A few weekends ago I attended a workshop all about trauma and dissociation that a professor recommended. The irony in this was that I filled the majority of a Saturday with trauma and dissociation..might be exposing some masochistic tendencies. Anyways, it was rather interesting, especially for me with wanting to focus on trauma in my future career, and I wanted to share with you guys what we covered. First, it was put on by The New England Society for the Treatment of Trauma and Dissociation or NESTTD. I know, a mouth full, right!? So glad they have an acronym, because who wants to say that full name all the time?
The day began with a lecture by Dr. James A. Chu, MD, entitled Fundamentals of Complex Trauma and Dissociation: What Every Clinician Needs to Know. Here are a few points that I found particularly interesting:
1) PTSD is found more in females – this is thought to be due to PTSD being more likely to develop for those who have experienced sexual trauma, particularly forcible trauma. Women are more likely to experience these types of trauma, which leads to increasing in PTSD. Side note with this: victims of forcible rape have close to a 100% rate of developing PTSD.
2) Men are more likely to experience trauma that involves physical attack or use of weapons, which apparently has a decreased risk of leading to PTSD.
3) Those who are experiencing dissociative symptoms with PTSD are not likely to respond to exposure therapy due to their ability to dissociate from the memories, instead of staying present to process the memories. (This seemed like one of those “ooooh, well duh!” moments, but I had never thought of this before.)
4) “Normal” types of dissociation was discussed, which includes imaginative involvement, trances, meditation, and hypnotic states. Interesting thought with this was that dissociation is actually a very normal part of childhood. Children spend quite a bit of time in their imaginative world, which is (clinically) considered a form of dissociation. Really, the learning point here is that dissociation is a normal part of our lives, from spacing out to being absorbed in a tv show or book, and it only becomes pathological when it interferes with our ability to function in our daily activities or is used to avoid painful memories or feelings.
5) One of the most powerful statements in the presentation was, “Self-care has little meaning for those whose bodies have been abused by others.” This was another one of those statements that made sense once it was heard but just made me feel sad about the amount of damage that trauma can have for individuals. He talked about how people who have been abused often feel disconnected from their own body and can see it in a very negative light, because it was the object that was used to carry out the abuse. He also tied this into self-harm and how this can often lead to clients cutting as a source of self-soothing and because the mindset of protecting their bodies has little meaning.
6) Lastly, often when working with clients who have experienced trauma, they can feel as though they have been through so much already that healing should just be handed to them. While this mentality is understandable, it doesn’t lead to much progress and can come with defensiveness. One line that he gave us that I’ll carry throughout my entire career was: What happened to you is horrible and in no way are you responsible for it; however, your treatment and recovery is your responsibility. This was one of those, “ooh, that’s a good one!” moments!
After a yummies lunch, we broke out into smaller lectures with specific topics. The one that I chose was about trauma and personality disorders and was lead by my professor (the one that recommended the workshop)! First off, this professor is kind of the embodiment of what I hope to become as a future clinician. She is all about trauma and views things such as dissociation and self-harm as coping mechanisms or survival skills for the pain that we feel after a trauma. So, the underlying theme in this talk was that the symptoms of personality disorders are simply survival skills that one learned through experiencing trauma. Individuals who are experiencing PTSD or personality disorders haven’t been able to let go of the past and the skills they learned in those moments to survive; they are living in the present as though they are still in the past. Whatever your thoughts are on personality disorders, viewing them through this lens allows (I believe) far more empathy towards understanding their situation, motivation and helping them to overcome the past. This is especially powerful when thinking about how difficult it can be to work with those who have borderline personality disorder. For those of you that have, you know how difficult and frustrating it can be to work with someone is constantly in crisis, loves you one minutes, and hates you the next.
So, even though it was on a Saturday (one of my precious days to either relax or catch up on everything that got brushed to the side during the week), it was worth giving up the day and again reaffirmed my desire to go into trauma work. I’m also pretty certain that it got me brownie points with that professor. The way she converses with me in class afterwards makes me believe that I have a special, if small, place in her now. If you want more information than what I went into, I attached both packets of lecture notes along with a recommended book list that they handed out. You better believe I’ll be getting me some of those! I’m specifically interested in these:
Traumatic Stress by Bessel van der Kolk
The Body Keeps the Score by Bessel van der Kolk
Creative Arts and Play Therapy for Attachment Problems by Malchoidi
Attachment-Focused Parenting by Daniel Hughes
Ones that I can recommend:
Treating Traumatic Stress in Children and Adolescents by Margaret Blaustein
Brain-Based Parenting by Daniel Hughes
Both are amazing books with actual examples. I would highly recommend reading either one if your interested in learning more about trauma. The first is designed specifically for clinicians and is filled with examples to use in therapy. They second is very readable and focuses on neuroscience in parenting, can be read by both clinicians and parents.
I know this might be a bit dry for some of you guys, but hopefully you found some parts interesting. Have you read of any of these books and would recommend them? How do you see the link between trauma and dissociation or trauma and personality disorders? Let me know your thoughts below!