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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Wow. I have taken SO many courses about the treatment of traumatized clients over the years, but this one has been a “gut punch” for me. I have learned so many new ways to work with my dissociated clients- or perhaps I should say clients who have parts that dissociate when triggered by often unconscious and often very “insignificant things”(though I’d never believe that Anything is insignificant!!). I am blown away by the content- the helpful information you have given here. Though I am suffering significant financial hardship myself, I am getting closer to purchasing the gold package to have these weekly “courses” to keep forever. Have to run to meet with a client now– but felt I had to express how powerful this training is and how much I am learning (now in my 63rd year of life!). Never stop learning!! And Thank You 😊!!
Hi. My position is a speech language pathologist. I work in an outpatient clinic with OT’s and PT’s. This information is so beneficial for me, my clients, and family members. I have a daughter-in-law who experienced trauma growing up. I wanted to listen to today’s seminar because I am trying to grow in our relationship. I see the disassociating in her, and needed to know how to approach her. She runs hot or cold. Thanks so much for aiding in my understanding.
I’m interested in a better relationship with my DIL as well, and for the same reasons. It’s very difficult at times to integrate her behaviors into our family (or at least my concept of family)- but we keep trying.
I like the affirmation of doing the breathing, sighing, movement or tapping along with the client. And I like mindfully noticing that a certain part has shown up just in the nick of time.
Too much empathy can derail the client. That has never occurred to me before. Thanks so much!
Great webinar again thank you.
I have learned about the different ways a person can dissociate and how to try to bring them back to the present.
I have learned about the difference between dissociation and dissociative identity disorder and how not to treat the person like child if they are in that state but to be more matter of fact.
How to also break that state of dissociation by breathing or standing up or walking etc
I will be more careful with my voice tone… probably often too “empathic”
I won’t go too fast adressing the child part
I will more co-regulate, asking more “how it is” for the client right now and asking what he could do/think of doing instead and/or before prescriptions or suggestions
Thank you so much for sharing this broadcast.
My biggest takeaway was hearing that my reaction to a client (another person) could be giving me information about what is happening with that person. So, learning and staying alert to my own stuff can help me be effective when I am with others. I used to be a therapist and am now mainly trying to heal from severe trauma. I do help others who are also healing, informally.
I appreciate being reminded of just how serious and complex trauma can be . Thank you
Hello, I am a Jungian analyst and trauma therapist (somatic experiencing practitioner) writing from Bari, Italy, and I wanted to say that I really appreciated the high level of this training, which is a rare jewel and an excellent example in itself of the magic of a mandala of “parts” working together in a coherent, cohesive, cooperative and coordinated way. I enjoyed it, and found it helpful and inspiring for my own practice. I also appreciated the diversity perspective and the inclusion of racial trauma, and how this program is conceived to be at least partially free-of-cost (thank you!!) AND helpful for non-clinicians (who of course need it the most).
Thank you for this rich presentation. I’ve been a follower during undergrad and now master studies. Coincidently we are covering DIDs this week. Key takeaways today a) Empathy triggers; b) poly vagal energy level professionals bring to clients that can potentially become a trigger for the clinician; c) answers to why I have had emotion responses to getting dental work; and separately, having an adverse reaction coming out of anesthesia. Later, when inquiring to medical attendants they could not explain why.
Hi,
I learnt a lot from today’s session. I’m a fully registered Music Therapist with an annual practicing certification. I found myself thinking about ways to transfer today’s information to bring about healing for trauma clients through music.
It would be great if you could add Music Therapy to your list of professions.
Thank you for clearly describing my state. This presentation has been extremely eye-opening.
I found under standing the state of having the five areas of dissaossciation very helpful and provides a more comprehensive overview when diagnosing and having observed this recently it helps solidify my understanding. I found that the use of moving away from the trauma and helping the client observe self and their state very helpful to assist client in selfawareness and not shame.
Learnings/insights/apply to specific clients.
1. Gift of Dissociation, particularly memory. The split off of trauma, so it doesn’t become part of the person’s history. My client asks, at 42y/o, trying to affirm if the ongoing child sexual abuse by gdad really happened.
