Greg Nooney – Trauma-Related Dissociation and Dissociative Disorders: Assessment and Treatment Strategies for Some of the Most Misunderstood Disorders in the DSM

Outline

Developmental Trauma, Symptomology and Risk Factors

• The role of early traumatic stress and insecure attachment
• Types of Dissociative Disorders and symptomology
• Dissociative Amnesia, Depersonalization Disorder,
• Dissociative Identity Disorder
• Populations at risk for dissociative issues
• The controversy – misconceptions and false memories

Clinical Assessment Tools for Trauma and Dissociative Disorders

• Adult Attachment Interview
• Adverse Childhood Experiences Questionnaire
• Dissociative Experiences Scale
• Identifying co-occurring disorders
• Avoiding false negatives and false positives in diagnosing DID

Problems and Solutions in the Treatment of People with Dissociative Disorders

• Maximize attunement with clients who are dissociating
• Getting client buy in
• How to establish trust and cooperation
• Manage issues that can interfere in therapy
• Compassion fatigue
• Modulating your own reactions
• The dangers of vicarious trauma
• Identify and address implicit biases
• Maintain therapeutic limits and boundaries
• Engagement of alternate identities in DID

Therapeutic Techniques that Develop Stability and Safety for Dissociating Clients

• Calming practices to ground the dissociative client
• Conscious breathing
• Relaxation techniques
• Mindfulness
• Working with clients facing continued abuse
• Techniques to manage suicidal crises – account for the suicidal alter
• Don’t let “crises of the week” keep you from reaching treatment goals
• Build support systems with WRAP plans (Wellness Recovery Action Plan)

Specific Trauma Work for Dissociative Disorder Treatment Plans

• Differences in working with DID clients
• The role of resourcing in trauma
• Calm clients and create personal safety with TF-CBT
• Eye Movement Desensitization and Reprocessing (EMDR)
• Somatic approaches – connect memory to the body

Limitations of the Research and Potential Treatment Risks

• Feasibility of randomized prospective double-blind placebo-controlled studies
• Ethical, financial, and logistical constraints
• Trauma, disorganized attachment and research data
• Potential risks in treating trauma and Dissociative disorders