. Dissociative defences may manifest in new ways as there is disintegration of their being. Behavioural and psychological symptoms of dementia could be interpreted from a trauma perspective, perhaps mapped to post-traumatic symptoms. Dementia results from physiological damage to varying areas of the brain, areas probably involved in fear extinction. At the same time there may be temporally graded destruction of memory, leaving earlier memories; where the monster lurks, more intact. The survivor now has double jeopardy fear and fragments of memory, with no way to place them in context. This distress is terminal and too often; apart from medication, there is little we can do. Trauma informed care holds the key. Discuss questions raised in this exploration that may change the direction of their research interests. Apply knowledge of trauma experienced by older survivors with dementia into their own trauma world view. Discuss how dissociation may manifest in this situation and how BPSD may be mapped to post-traumatic symptoms. PS 9.4 (06-019) Trauma Therapy with the Child and Family: A Chart Review Sara L. Rependa, MA, Primary Presenter; Robert T. Muller, PhD, CPsych, Co-Presenter We performed a retrospective chart review on child clients who received trauma therapy at a publicly funded mental health organization and teaching institution in Toronto, Canada. Chart data compiled spanned an 11 year period, between 2005 and The treatment model used is a systems-oriented trauma therapy informed by attachment theory. Clients were 43 children and their families with histories of complex, interpersonal trauma. Therapists were Masters and Doctoral level clinicians, as well as clinicians-in-training who had previous experience working with trauma, families, and children. Therapy teams were multidisciplinary and consisted of social workers, psychologists, art therapists, and psychiatrists. This therapy model includes an assessment phase of four to five sessions followed by eight to twenty therapy sessions, depending on the needs of the child. Exploratory analyses were conducted investigating common therapeutic themes, parental involvement and compliance, family history, and therapy outcome. Preliminary analyses of the chart review are presented. Describe the family based trauma therapy being presented. Identify what types of clients are typically referred to this program. Express how attachment theory is incorporated into the trauma treatment model being presented. 12:00 PM 1:30 PM Lunch (on Your Own) 12:00 PM 1:30 PM Room: Arlington Foyer Exhibitors/Mentor Books Bookstore/Posters 1:30 PM 6:00 PM CONCURRENT SESSIONS POSTCON 1 Room: Arlington Ballroom Salon I LEVEL: INTERMEDIATE (06-022) Bootcamp for Clinicians: Culturally Sensitive Therapy with the Military Elizabeth F. Pillsbury, MSW, LICSW, Primary Presenter; Christian Labra, MD, Co-Presenter There is a critical need for mental health providers in both civilian and military settings to be trained in the treatment of trauma and dissociation with active duty military, retirees, and their family members. Understanding military culture and the unique types of trauma seen in this population are essential for effective treatment. Through clinical case examples and personal accounts by service members, this workshop will educate clinicians about military culture at large, as well as address specific types of challenges faced by service members and their families, such as combat, the psychosocial aspects of deployment, moral injury, survivor guilt, military sexual trauma, the use of dissociation, and suicide. Panelists will offer their military experiences to illustrate these themes. Evidence based treatments for trauma will be reviewed and special considerations of treatment within the military will also be discussed. MONDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 73

