How to Identify and Treat Dissociation (Even When It’s Subtle)
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with Peter Levine, PhD;
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with Peter Levine, PhD; Ruth Lanius, MD, PhD; Stephen Porges, PhD; Bessel van der Kolk, MD; Thema Bryant-Davis, PhD; Kathy Steele, MN, CS; Janina Fisher, PhD; Bethany Brand, PhD; Pat Ogden, PhD; Ruth Buczynski, PhD
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Eye opening. How will I use with my clients? Well, first let me look for signs of disassociation and then, we’ll take it from there, G-d willing! Honestly, the fact that a client can become disregulated and then go on to hurt themselves because the therapist is being empathic, is food for lots of thought.
Thank you!
Thank you once again for an awesome class. It saddens me that your course is simply not affordable in South African Rands due to our poor exchange rate.
I especially enjoyed the parts references, somatic and imagery work. Also interesting the notion that dissociation is often misdiagnosed as a mental disorder thus never getting treated. I will watch more for the physical signs mentioned as well as the verbal mentioned earlier, feeling ashamed but also acting superior.
Thank you for such a fantastic webinar. It’s really helpful to hear more about dissociation as a much broader phenomenon involving a wide range of types of fragmented parts, not just a ‘detached’ type protector part. Thank you
Helping clients better understand the different states. Helping clients overcome shame. The impact of treating someone with trauma is that it can have an impact on their partner, their children, their friends, their family ….. excellent thank you!
By takeaway is the importance of connecting with the protector parts and finding out from the protector parts what their concerns are.
Today’s information gave me a better way to make a diagnosis, and this will help me to give a better treatment to my clients.
TODAYS PRESENTATION WAS VERY CLEAR AND PRECISE. MUCH THANKS FOR SHARING THIS.
Excellent quality presentation from the best trauma experts re dissociation an DID very helpful. I wil certainly use this in my practice.
Great session, look forward to deepening my understanding of structural dissociation. This module has helped get some notion as to what to watch out for in clients and how DID differed from structural dissociation. Thank you for sharing this!
As an educator, identifying potential trauma in a student and how that may interfere with their ability to learn, or cause holes in their learning is really important.
Wonderful information to digest, not only for my early childhood traumas, but how I can support my Yoga Therapy Trauma clients as a Yoga Therapist.
Appreciated differentiation of defence strategies beyond fight/flight and freeze ie., attach cry for help; collapse/submit; and please & appease. Thanks!
This was well done! I find myself interested more in finding access to trauma informed experiential learning. Any suggestions would be greatly appreciated. I can be contacted at bobhedrick@aol.com.
I like the statement that trauma is not a life sentence. I also like the idea that thoughts are thoughts, they are not the truth.
As always SO HELPFUL to hear from giants in the trauma field, made pcing error earlier today with a very complex patient. Helpful debriefing session through lense of todays’s discussion. Thanks so much
Oh my goodness this was SO amazing! I will use a lot of the grounding techniques with clients as well as psychoeducation to help normalize their experience for them. So often clients feel the guilt and shame and that it is their fault and I love how you helped explain how these are normal physiological responses. Thank you so much!
Great session thanks
Good stuff. thanks for putting this together!
I’m a patient, not a practitioner. I’ve realized I have dissociation and I want to treat it now. This video has been very helpful to my self knowledge and health.
hey good for you Rachel. good luck! 🙂
thanks for this review of strategies and caveats in working with people who suffer from trauma.
Excellent presentation; PARADOXES IN CONTRADICTIONS, can be used to help persons who struggle with shame and superiority by helping them to recognize and deal with their fears and panic episodes and example would be a person repeatedly sexually molested as a child who goes to work and does not want anyone to look at their face so they wear a mask that covers their whole head and only their eyes are seen by their co-workers because they hate their skin color and their body and everything about their facial appearance is disgusting to them. This is a person who also always refers to their senior supervisors as stupid and incompetent and uses jogging in a similar manner as the person described in the presentation Red Flags can also be used to help with terminal ambivalence and the Somatic approach can be utilized to help the person understand why they have a collapsed body posture. empathy/attachment needs/compassion/recognition of fragmenting…Emotional Trauma/bodily symptoms can be used to help persons feel safe provide an understanding of why there is an issue such as Trouble with sleep / understand why a person can only sleeps with a light on as an adult, has bouts with rage/fierce states of being and assist in and provide Assessment of Dramatic Changes that a person may be unaware of such as loss of time, detachment, Voice Hearing and allow for regulating, getting grounded, feeling safe and prevention of self-harm.
