Notes from Recent Courses Taken
International Conference on Treating Complex Developmental Trauma Disorder: Integrating EMDR and the Theory of Structural Dissociation, Niagara Falls, New York State
Presenter Day 1: Kathy Steele, MN, CS
Treating Complex Developmental Trauma Disorders
Understanding dissociation and EMDR is mandatory for the effective treatment of complex trauma. What is a complex trauma? Complex trauma is defined by Dr. Bessel van der Kolk (2005) as the experience of multiple and/or chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature such as sexual or physical abuse, war, community violence, AND it occurs early in life. Often these traumas occur within the child’s family.
What is Dissociation? Dissociation involves an unsolvable conflict between approach and avoidance. As a result of this unsolvable conflict there develops multiple senses of Self. One part of self engages in approach, while another part engages in mobilizing (fight, flight), OR immobilizing (freeze, submission, collapse) defenses (Kathy Steele).
A common example of dissociation is a dissociative child part feeling “I hate you” and another dissociative child part feeling “Don’t leave me.” An example given at the training by Kathy Steele, MN, CS, was that a little girl at night is abused by her father and is terrified, yet at breakfast the next morning she has to act as if all is okay with the perpetrator sitting at the breakfast table.
Disorder: Integrating EMDR and the Theory of Structural Dissociation, Niagara Falls, New York State
Presenter Day 2: Jim Knipe, Ph.D. EMDR
Safely treating traumatic memories of clients with Complex PTSD
What is Complex PTSD? It is a pattern of emotional disturbance resulting from extensive and repeated childhood neglect and trauma (Jim Knipe, 2012).
Additionally, clinically complex PTSD is a combination of existing DSM IV diagnostic categories with elements of PTSD, Dissociative Disorders, and Personality Disorders as first described by Judith Herman, 1982, 1992.
J. Knipe pointed out Dr. Bessel van der Kolk's research (2007) where Dr. B. van der Kolk et al conducted a randomized clinical trail of EMDR, Fluoxetine, and Pill Placebo in the treatment of PTSD for childhood onset. The findings were that for the first 8 weeks of the treatment there was the same effectiveness for EMDR and Fluoxetine. But, when a subject stopped taking the medication the subject returned to having the original PTSD symptoms, That was not the case for EMDR-the subjects retained what they had healed.
A good reminder about a basic assumption of EMDR is that it is a body-based information processing system that helps the client move their emotional disturbances into a healthy and accurate reality-perception (Francine Shapiro). This assumption, along with the bi-lateral stimulation to integrate the left and right hemispheres of the brain, are the essence of why EMDR is so successful-it has the client first identify the problem, then connect the problem with where it is held in their body. This mind-body connection supports the ability of both hemispheres of the brain to move towards wholeness and health.
An interesting note is the power of Shame. Shame results in an adult client still feeling "less powerless" because they do not see themselves as separate from the problem. Their child part is still seeing them as part of the problem, such that it is not entirely their parents' fault that there was neglect or physical attacks on them. They see their child self as a bad kid and the parent as a good parent, and may even say that their childhood was normal. In this perception their child part takes on the flaws of the parent, they seem themselves as a bad kid who must just work harder to be a good kid and everything will eventually be better.
Presenter Day 3: Roger Solomon, Ph.D,
Overcoming trauma-related phobias
Dr. Solomon pointed out that a client's presenting problems are the result of past experiences and memories that get locked in the brain then triggered. To heal, the client must access the dysfunctionally stored memory, which can be done through EMDR, change the emotions about the memory, and then integrate just the facts of the memory without the previous emotional charges that were causing the disturbances.
The main challenge in integration is to help the client identify and resolve their defenses that they had to develop to protect themselves.. The client can be helped over time to understand that their defenses can be eased so that the client's true power, strength and control doesn't need to be based on reactive rage, instead it can change to be based on calm, thoughtful, decision-making through the pre-frontal cortex.
Examples of defences are:
- avoidance of the problem,
- shame as discussed on Day 2 by Dr. Knipe,
- rage, anger
- phobic/distrust, still carries fear of the past experiences
- disgust/revulsion of self or others (often more powerful than fear)
- despise self or others
Presenter Day 4: Kathy Steele, MN, CS
Treating Complex Developmental Trauma Disorders
Understanding dissociation and EMDR is mandatory for the effective treatment of complex trauma. What is a complex trauma? Complex trauma is defined by Dr. Bessel van der Kolk (2005) as the experience of multiple and/or chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature such as sexual or physical abuse, war, community violence, AND it occurs early in life. Often these traumas occur within the child's family.
What is Dissociation? Dissociation involves an unsolvable conflict between approach and avoidance. As a result of this unsolvable conflict there develops multiple senses of Self. One part of self engages in approach, while another part engages in mobilizing (fight, flight), OR immobilizing (freeze, submission, collapse) defenses (Kathy Steele).
>BT?
A common example of dissociation is a dissociative child part feeling "I hate you" and another dissociative child part feeling "Don't leave me." An example given at the training by Kathy Steele, MN, CS, was that a little girl at night is abused by her father and is terrified, yet at breakfast the next morning she has to act as if all is okay with the perpetrator sitting at the breakfast table.
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