74 MONDAY, APRIL 3 Recognize characteristics of military culture at large. Describe types of trauma which are often experienced in the military. Identify unique considerations for working with the military. POSTCON 2 Room: Arlington Ballroom Salon II LEVEL: ALL (06-023) Managing the Effects of Vicarious Trauma with Creative Arts Therapies Tally Tripp, MA, MSW, ATR-BC, Primary Presenter; Barbara Sobol, MA, ATR-BC; LPC; CTT, Co-Presenter This is an experiential workshop focused on creative approaches to combat the negative effects of countertransference and vicarious trauma on the therapist and the therapeutic relationship. In this workshop, participants will have an opportunity to explore a range of art materials and techniques, creating art pieces that help us contain, understand and process responses to our clients as we engage in this difficult and important work. Please note: no previous art experience is required. We will begin with an overview of the professional literature on countertransference and vicarious trauma, describing the potentially negative effect of a client s trauma on the therapist. Next we will describe some of the ways art making can be integrated into therapy with trauma clients and also used for personal processing by the trauma therapist. When we move into our right brain artistic selves for accessing and processing information, we may discover new meaning that was not available to us in our verbal left brain minds. In making art and looking at the creative process, we will experience the way art can be a unique and powerful resource for clients and therapists alike. For the experiential portion of the workshop, participants will work individually and in small groups to create subjective pieces of art related to their relationship with trauma clients. A quiet space and an array of engaging materials will be provided for the inner artist in each of us to come out and play. Participants can expect to come away from the experience with an artistic expression that may help with managing vicarious trauma and be a reminder of a resourced self-state. We hope that this shared process of tapping into our own creativity, intuition, and right brain spontaneity will afford us a wonderful opportunity for self-care. Define vicarious trauma and describe its long-term effect on the therapist and the therapy. Define countertransference and distinguish its impact from that of vicarious trauma. Describe 5 common signs and symptoms of vicarious trauma. POSTCON 3 Room: Arlington Ballroom Salon V LEVEL: ADVANCED (06-024) Neurofeedback and Neural Regulation: Brain and Body Ulrich F. Lanius, PhD, Primary Presenter Recent research in the neurosciences suggests that the brain organizes itself in its oscillatory patterns. People with histories of early neglect and abuse, i.e., developmental trauma, routinely exhibit disorganized and dysregulated neural activity that interferes with effective psychotherapeutic interventions. Neurofeedback or neurotherapy provides patients access to the electrical or frequency domain of brain function. Interventions that target neural regulation of the brain and body, particularly the use of LENS neurofeedback and associated interventions, are discussed. The LENS is unique in the field of neurofeedback in that the LENS feedback terminates at the scalp, rather than in a video or auditory display, which is likely more effective in facilitating the brain to re-organize its physiology. Particular emphasis is on how such interventions can be interwoven and integrated with more traditional trauma treatment interventions, such as Ego-State Therapy, EMDR and Somatic Psychotherapy. It is proposed that the addition of neurofeedback during all three trauma treatment phases (stabilization phase, trauma processing, re-integration) can assist in increasing therapeutic response by directly intervening at the level of the electrical or frequency domain of brain function. Case studies will be presented to demonstrate how the integration of LENS neurofeedback and associated neural regulation approaches into standard trauma treatment interventions. Particular focus is on the Dissociative Disorders, including severe DID, and Somatoform Dissociation. The neurobiological rationale for the integration of these techniques into treatment as usual is discussed. Describe the role of neural regulation and neurofeedback approaches and their role in stabilization and trauma processing. Discuss the role and the effects of LENS neurofeedback. Discuss hypotheses with regard to the underlying neurobiology that may account for synergistic treatment effects. POSTCON 4 Room: Arlington Ballroom Salon VI LEVEL: ALL (06-025) Trauma and Sexuality: Engaging and Treating the LGBTQ Client Sara Mindel, LICSW, Primary Presenter In addition to the many traumas that life imposes on all people, LGBTQ individuals have the additional burden of living in a culture that is uniquely and intrinsically traumatic to them. Sexuality and sexual orientation are a fundamental part of the FINAL CONFERENCE PROGRAM & PROCEEDINGS

75 human experience and make-up. A person s sexual orientation and identity can be greatly impacted by trauma and in turn affect how a person experiences the world and processes trauma and traumatic experiences. Through this workshop, participants will learn both experientially and through didactic conversation not only sexuality development but also the pertinent issues that go with treating LGBT (Lesbian, Gay, Bisexual and Transgender) clients. As well, this workshop will assist clinicians to understand the intersections of trauma and identity as well as be able to more effectively work with this population. Thank you for attending the ISSTD 34 th Annual International Conference. Please join us in Chicago, March 22 26, 2018 to celebrate our 35 th Anniversary! Recognize interventions and intersections for LGBT clients and trauma history and treatment. Describe LGBT issues and development. Address internal biases and countertransference of the as a way to reduce further traumatization both inside and outside the therapy room. 3:00 PM 3:30 PM Room: Arlington Foyer Break - Refreshment 6:00 PM MEETING AJOURNED LOCATION: Hilton Palmer House Hotel THEME: Bridges to the Future: The Impact of Trauma and Dissociation on Human Dignity - Local and Global Perspectives Call for Proposals will open Summer of 2017! Visit for details. MONDAY, APRIL FINAL CONFERENCE PROGRAM & PROCEEDINGS 75