2. Slow down. Slow down. Slow down. I need to do that more with my adult clients. I realize how my move toward retirement has created a sense of urgency in me.
3. Structural Dissociation. The somatic strategy. I will see if my client will walk out the door when not in dissociative state as a prep for trying to interrupt the dissociative state in session. We’ve done some of this somatic work as prep and applying it during the early stage of her dissociation in session.
4. Really like the welcoming of the dissociative state. “Oh, the spacy part is here.” Bring in curiosity and reduce shame. Not sure where to go after welcoming the ‘spacy part’, maybe be curious about what that part would most like to do right now.
Thank you very much.
I work in the forensic arena. I was wondering if anybody has experience with defending a client in court who suffers from a history of complex trauma and has committed a serious crime while in state of dissociation? If so, do you know of knowledgeable experts who have experience with defending such cases?
Although I have learned about attachment theory, many times, learning about it with the knowledge of the nervous system — the attachment and defense systems was especially eye-opening. I didn’t realize that there was a deeper biological and structural component in building the self.
Thankyou for sharing this broadcast for free.
I am going to practice the techniques myself to build more self awareness. I will also be more present and aware of the signs of dissociation with my clients and getting practice the strategies mentioned to help me guide my client. The biggest take away for me was leaning when to have an empathetic tone of voice and when it is necessary to remain neutral! Thank you for all of the information shared!
Such a well organized & updated informative presentation on a very difficult & often misunderstood area. Please train more of the general medical & health care providers in this given increased trauma of our civil action! Having decades of experience from both sides of these issues, I applaud these efforts compared to so many other incomplete, segmented or incorrect information especially used for profit using educational ‘store’ fronts! I pray you get more funding for your programs to inform those who can be an ‘army’ trained to combat the impacts & damage caused by trauma throughout our communities & the world.
I work with many traumatized clients, and feel profound gratitude for the tools to identify, name, work with, and mishaps as to how we as practitioners to support our clients more fully. I am particularly interested with when the use of empathy, when the client hasn’t been brought to a place where their parts are integrated and understood as separate and unique, can be harmful, as it stimulates an attachment need that we haven’t worked with/confronted in the work together.
Thank you, thank you!
Great session – the concept of giving empathy/compassion to the child when the adult is not ready – is something I have seen a lot with clients who could not trust the caregivers in their upbringing to be there for them in a safe secure stable way also anything that helps me be more attuned to what’s happening with my client is always so helpful since when we miss something than they feel like another person is not getting them and they just go into their protective response with another person.
This workshop is well edited and always on point.
You have to move quickly as significant information is provided.
I’m going to rethink some of my clients who have been frozen and stuck in their progress. I’ve been feeling ineffective with them so this is a good impetus to rethink.
It seems important to remember that an empathetic response is not always the helpful one. And also just in general that there may be opposing motivational systems pulling the client.
Sometimes I work with people with schizophrenia. During today’s training, I really appreciated learning to differentiate between voice-hearing related to dissociation vs voice-hearing related to schizophrenia
I just want to say thank you and express my profound gratitude for making this course available for free.
I’ve learned so much in just one session (missed the first one unfortunately; hope you’ll ever do a re-run maybe some day 🙂
A special eye-opener for me , as a counselor/energy worker, is how easy it is to miss dissociation in a client. I will certainly pay more more attention to the red flags mentioned.
Also the suggestions for grounding and the more cheerful ‘hey I see’ rather than possibly more judgemental ‘ I notice’ (which for a long time seemed perfectly admissible to say) has changed my view on the relationship with clients.
Looking forward to next week 🙂
Thank you. I appreciate the Direct and Brief clear enough explanation that can arroyse curiosity to dive deeper into understanding of a specific topic.
I appreciated and will implement the “ Spacey Part” toni brinv in shame but keep all aware of where we are in the moment.
All very relevant, as I believe many people disassociate or have fragmented parts…
Alot of Useful information.
The clear definitions initially are helpful.
Much thanks,
Kathy S.