Thank you for a well ordered presentation. A few thoughts I’d like to share:
-Sometimes the therapist not a good match for client, and its ok for them to get another that is a better match; as they get better they realize when to make the change for their needs to be met in therapy, and they may make several changes along the way.
-I think it is worth stating that sometimes doctors will automatically fall back on a mental health issue instead of finding the physical cause of patient’s complaint if they are prejudiced in that way (often, I’ve seen it happen and patient gets mis-diagnosed and undiagnosed in the physical realm for lack of appropriate testing)
-Thirdly, sugar dysregulation or dehydration can be seen as “dissociation” when all the client needs to do is eat or drink!
-Fourth, if I may, is that injuries to head and neck cervical area (neck injuries) may also present as dissociation due to blocking blood or spinal flow and appropriate diagnostic procedures must be used to determine if this is the case…
And yes, there can be co-existing conditions. a trauma in the past or present does not necessitate automatic assumption that nothing physical is going on…I’ve lost loved ones due to assumptions as such, and seen ones mis-diagnosed for lacking information about the accident or injury the client just suffered or was just in…so healing of the physical injury gets impeded. Medical doctors want access to psychiatric records, but I believe it is even more important for therapist and psychiatrists, psychologists to have access to medical information of client as it appears. generally speaking. that the therapist is more “sensitive” to client and would be more apt to ascertain the difference between the psycho and physical, and also not see soley(?) a mental status, but perhaps the physical cause or part played in such (though we all know they are intertwined and one plays off the other).
Thank you again for these presentations as I appreciate your focus on self-awareness, and believe it is as important for therapist, doctor, as well as client.
I’ve seen it work both ways:
“a little knowledge can go a long way” or
“a little knowledge can be dangerous” and I believe it depends on the level of professionalism you’re working from….great points on observation! Thank you!
that being said, basically, there ARE physical conditions that can very well be CAUSING dissociative symptoms and are to be considered, not neglected, even in a client or patient who has past emotional trauma! We must listen with intent to understand and not simply “reply”.
It is certainly an exciting field, these trauma studies. (please be as accurate as possible for even I have been part of a botox study for “spasms” which the neurologist lied about results…it nearly killed me, but was reported as “successful” in his documentations in order to use to get the drug usage passed for neuro-muscular disease interventional use.)
So I write to raise awareness to still be diligent.
Thank you for letting me have a part in learning more about trauma and “parts” along with treatment strategies, while explaining why they work. Your time spent in researching and documenting along with putting into great teaching tools will continue to change the way clients/patients are served…lets keep moving forward…..remembering the creed: to first, do no harm.
Wow be in touch kindred spirits achalaphat2020@gmail.com
Thank you so much for making this available to so many people. I am not a practitioner, but a person who has had trauma and at 62 have seen several different professionals who have approached the trauma’s in different ways. It does bring a sense of never really getting better….but will need help all my life….and what a failure I must be. I study everything I can to figure out what is going on and move forward. Right now I have an excellent councilor and also see a chiropractor for Nuero-Emotional- technique treatments. (NET). Having access to these informational classes helps me feel as if there is SOMETHING I can do for myself by learning more.
The only thing that made understanding this class today difficult for me was switching from person to person. It may not be a problem for many others, but I found that as soon as I got on track on with the person speaking and what they were saying the video switched to a new person and place to try to get on track with.
I did learn some helpful and some interesting things by watching this. Thank you again for making these available to everyone.
Dear colleagues I have been watching your videos and webinars. I feel that they illuminate and bring rigor and effectiveness to my practice. And I wish to thank you deeply for that.
