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 FactorsDevelopmental Trauma, Symptomology and Risk Factors

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

Clinical Assessment Tools for Trauma and Dissociative DisordersClinical Assessment Tools for Trauma and Dissociative Disorders

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

Problems and Solutions in the Treatment of People with Dissociative DisordersProblems and Solutions in the Treatment of People with Dissociative Disorders

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

Therapeutic Techniques that Develop Stability and Safety for Dissociating ClientsTherapeutic Techniques that Develop Stability and Safety for Dissociating Clients

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

Specific Trauma Work for Dissociative Disorder Treatment PlansSpecific Trauma Work for Dissociative Disorder Treatment Plans

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

Limitations of the Research and Potential Treatment RisksLimitations of the Research and Potential Treatment Risks

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