76 ISSTD Extends its Thanks to All of the 2017 Conference Supporters An Infinite Mind Cottonwood Tucson Nova Southeastern University Psychiatric Institute of Washington Ross Institute for Trauma at UBH Sheppard Pratt Health System Somatic Experiencing Trauma Institute The Colin A. Ross Institute Trauma Disorders Program at Sheppard Pratt Health System Yellowbrick and Association Management Group, Inc. Meetings Management Group, Inc. Creative Design CONFERENCE SUPPORTERS BREAK SUPPORTER: GOLD SUPPORTER: STUDENT AND EMERGING PROFESSIONAL EVENT SUPPORTERS: LUNCH SUPPORTER: SPECIAL THANKS TO ALL THOSE WHO CONTRIBUTED GOODS OR SERVICES TO ISSTD IN 2017: FINAL CONFERENCE PROGRAM & PROCEEDINGS

77 Index Abduragimova, Patricia, 55 Forner, Christine, 4, 6, 37, 40, 77 Lee, Nabin, 45, 48 Schielke, Hugo, 55, 77 Alexander, Pamela, 4, 13, 15, 68 Foroughe, Mirisse, 57, 67, 77 Lee-Evoy, Janet, 56 Schuck, Allison, 55 Alire, Elizabeth, 39 Araujo, Kelly, 59 Aveni, Eileen, 36, 63 Aynes, Amanda, 45 Badouk-Epstein, Orit, 56 Baker, Su, 12, 25, 34, 77 Barclay, Jade, 39, 69 Beauregard, Jan, 12, 21 Blizard, Ruth, 31-32, 68 Brand, Bethany, 6, 41, 55, 77 Brend, Denise, 62 Carlton, Thomas, 62 Chandler, Genevieve, 39 Chefetz, Richard, 6, 12, 25, 30, 37, 71, 77 Cinamon, Julie, 56 Clare, Diane, 42 Cleveland, Jonathan, 43 Connors, Kevin, 4, 6, 12, 23, 30, 65, 77 Cordeiro, Kristina, 48, 56-57, 77 Corrigan, Frank, 29 Courtois, Christine, 6, 62 Danylchuk, Lynette, 4, 6, 12, 16, 23, 37, 65, 77 Dell, Paul, 6, 16, 27, 77 D hooghe, Doris, 43, 64, 72, 77 Dodd, Marilyn, 73 Dorahy, Martin, 4-6, 12, 25, 30, 57, 62, 77 Doughty, Frances, 71, 77 Draeger-Muenke, Reinhild, 20, 40 Drass, Jessica, 44, 71 Ellis, Amy, 59, 77 Fani, Negar, Farina, Anne, 44 Felicetti, Richard, 45 Fine, Catherine, 35 Fine, Stephanie, 35 Foote, Brad, 6, 47, 50, 77 Ford, Julian, 4, 6, 13-14, 52 Frankel, A. Steven, 6, 11, 37, 61, 77 Gantt, Linda, 60, 77 Gerstenblith, Judith, 60 Gold, Steven, 6, 59, 77 Goldstein, Laura, 67 Gomez-Perales, Niki (Veronica), 12, 22 Gonzalez, Genesis, 45 Griffin, Eileen, 44 Groenendal, Edward, 62 Hall, Heather, 4, 6, 70 Hallett, Kristina, 67 Halpern, Naomi, 53 Harris, Lynne, 70 Hatchard, Christine, 45 Helling, Jim, 39 Hohfeler, Richard, 56, 65-66, 71 Howard, Hedy, 35 Hykes, Susan, 72 Jacobs, Simone, 61, 77 Jacobson-Levy, Mindy, 71 Kacar, Anil S., 31, 42 Kahhale, Isabella, 45 Kallivayalil, Diya, 31 Kate, Mary-Anne, 6, 32, 57, 77 Kaufman, Milissa, 37-38, 45 Kilciksiz, Can, 31, 42 Kinsler, Philip, 37, 53, 