Complex Dissociative Disorders:
Effective Diagnosis and Phase Oriented Therapy
A 2-day training workshop at Dublin with Dr Suzette Boon
Dublin, 9 & 10 June 2017, Friday & Saturday
As therapists, we often find it extremely challenging to diagnose dissociative disorders for a number of reasons:
- The classifications of dissociation differ and are not always clear. Some therapists consider dissociation a phenomenon that exists on a continuum (from normal to pathological) while others consider dissociation as strongly pathological and representative of a divided self
- Clients rarely present with explicit dissociative symptoms and often attempt to hide or dissimulate such manifestations
- There is considerable overlap with other disorders including complex PTSD and cluster B personality disorders
- Differentiation with psychosis and bipolar disorder can often prove difficult
- Even the widely-accepted classification methodologies (DSM & ICD) differ with regards to dissociative disorders
- Therapists often do not receive systematic education with regards to diagnosis and therapy for dissociative disorders
- There is ongoing polarized debate about the existence of Dissociative Identity Disorder (DID) as a reliable and valid diagnosis
As a consequence of misplaced recognition of dissociate symptomatology, such clients may receive incompatible diagnoses and lose out on adequate therapy for their core problems. In addition, if dissociative pathology is not assessed or recognised, treatment of traumatic memories with methods like EMDR may be dangerous and result in decompensation of the client. On the other hand, we run the risk of over-diagnosis and false positive situations.
Effective diagnosis is just Step 1 however. All therapeutic approaches for individuals suffering from complex trauma-related disorders, including dissociative disorders, need to be aligned with the client’s individual capacity for managing intense affects while recognising the myriad psychic defenses that the client may be deploying to manage traumatic memories and triggers. Over the years, a phase-oriented approach has shown proven efficacy in such situations. While the stages of a phase-oriented approach are easy to list, therapists need an acute understanding of the synchronization of affect with each stage and the relative therapeutic time that each stage requires depending on specific situations.
At this practical, engaging and therapeutically oriented workshop, which would be especially relevant for psychotherapists, psychologists, counsellors and psychiatrists, Dr Boon draws on her innovative work on dissociative disorders and complex trauma to help us with:
- Recognising pathological dissociative symptoms
- Effectively assessing DSM-5 dissociative disorders
- Distinguishing between genuine and false positive cases
- The three phases of therapy: (1) stabilization and symptom reduction; (2) treatment of traumatic memories, realization of the past (3) integration and rehabilitation
- Stabilization techniques for clients with complex dissociative disorders
- Working with dissociative parts
- Working with angry and sadistic parts, and self-destructive behavior
- Dealing with difficulties in the therapeutic relationship in phase I; specifically considering the unique transference and countertransference challenges
- The prerequisites for moving from Phase 1 to Phase 2 including the regulation of intense emotions
Explaining phase-oriented therapy with a specific focus on Complex Dissociative Disorders, Dr Boon explains how therapists can apply these learnings in clinical settings and allow their clients to move towards an acceptance of themselves and their bodies.
On Day 1, the workshop focusses on recognising pathological dissociative symptoms and the assessment of dissociative disorders. On Day 2, the workshop provides an overview of the phase-oriented approach and specifically delves deeper into Phase 1 techniques using video vignettes and demonstrations.
About the speaker
Suzette A. Boon PhD, is a clinical psychologist and psychotherapist. She is a trainer and supervisor for the Dutch Society for Family Therapy and the Dutch Society for Clinical Hypnosis. Since the late eighties she has specialized in the diagnosis and treatment of complex dissociative disorders. She has worked as a researcher at the free University of Amsterdam (psychiatric department). She translated and validated the Dutch version of the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) and received a PhD for her thesis “Multiple Personality Disorder in the Netherlands” in 1993. She has published several books, book chapters and articles both on diagnosis as well as treatment of dissociative disorders. She has developed a skills training manual for clients with complex dissociative disorder, the English version of which, with Kathy Steele, MN, CS and Onno van der Hart PhD has been published in March 2011 (Norton publishers).
She has developed together with Helga Matthess, a new semi structured interview for complex dissociative disorders and trauma related symptoms: the “Trauma and Dissociation Symptoms Interview (TADS-I)”. A validation study for this interview is currently in progress.
She is co-founder of the European Society for Trauma and Dissociation (ESTD) and was the first president of this Society. The International Society for the Study of Trauma and Dissociation (ISSTD) granted her the David Caul Memorial Award in 1993, the Morton Prince Award in 1994 and the President’s Award of distinction and the status of fellow in 1995 for her contributions to diagnosis, treatment, research and education in the field of dissociative disorders. In 2009, she received the Life Time Achievement Award and in 2011 the Pierre Janet writing Award for the book Coping with trauma-related Dissociation: skills training for patients and therapists. She is co-author of a new book: Treating Trauma-Related Dissociation: a Practical Integrative Approach (Steele, Boon & van der Hart, 2017. New York: Norton publishers).
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