Thank you so much for this incredibly educational and professional teachings. I feel I understand my own behaviours better and the behaviours of patient I came across. In the same time it saddens me knowing how traditional approach to disorders is still limited and old school. Your program brings really great hopes for the future. I hope you’ll also cover the power of touch therapy, especially Craniosacral sessions in working with trauma, soothing the nervous system and bringing the tissue memory to life. Personally, for me, one of the most powerful ways in working with trauma when our self awareness and cognitive function were not developed yet.
As a massage therapist with 20 years practicing Barnes Myofascial Release and Milne Craniosacral therapy, I found the content here so helpful and useful that I’m about to sign up for the Gold Package.
I do wish that the massage therapist experience and perspective would be included in the course content. My profession isn’t even listed in the possibilities below.
Clients frequently tell me they find me the first professional they are able to trust. I can’t simply refer them out; they’ve had a history of being unheard and betrayed (they feel) by professionals in other fields. I understand my scope of practice. And, people talk to me about things they say they’ve not told anyone else. I work with clients identified as dissociated or DID with great frequency.
I’ll use what I learned today in countless ways. Perhaps the most important is recognizing the more subtle signs of dissociation.
Thank you for your work!
Joe Miller, LCMT
20 years practicing exclusively Barnes Myofascial Release and Milne Craniosacral therapy
I use Dr. Levine’s rumble breathing to bring us into a comfortable safe place. Checking in with body – how it feels and inviting the body to share images. If person seems to be flooding at all we go back to breathing then we go to a really safe place and spend as long as we need in this place. I find they will be getting the foundations they need to hold what has happened so far; as well may be strengthened enough to continue dealing with the trauma. I wait until the persons heavy breathing has ceased before I stop whatever inner work we are doing. They will come to a natural conclusion – resolution and ready to report what was happenning. I have invited them to let The Light join them or whatever makes them feel really safe.
I have found Dr. Levine’s material to be so helpful. Enjoyed all your presenters. I am a practitioner for 20 years working with trauma and dissociation. Thank you for your work!
Wonderful insights.
My take away today: go slow. It makes me realise again how challenging it can be to release the outcome of a session and remain instep with the patient and its delicate process.
Thank you.
I REALLY appreciate the wisdom you’re offering free of cost. Janina Fischer’s strategies are really simple and appealing for me. I got a lot of tips from this session- thank you. I really wish the speakers would go a bit slower or that the video would pause when strategies or concepts are listed!
Can anyone clarify or point me to information on the concept of our nervous systems playing off one another, that when we offer our ventral vagal state in our session with the client, they have a better chance of going toward that state. As an energy medicine practitioner, it makes sense to me but wonder how it is explained in Polyvagal Theory. Thank you.
Very informative, thank you.
What came to mind, when I reflect on clients, that could be associated with disassociation after trauma, in a mariiage, is that the person, no longer is attracted to opposite sex, but then gets attracted to feel safe to their own sex gender.
So then adopts, that way of relating to help them feel safe.
Thank you for today’s webinar. As a trauma therapist, I need to think how I may apply some of the fine-tuning you all provided for some of my pts, but feel it will definitely help!
Thank you so much, I had several clients who just… as I thought just wonder of to a other world or sometimes makes me feel I do not connect with them…now I know! Thanks a million
I found the question “How much of you is here right now?” to be quite interesting. And that fact that many patients are able to respond with a percentage is AMAZING!
Very helpful and informative on Structural Dissociation and DID. Thank you! Karen UK Psychotherapist
Excellent. I only wish I had some of this knowledge many years ago. I had to learn a lot about dissociation as I went along.
This webinar is truly a practi al venture into firstly noticing and then treating disassociation. what was truly amazing is how it offers concrete examples of questions and interventions to be used with clients who disassociate otherwise or in the session. The window of tolerance is one concept that fascinates me as an early trainee in the field. Psychoeducating about this and bringing the client’s focus back to their present reality and bodily responses is one method I would like to integrate with all my clients who have a history of trauma.
I am grateful for this program. I am a current psychology student and I feel that I have learnt a great deal from this presentation that will allow me to look at, and home in on more beneficial focuses.
Where can I review the session (I’ve paid for gold package)? Thank you.
Hi, please email us at respond@nicabm.com, and we can help you with access to your Gold Package.