77 Kluft, Richard, 6, 9, 12, 24, 35, 62, 77 Korzekwa, Marilyn, 6, 30, 77 Kruger, Christa, 6, 58 Kudler, Harold, 69 Kumar, Shaina, 55 Labra, Christian, 13, 73 Laddis, Andreas, 11, 30, 77 Lanius, Ruth, 6, Lanius, Ulrich, 6, 13, 74, 77 Lebois, Lauren, 37-38, 45 Lee, Kellie Ann, 47 Lemke, Wendy, 33 Loewenstein, Richard, 6, 12, 21, 60, 65, 77 Maves, Peter, 61, 72 McLaughlin-Ryan, Judy, 46 Middleton, Warwick, 4, 6, 13-14, 52, 62, 72, 77 Miller, Alison, 36, 41 Min, Jiwon, 46 Min, Moonkyung, Mindel, Sara, 13, 74 Moser, Louis, 39 Moskowitz, Andrew, 6, 59 Mosquera, Dolores, 4, 13-14, 36, 52, 59 Muller, Robert, 48, 56-57, 73, 77 Myrick, Amie, 55, 77 Nieves, Nadia, 47 O Neil, John, 4, 6, 77 Pari, Andrew, 53 Paulsen, Sandra, 12, 24, 77 Pearson, Greg, 66 Peebles, Mary Jo, 20 Perry, Bruce, 4, 12, 14, Philipp, Diane, 56 Pillsbury, Elizabeth, 13, 73 Pivnick, Billie, 54 Ramaswamy, Sanjana, 47 Reinders, A.A.T. Simone, 37, 41 Rependa, Sara, 48, 73, 77 Reuther, Bryan, 33, 59 Riding-Malon, Ruth, 50 Robinson, Matthew, 58 Roseman, Mark, 37 Ross, Colin, 6, 28, 66, 69, Ross, Dana, 69, 77 Rousell, Charles, 29 Ruffing, Elizabeth, 48 Ruhl, Michaelene, 39, 69 Sacks, Susan, 20 Şar, Vedat, 6, 77 Schwarz, Lisa, 29 Sciarrino, Nicole, 59, 77 Sharpe Lohrasbe, Rochelle, 54 Silberg, Joyanna, 60, 71 Sim, Kisun, 45-46, 48 Slater, Robert, 60 Smidt, Alec, 49 Sobol, Barbara, 13, 74 Soilleux, Melanie, 44 Somer, Eli, 6, 64 Stach, Kirsten, Stauffer, Carolyn, 63 Steele, Kathy, 4, 6, 30, 36, 54, 77 Stierum, Adrian, 35, 77 Struik, Arianne, 28, 77 Taylor, Leah, 49 Thomas, Juliana, 45 Thomson, Paula, 33, 42, 77 To, Michelle, 50 Toledo, Elizabeth, 34 Tomas-Tolentino, Grace, 43, 77 Tordella, Denise, 12, 21 Torres, Marie, 50 Tripodi, Cara, 63 Tripp, Tally, 13, 60, 74, 77 Turkus, Joan, 4, 6, 16, 54, 69 Vandevender, Anna, 50 Vogt, Irina, 30, 77 Vogt, Ralf, 30-31, 53, 77 Waters, Frances, 6, 35, 71, 77 Webermann, Aliya, 41, 55, 77 Wertheimer, Willa, 62 Widera-Wysoczanska, Agnieszka, 51 Wise, Christy, 37 Wolff, Jonathan, 45, 51 Yehuda, Na ama, 12, 22, 71, 77 Zhu, Peitao, 42, 52 Zipris, Patricia, 38 Zucchetto, Joanne, 61, 71, 77 INDEX 2017 FINAL CONFERENCE PROGRAM & PROCEEDINGS 77

78 Hotel Floor Plan Lobby HOTEL FLOOR PLAN FINAL CONFERENCE PROGRAM & PROCEEDINGS

79 First Floor Second Floor HOTEL FLOOR PLAN 2017 FINAL CONFERENCE PROGRAM & PROCEEDINGS 79

80 PRE CONFERENCE: March 22 23, 2018 CONFERENCE: March 24 26, 2018 Hilton Palmer House Hotel, Chicago, IL

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