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ESTD-UK

ESTD-UK is a professional network consisting of UK members of the European Society for Trauma & Dissociation (ESTD). The latter was established in 2006 as a professional society and ESTD-UK formed shortly after.  The society is for clinicians, academics, and researchers with a professional interest in the field of complex traumatic dissociation, and also for official representatives of constituted national organisations who are actively engaged in education, service provision or research in the field of complex traumatic dissociation.

ESTD-UK has an established training faculty, produces information resources and provides professional networking opportunities, including stimulating and contributing to research projects. Collaboration with experts-by-experience is a core aspect of its ethos.

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Online

Online

Introduction to Trauma-related Complex Dissociation

This course is a first introduction to the concept of dissociation, the dissociative disorders and some common misunderstanding in relation to those who experience these conditions.

It consists of four units of approximately 25 to 45 minutes each. On completion a certificate for 3 hours of CPD can be downloaded.

Presented by Melanie Goodwin and Kathryn Livingston BEM of First Person Plural – dissociative identity disorders association

Unit 1 – Dissociation : a continuum of normality
This unit looks at everyday dissociation and how this adapts naturally to deal with all types of experience. It discusses the importance of the continuum of dissociation explaining why the child still being abused is not dissociating abnormally by compartmentalising their experience and erecting amnesic barriers; they are using this natural, instinctive survival mechanism in its most extreme form.

It introduces the screening tool – Dissociative Experience Scale (DES) and how this may also be used as an integrated resource with clients to begin to raise an awareness of some of their dissociative experiences they might otherwise be unaware of.

The presenters discuss the five dissociative experiences: – depersonalisation, derealisation, amnesia, identity confusion and identity alteration using lived examples to offer a context for some presenting behaviours that may appear irrational without a framework of understanding. They introduce ‘The Diagnostic and Statistical Manual of Mental Disorders’ (DSM V) diagnostic criteria for dissociative identity disorder (DID) and discuss the need for someone who has DID to be correctly diagnosed and worked with accordingly.

Unit 2 – Dissociation : Finding a language
By sharing some of their own history the presenters explain how finding a language that offered a sense of ‘shape’ and ‘containment’ enabled them to begin to understand and convey their reality and why it has been such an important part of their journey. They discuss how the Structural Dissociation of the Personality Model (Hart. Onno van der, Nijenhuis, Ellert R and Steel, Kathy : The Haunted Self) recognises parts of the personality who manage daily living and others who are stuck back in trauma time; how this concept encourages the start of a dialogue between the therapist and client and internal communication. The unit reflects on the growing understanding of how trauma impacts on a child’s attachment patterns and later relationships and how obsolete behaviour patterns may still impact daily living. Introducing how all trauma-related diagnoses can be described in terms of Structural Dissociation of the Personality helps to clarify the overlap between primary and secondary levels of dissociation and where the tertiary level, (DID) fits in the diagnostic spectrum.

Unit 3 – Dissociation : Understanding misunderstandings
This unit looks at the discrepancies, and contradictions that are recognised as a major part of living with DID. Under the five headings: – early days, trust, attachment, triggers and language the presenters begin to link past experiences that are frozen in time, as though they have ‘just happened’ to conflicting behaviours experienced in the present. Children who experience enduring abuse have few opportunities to learn about affect regulation within a healthy, stable environment. This results in self-regulation in adulthood being complicated, challenging and often frustrating as old behaviour patterns are triggered before an alternative way can be reflected upon. The unit stresses the importance of psycho-education. Within this context, it discusses how the brain has been ‘hard wired’ throughout childhood for managing the abuse; how understanding this allows the development of techniques, strategies and other coping mechanisms to be considered and cautiously implemented while lowering the fear level of behaviours that can feel out of control.