But in this comment I also want to apologize for not having been able, up to now, to sign up for the complete packages you offer. I’m aware of the relevance of the work you produce, and the time it takes to do it. I live in a country in southern Europe, with reduced income, working often for free.
…
Thank you once again for your teachings, for your personal commitment, for your sharing.
Gracinda Hamido
Hi, thank you so much for this. I myself am not a therapist, or practitioner but a (patient) with a diagnosis of complex PTSD undergoing trauma therapy for almost 2yrs and I’m happy to say that my psychologist has used some these techniques with me, some of which have worked, some not…
I sent her this link as I believe that she’ll be very interested with these valuable tools.
Thanks again
This was beautifully done with incredible implied respect and carefulness for the client. The subtle signs of dissociation were well described and the more serious signs of DID were clearly identified and differentiated. I could see ways that I could best diagnose correctly and how and where real carefulness was most important for protecting the client. Thank you!
I realised that coming to close, being to warm triggers parts in the client : being on guard.
In future I will check more, what the client needs to stay with me, to become.
To label a feeling as for exampel Hyperarousal ,a reaction of their nervous system
Also not to go into the feeling maar to desribe that this is happening and what it needs from the person as a hole.
Keep distance tot stay close!
Thanks
I am a retired counselor but I will always be a full-time family member grandmother community member neighbor or friend. I intend to use the greater awareness I’m developing attending this in-depth dive into trauma so that I Increase INTENTIONAL ways of being and relating which will be more n more beneficial to traumatized persons I am around day in day out in my now totally non- professional relationships. Like they said at the end …healing from trauma ripples out into the family the community and eventually helps heal the whole world. I can’t think of a better mission for the last years of my life.
I’m just wondering if the concept of a “personality disorder” is ever useful in any case. Is that just what people called patterns of trauma effects that no one recognized or knew what to do with before?
I am not a therapist, I am in therapy and trying to help my therapist help me. I am beginning to recognize my parts. At the present my primary parts are a young child and an adult. The fear of the child is preventing my adult from being a contributing part of society. Thank you for the material about dealing with children. I need to get to know the positive attributes of the child and work with those aspects so I can be fully present and appropriate with the adults in my life. Thank you.
I will make sure to always do deep or sighing breathing with a client. I usually do. However, sometimes after having taught deep breathing to the pt. in later sessions, I have let pt’s do it on their own. I will make sure to always join with them in some way.
I also feel like this broadcast refreshed me on some ways to tune into my nervous system to help get insight into a pt’s nervous system state.
Lastly, it was very helpful to identify which clients I will use these techniques with, or combine some of the techniques. Thank you.
Thankyou so much. I loved the webinar and got lots of food for thought today.
Such an informative, thought-provoking session. Thank you. I am recognizing evermore how systemic and instutional bias has resulted in the hopelessness I see in many disenfranchised and marginalized communities. Dr. Bryant-Davis’s comments on “erasing of self” is so prevalent in these communities. Hopelessness is truly a survival mechanism.
When working with a new DID client, the go slowly is very important, so thanks for that one. Also, very importantly is that the issue may be structural dissociation rather than DID, hence I will need to keep my mind open and be observant.
I also very much appreciate the work of Dr Thema Bryant-Davis in bringing into these discussions the idea of cultural trauma that someone might experience because of race, gender, etc. I investigate and mediate claims of discrimination and sexual harassment, sometimes involving sexual assault, and looking at the larger psychological context, and the fact that someone has repeatedly been traumatized by virtue of something they have no control over, for example, race or sex, has been very helpful to me. I think this is a really unrecognized and undeveloped area that deserves more attention, thank you for being in the vanguard by starting to acknowledge this reality and provide some treatment techniques to address it.
invaluable session, thank you so much for allowing this to be watched for free ( was worth getting up to see if at 4 a.m. !) I particularly appreciated the insights around not confusing DID with schizophrenia or other personality disorders. I have come across clients who report that medications do not work for them and will be more curious about this within the potential for this being due to trauma and dissociation. Kia ora, Delia.