Great lectures, but completely lost audio at one point. I don’t think it’s my computer.
Thank you all. I’m getting better and better in identifying my own levels of dissociating. I can now identify three levels in what I call my orange state. My red state is full blown DP/DR.
Yesterday I had group therapy and somebody triggert my alarm bells big time. But instead of escaping, I stayed with all these super intens sensations in my body. My sympathetic system was running at full speed and at the same time I felt my dorsal vagal on top of that trying to control the situation. The right side of my body felt really warm and my left side was freezing cold. But I stayed present! Big win for me.
Special shoutout to Bessel 🌷
Thank you for the great session. I have observed what were mentioned about dissociation in some of my clients and I am glad to know that my practice in dealing with it were affirmed. I also appreciate the additional tips and explanation about the science on how to explain and address them especially the somatic and experiential way.
I am a person who has spent a great deal of her adult life fighting eating disorders and severe cutting episodes and suicidal attempts Over the years of seeking help I spent a tremendous amount of time in both inpatient and outpatient hospital stays and was diagnosed with DID I spent forever denying that all the lost time and dissociation was DID because there was no way there was that extent of trauma since most of my childhood prior to 4th grade was not mine. After years of work I was able to “integrate “ the many parts of myself and was able to save my marriage and even able to feel whole enough to have a child and raise her well. What I struggle to know and would like help understanding is if it is possible after all the work and recovery, for the fragmentation and dissociation to stir back up We adopted a daughter years ago and she struggles with her own early trauma by acting out sexually and I am constantly triggered by her and split between anger and sympathy and shame etc. and it is getting worse all the time. This last month my father passed away and all I hear and feel is that “we killed him”. And we have to die too. My question is whether a person who “integrated can fragment again later in life with circumstances that overwhelm. If so does this mean I am going to deteriorate like I did in my late 20’s when I got married. I so appreciate the free sessions and so admire those Drs and therapists who care enough to spend their lives helping to heal the wounded. Thanks Suzyn
I LOVEd this session! I am a client on disability, so I very much appreciate those who purchase gold packages so that I can access this priceless psychoeducation. I have watched these before and they always result in highly productive sessions and adjustments to my treatment when I talk to my therapist afterwards. Thank you <3 I very much appreciated the discussion of what to look for, because I CAN LOOK TOO!! this is usually how this operates for me in session, I learn something cool here, me and my t discuss it, and it becomes truly collaborative as we figure out what works together! Thank you <3
I’m currently studying to become a psychotherapist and not working with clients, but I used to be in contact with people who suffered from trauma and abuse as a Mental Health Supppor Worker. Today’s session shed some light on the behaviours I observed, especially with one client who showed all the red flags mentioned for structural dissociation. The idolizing and devaluating, the inability to take next steps and complete goals, always presenting with physical symptoms that showed no medical cause, poor sleep, moving into a childlike state, voices, and she was diagnosed with Personality Disorder. When I am ready to practice this training will be very valuable. Thanks!
I found Dr. Fisher comments helpful regarding our need for a deeper understanding of Dissociation vs. mis-dx personality disorder. I have been working with a client who is highly defended and repeats self defeating patterns over and over: I have been inquisitive about my approach as progress has been minimal to none. I have a new breath of understanding to rethink what is happening- her defensive structures protecting her split off parts. I have a lot more opportunity for inquiry. Thank you.
So much good info! My daughter was diagnosed with BPE in 2017. This episode gave me some clarity around what I can now see as possible episodes of dissociation. I was diagnosed with PTSD in 2019 and can point to a litany of traumas. I invited my sister’s children (all in their 30s to 40s) to this series to help them understand their trauma and how this could be treated. Such a valuable series. Thank you for presenting!
Thank you for the session. There were lots of great take aways. The one that really sticks with me is “the sigh” and focusing on the relaxing in breath afterwards. I think this will be easy to weave into sessions. Janine
I was encouraged that what can appear to be personality disorder is coming to be seen as structural dissociation. Hopefully that will inform therapists such that they will no longer blame patients but instead have sympathy for them when they are acting in a way that is difficult to tolerate.