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Dissociation and Dissociative Disorders: Therapy for ‘Difficult’ Clients

nscience UK

Thursday, 23 November 2017 at 09:30 - Friday, 24 November 2017 at 17:00

Dissociation and Dissociative Disorders: Therapy for...

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Ticket Type Sales End Price Fee Quantity
Individual Ticket for both days 23 Nov 2017 £249.00 £0.00
One day attendance ticket 24 Nov 2017 £135.00 £0.00

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Dissociation and Dissociative Disorders: Therapy for ‘Difficult’ Clients

A 2-day training workshop at London with Dr Suzette Boon  

London, 23 & 24 November 2017, Thursday & Friday

Our challenges, as therapists, are manifold when faced with acute manifestations of dissociation, including complex dissociative disorders:

  • Our clients may present with difficult conditions – engendering feelings of guilt, rage, shame, humiliation, helplessness and incompetency while seeming to resist all therapeutic efforts
  • We may not have an in-depth comprehension of dissociation – some schools of thought 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
  • Our clients rarely present with explicit dissociative symptoms – they often attempt to hide or dissimulate such manifestations
  • Dissociative disorders are hard to differentiate from cluster B personality disorders and bipolar disorders
  • Even the existence of certain dissociative disorders is a subject of ongoing polarized debates


As a consequence of these challenges and in the face of apparent resistance, we run the risk of retreating into destructive enmeshment or distancing from our clients.

At this practical, engaging and therapeutically oriented workshop which would be especially relevant for psychotherapists, psychologists, counsellors and psychiatrists, across modalities, Dr Boon draws on her innovative work on dissociative disorders and complex trauma to help us work especially with such difficult clients. Through case vignettes and examples, she equips us with therapeutic tools that prove useful for four interconnected challenges that difficult clients present:

 1.       Dissociation: the workshop enables us to recognise pathological dissociative symptoms, assess DSM-5 dissociative disorders, distinguish between genuine and false positive cases and explains therapeutic work techniques for dissociative parts

2.       Chronic defences: we look at defences against perceived relational threats including criticism, rejection, abandonment, engulfment and control; working with angry and sadistic dissociative parts and self-destructive behaviour

3.       Chronic defences against inner experience: the workshop looks at our clients’ defences with reference to affects, cognitions, physical sensations, wishes and needs. We look at the challenges this presents for therapy, especially where regulation of intense emotions becomes a pre-requisite for therapeutic progress

4.       Self-regulation difficulties: we look at these through the lens of the three phases of therapy:

  • Stabilisation and symptom reduction
  • Treatment of traumatic memories, realization of the past
  • Integration and rehabilitation

The workshop highlights that the actual prognosis of a difficult client depends to some extent on the goodness of fit between client and therapist – as well as on prognostic indicators. In the overall approach advocated by this workshop, interventions are first directed at the therapist who must walk the fine line of acting with reflection rather than reaction. Dr Boon explains that such a reflective stance can prove to be a therapeutic strategy in itself for the client, paving the way for further interventions. Using video vignettes, Dr Boon explains practical therapeutic strategies that incorporate comprehension of: 

  • The differences and similarities between dissociation and hypoarousal – when do clients alternate between hypoarousal and hyperarousal?
  • Compartmentalized and disparate senses of self in our clients, thus allowing us to comprehend manifestations as activities of dissociative parts
  • Situations where dissociation and psychosis may co-exist and situations where these may lead to confusing symptomatology
  • The role of dissociative parts in other comorbid clinical manifestations (such as the exacerbation of other symptoms and disorders like depression, self-harm, suicidality, eating problems, addition and panic)
  • Avoiding false positive assessments
  • Overcoming the challenging task of obtaining a therapeutic alliance with clients who have a complex trauma history (in particular with those who exhibit dissociative disorders)
  • Developing a working alliance with hostile and destructive dissociative parts; Techniques for regulating emotions and for dealing with triggers
  • Transference and countertransference considerations in the phase oriented approach; Self-care for the therapist
  • Creating a working alliance with aggressive and / or persecutory personalities

© nscience 2017 / 18


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When & Where

Radisson Blu Edwardian Grafton
130 Tottenham Court Rd
W1T 5AY London
United Kingdom

Thursday, 23 November 2017 at 09:30 - Friday, 24 November 2017 at 17:00

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nscience UK

nscience is an independent organisation that seeks to explore the interdisciplinary richness of mental health disciplines. Through a series of seminars, workshops and conferences that are conducted throughout the year, we aim to present the latest advances in theory and research to practitioners; with a view to furthering their continuing professional development.

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Dissociation and Dissociative Disorders: Therapy for ‘Difficult’ Clients
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