Unit 4 - Dissociation : A foundation for recovery
Completing this unit, you will begin to understand the importance of the first stage of therapy, i.e. stabilisation and symptom reduction; how this is partly accomplished through developing internal co-operation and communication; and how this is achieved through engaging and working with the parts, validating their reality without exploring their traumas, including the narrow path the therapist walks between acceptance, validation and re-traumatisation. The presenters discuss the need for as many parts as possible to establish their therapeutic relationship with the therapist including those parts who may be thought of as perpetrators parts but are actually trying to protect the whole. Through respectful acceptance and reflection these parts can be helped to adapt to the life they are now living and to find new roles that are helpful in the present time. The unit explores why this stage is so important to every aspect of the client’s life including the therapeutic journey. Although stabilization is thought of as the first stage it will be returned to throughout therapy. It can be almost as much about working to equip the client with the wide range of skills everyone needs as it is about addressing specific areas of living with DID.

Online

Introduction to Assessment and Treatment of Complex Dissociation

Before doing this course you are strongly recommended to complete our Course 1 – Introduction to Trauma-related Complex Dissociation. There are discounts for purchasing more than one course at a time.

This course 2 introduces the history of the field of dissociation and provides a foundation level introduction to the assessment and treatment of complex dissociative disorders, including Dissociative Identity Disorder (DID) and Dissociative Disorder Not Otherwise Specified (DDNOS) or Other Specified Dissociative Disorder (OSDD)

It consists of six units of approximately 20 to 60 minutes each. On completion a certificate for 4 hours of CPD can be downloaded.

Presented by Rémy Aquarone, Analytical Psychotherapist and Director of Pottergate Centre for Dissociation and Trauma

Unit 1 – An introduction and history of dissociation
This unit provides an introduction to the history of dissociation spanning the early works of Pierre Janet, the cultural reasons for its near disappearance and its eventual re-emergence. It includes an initial description of the internal hierarchy of a DID system, assessment tools and the 3 stage model of treatment.

Unit 2 – Dissociation and Attachment
This unit looks at the innate need to attach, primitive animal survival responses, and the continuum from everyday dissociative experiences (alterations of consciousness) to mal-adaptive (pathological) dissociation.

Unit 3 – Foundation for Therapy
This unit explores the stabilisation phase of therapy and emphasises its the critical importance as the foundation of therapy as a whole. It also explores issues of the use of language, counter-transference, and some challenges for out-patient therapy services.

Unit 4 - Introducing Structural Dissociation of the Personality Model
This unit consists of two video presentations providing an introduction to the concept of the structural dissociation of the personality model. It looks at the role of “Apparently Normal Parts of the Personality” (ANPs) and “Emotional Parts of the Personality” (EPs) defined in this concept. The unit discusses the importance of establishing communication between parts, understanding the interaction between parts in the clients’ inner world and the need to develop the clients’ ability to maintain contact with the outer world. In relation to these tasks the role of therapist as facilitator and the importance of continuity of care is emphasised. It explores further the three phases of therapy and briefly discusses the issue of organised abuse.

Unit 5 – Screening Instruments & Developing an Outpatient Therapy Service
This unit looks at two evidence-based instruments to screen for dissociative distress, the DES (Dissociative Experience Scale) and SDQ20 (Somatoform Dissociation Questionnaire). It describes cost savings from setting up effective treatment protocols within the NHS for clients/patients who have a complex dissociative disorder. It also describes dissociative symptom levels found during an audit at an inpatient psychiatric service.

Unit 6 – Issues for Diagnosticians including Differential Diagnosis
This unit references the two diagnostic manuals – Diagnostic & Statistical Manual (DSMIV) and the International Classification of Diseases (ICD10), including the changes to the section on Dissociative Disorders with the publication of DSM5. It looks at what the National Institute for Health & Care Excellence (NICE) guidance for the treatment of Post-Traumatic Stress Disorder PTSD) says about complex dissociative disorders. It outlines the approach needed by therapists when working with clients/patients with a known or suspected trauma history. Explaining the importance of differential diagnosis, the unit presents statistics showing the proportion of wrongly diagnosed conditions such as Schizophrenia, Borderline Personality Disorder and other presentations in patients who actually have Dissociative Identity or similar complex dissociative disorder.

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