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  • 6th and 7th March 2020
  • Presenter(s): Christiane Sanderson

Living in a Fog: Dissociation, Complex Trauma and PTSD

6th and 7th March 2020
9.30am – 4.30pm
St Michael’s Centre, Budbrooke, Warwick

(includes refreshments and sandwich lunch)

Christiane Sanderson BSc., MSc. is a senior lecturer in Psychology at the University of Roehampton. With 26 years’ experience working with survivors of child sexual abuse, sexual violence, complex trauma and domestic abuse she has delivered consultancy, continuous professional development and professional training for parents, teachers, social workers, nurses, therapists, counsellors, solicitors, the NSPCC, the Catholic Safeguarding Advisory Committee, the Methodist Church, the Metropolitan Police Service, SOLACE, the Refugee Council, Birmingham City Council Youth Offending Team, and HMP Bronzefield. In her capacity as a sexual violence and child sexual abuse consultant she has contributed to news coverage on BBC TV and BBC Radio, and Sky News, as well as being featured in a number of documentaries involving sexual violence, most recently Fred and Rose (West): The Untold Story (Channel 5, 2014); ‘Hotel of Horrors’ (2014) and The Cul-de-Sac Cult (2015) on the Crime and Investigation Network (Sky Channel 553).

Christiane is the author of Counselling Skills for Working with Shame; Counselling Skills for Working with Trauma: Healing from Child Sexual Abuse, Sexual Violence and Domestic Abuse; Counselling Adult Survivors of Child Sexual Abuse, 3rd edition; Counselling Survivors of Domestic Abuse; The Seduction of Children: Empowering Parents and Teachers to Protect Children from Child Sexual Abuse, and Introduction to Counselling Survivors of Interpersonal Trauma, all published by Jessica Kingsley Publishers. She has also written The Warrior Within: A One in Four Handbook to Aid Recovery from Sexual Violence; The Spirit Within: A One in Four Handbook to Aid Recovery from Religious Sexual Abuse Across All Faiths and Responding to Survivors of Child Sexual Abuse: A pocket guide for professionals, partners, families and friends and provided the analysis for Survivors’ Voices: Breaking the Silence on living with the impact of child sexual abuse in the family environment for the charity One in Four for whom she is a trustee.

Living in a Fog: Dissociation, Complex Trauma and PTSD

Dissociation is a highly adaptive survival strategy, especially in the presence of systematic and prolonged trauma, characteristic of child sexual abuse (CSA) and/or domestic violence. In the presence of repeated traumatic experiences in which there is no escape, dissociation becomes the default setting, making it hard to remain present in the body. As a result, many survivors of CSA, rape and domestic abuse numb all affect, disconnect from or delete their body and retreat into their head. This can lead to a range of symptoms which are currently subsumed under subtype Post Traumatic Stress Disorder with Prominent Dissociative Symptoms.

To fully understand the role of dissociation in complex trauma, it is essential to understand the psychobiological mechanisms that underpin peritraumatic dissociation through the loss of conscious awareness, fragmented memory, loss of identity and changed perception: which are the core features of secondary dissociation and structural dissociation. In addition, it is critical to make the link between dissociation and shame, its role in suppressing feelings of anger or rage, and increased risk and vulnerability to addictions to numb the pain. We also need to comprehend how these produce dissociative states and symptoms seen in:

  • • Dissociative Disorders
  • • Dissociative Disorder Not Otherwise Specified (DDNOS) and
  • • Other Specified Dissociative Disorder (OSDD)

Many survivors do not initially present with dissociative states or are not aware of the signs or symptoms of dissociation, making it imperative that clinicians are able to link client experience of ‘living in a fog’, ‘wading through mud’, ‘sieve like memory’ and ‘feeling as though someone else is in control’ as dissociative states.

In this practical and unique two-day seminar, which would be relevant for psychotherapists, counsellors, psychologists and psychiatrists, across modalities, Christiane draws on her extensive clinical experience to examine the complex nature of dissociation, its origins, its functions and its long-term effects, to explain how we can:

  • • Identify clues to dissociation such as distortions in time, perception and memory, changes in verbal and non-verbal communication, bodily sensations and cognitive processing, as well as depersonalisation and derealisation – with a view to helping survivors understand the symptoms of dissociation and how these can be managed more effectively
  • • Be aware of our own capacity for dissociation when bearing witness to traumatic experiences and how to ensure that we remain present and embodied, especially when faced with a deep sense of somatic countertransference or somatic empathy.
  • • Comprehend what dissociation looks like in practice and how we can translate survivors’ reports of their experiencing of the world into clinical formulation of dissociation – and how this can best be managed in the therapeutic setting.
  • • Work therapeutically with structural dissociation, including parts work

Overall, the aim is to facilitate reconnection of mind, body and brain and integration of disavowed parts, to restore presence and embodiment in both client and therapist.

Christiane will make use of experiential exercises, small group discussions, role play and case studies to facilitate a deeper understanding of dissociation and how to work more effectively with clients. Emphasis will be placed on the challenges of working with dissociation, assessment, readiness for therapy, case formulation and the importance of integration of dissociated parts. Participants will have an opportunity to familiarise themselves with a range of clinical measurement scales such as the Dissociative Experience Scale (DES), the Somatoform Dissociation Questionnaire (SDQ-5 and SDQ-20) and the Patient Health Questionnaire 15 Somatic Symptom Severity Scale (PHQ-15). In addition, participants will be encouraged to identify their own capacity for dissociation and to build their own ‘dissociation profile’ including triggers and cues to dissociation as well as exploring different aspects, or fragmented ‘parts’ of the self, and how these manifest both inside and outside of the therapeutic space. In this they will be able through role plays to practise a range of techniques and skills such as psychoeducation, stabilisation, grounding skills, and working with parts to integrate the fragmented aspects of the self. Sensorimotor techniques and exercises that facilitate embodiment will be explored to ensure that practitioners remain present when working with dissociative clients, and how they can use their body as tuning fork to resonate with their client’s somatic and dissociative states so that they are more able effectively to manage and work with somatic counter-transference.

Day one will consist primarily of identifying the neurobiological nature of dissociation and its function as an adaptive survival strategy. It will examine the continuum of dissociation from everyday dissociation, or automaticity, and daydreaming through to clinical dissociation as seen in depersonalisation, derealisation, fugue states, structural dissociation and dissociative identity disorder. This will be accompanied with a number case studies and familiarisation with measurement scales which participants can use to assess their capacity to dissociate and enable to build their own dissociative profile.

Day two will focus on the challenges when working with dissociation and how these can be managed. Through role plays and experiential exercises, participants will be encouraged to examine how to work with fragmented aspects of the self, or parts, and how to integrate these. In addition, the importance of psychoeducation and stabilisation will be highlighted along with creative techniques to work with parts including the use of nesting dolls. Sensorimotor techniques, and embodiment will also be explored to ensure that practitioners can remain present and attuned. These exercises and techniques will enable practitioners to work more effectively with dissociative clients as well as facilitating integration and post traumatic growth.

To book, please fill out the following booking form and contact us at info@therapychallenges.com