Thank you, really helpful and some great new ways of thinking about things. I’m looking forward to going over my notes to try and embed what I have learnt!
Thank you for another great module! I plan to watch it again to get the missing pieces of my notes and absorb more information. I plan to specialize in trauma treatment and these webinars are helping me prepare and get acquainted with the types of clients I may encounter. The recommended books and other resources that are being shared only increase the value of this training. Thanks again for such a phenomenal video!
Today’s session was informative with some great strategies. My concern is that the overlap of executive dysfunction / ADHD symptoms & those of dissociation was not addressed. Both CAN be present in one person. Quite a few of the ‘clues’ ofgered that someone is dissociating could be ADHD symptoms.
Good point. Recently I have been referring clients more often to get psychological testing. I have found this really helps either tease out what other factors may be present or rule out ones that are not. I have seen that the results have been very illuminating for both myself and my client. Additionally, in almost all cases the client feels very good about the results or relieved to rule out certain issues. For example, with one client he was very relieved at what the testing did not show. And then we were able to work more deeply on areas of problems or weakness that the testing did show. Client showed much more rapid improvement thereafter.
Thank you. I have been in therapy for many years but only just realised this year what dissociation is, and that I experience it. My old therapist used to talk about bringing together fragmented parts sometimes, but never suggested that I may be dissociating or have DID. I didn’t quite understand what she meant. Education like this helps me get a better hold over what’s happening in my inner experience.
Today’s session has broadened my view of structural dissociation, how many times I may have missed the subtle ques, thanks for such valuable information. Paul.
I work with teens, so am doing a lot of translating related to their developmental stages and ability to process concepts and methods. Maybe strongest takeaway is working with posture and also identification of thoughts as “just thoughts,” not “me.” Will be using much of this with three particular clients and learning what seems to work best.
Thank you all the professors, the resource persons. It was amazing, insightfuL, Practical while dealing with clients. Thanks a lot.
Grateful to the entire panel for their great insight. I learned so much from this presentation about great techniques to use to approach sessions with clients. Thank you!
Wonderful content! I took 6 pages of notes! This information will greatly impact my work with clients to increase my awareness and attuning to the window of tolerance and know how to slowly move forward with my clients through their healing journey. Thank you!
Very helpful and informative and a good reminder of all aspects of my EMDR training. I follow my client and go at their speed despite misunderstandings about EMDR being a quick treatment and so the message about going slowly was very reassuring for me and my practice. I also learned that voice hearing is common in left brain trauma and can be easily misunderstood as schizophrenia. So learning to carefully and sensitively share this information with a patient and thereby hopefully gain their trust will enable them to feel safe enough to disclose further.
Many thanks
I am a coach grounded in somatic and trauma awareness. This was helpful in identifying more clearly the place where I am qualified to work and when therapy needs to be engaged by someone trained in that area. Thank you.
Thank you for offering free content. I am currently unable to purchase full access. Will this content be available in a couple months?
How May a masters level clinician and LPC ethically incorporate these lessons to their counseling practices? I am currently progressing through a MS Clinical Counseling program. Eventually I will incorporate such lessons to my work as a masters level clinician and LPC (as appropriate).
I am an amft and I use these techniques because I decided to gain experience with trauma work. That’s what it takes: committing. I sought out supervisors with trauma expertise. I read the Wounded Healer bk, and own my own trauma experiences. I have added NARM, a 2 yr training in developmental trauma (sub optimal parenting, etc.). I also do not skip out on self care if at all possible. I get out and excercise and meditate, so I am grounded, connected, and therefore trustable. I hope this is useful for you. Good luck, and may you have many satisfying sessions along the way, for yourself and your clients!
As a professional and as a family member of a person potentially experiencing DID, this was very helpful. In particular, understanding the issues with empathy and compassion and how this might overwhelm the person, help shed much light on personal experiences. I hope and pray healthcare and other professionals can learn to appreciate even some of what may be going on with a person who potentially has issues with dissociation. Thank you.