Full Course Description

PART 1 Learning Objectives:

Session I: Trauma and the Body

Objectives:

1. Demonstrate knowledge of three neurobiologically-based trauma responses and articulate how this information may inform choice of treatment interventions.

2. Explain how the somatosensory and autonomic effects of trauma exacerbate symptoms of PTSD in clients.

3. Assess the role and treatment implications of procedural learning and memory in client presentations.

4. Incorporate sensorimotor interventions into treatments to decrease symptoms of PTSD in clients.

Session II

Working with the Complications of Dysregulation: Addictions, Eating Disorders, & Self-Destructive Behavior

Objectives:

1. Assess the relationship between autonomic dysregulation and addictive or self-destructive behavior in relation to assessment and treatment planning.

2. Articulate the necessity for an integrated treatment of trauma and addictive or suicidal behavior to improve treatment outcomes.

3. Assess appropriate cognitive-behavioral techniques for treating autonomic dysregulation in clients.

4. Specify three somatic techniques for regulating autonomic arousal traumatic reactions.

Session III
Working with Traumatic Memory: Principles and Techniques

Objectives:

1. Define ‘implicit memory’ and breakdown its role in post-traumatic stress disorders

2. Explain potential complications of addressing narrative memories of traumatic events in treatment sessions.

3. Specify three interventions that address these complications and ensure safe, effective processing.

4. Analyze the efficacy of these interventions and distinguish the signs that traumatic memory has been sufficiently processed.

Session IV
Disorganized Attachment and the Traumatic Transference

Objectives:

1. Outline the root causes of ‘disorganized attachment’ status in children and its clinical implications.

2. Specify the symptoms and difficulties associated
with disorganized attachment in relation to assessment and treatment planning.

3. Articulate the role of disorganized attachment on therapeutic transference/countertransference.
4. Utilize clinical strategies that reduce the complications of traumatic attachment in clients.

Session V

The Role of Dissociation in Trauma-Related Disorders

Objectives;

1. Differentiate ‘dissociative states’ versus ‘structural dissociation’ as symptoms of trauma and express their treatment implications.
2. Evaluate the role of structural dissociation in the treatment of complex trauma and personality disorders.
3. Explain common trauma-related internal conflicts and their impact on clients in the context of treatment models.
4. Utilize mindfulness-based interventions to address resolution of internal conflicts in clients

Session VI
Working with Shame, Fear and Anger

Objectives:

1. Articulate the role of shame as an adaptation to trauma and its treatment implications.
2. Specify the roles of fear and anger as animal defense survival responses to traumatic experiences in clients.

3. Demonstrate use of both somatic and cognitive interventions to decrease shame, fear and anger in clients.

4. Explain the role of re-framing in the successful treatment of post-traumatic emotional responses.

PART 1 OUTLINE

I. Session I: Trauma and the Body

How the body and brain respond to threat
Implicit remembering as the hallmark of trauma-related disorders
Triggers and triggering
The long-term somatosensory and psychological effects of traumatic experiences
Understanding trauma-related procedural learning
Working with the traumatized nervous system
Restoration of precortical functioning
Increasing client ability to regulate the nervous system and tolerate triggering

II. Session II: Working with Complications of Dysregulation

The consequences of autonomic dysregulation
Addictive behavior
Eating Disorders
Suicidal and self-harming behavior
Post-traumatic complications of abstinence and sobriety
An integrated treatment for trauma and unsafe/addictive behavior
Top-down approaches to regulating dysregulation
Bottom-up somatic approaches to regulating dysregulation
Differentiating unsafe versus ‘safer’ versus safe behavior

III. Session III: Working with Traumatic Memory: Principles and Techniques

What brain science has taught us about traumatic memory
Recognizing and understanding implicit memory in client presentations
Do we treat traumatic events? Or do we treat their consequences?
Remembering vs. reprocessing vs. repairing
‘Telling the story’
Resolving the implicit memories
How do we know when memories have been adequately resolved?
Creating a healing story

IV. Session IV: Disorganized Attachment and the Traumatic Transference

Attachment and trauma
The effect of having attachment figures who are neglectful or abusive
“Frightening and frightened” parenting
Disorganized attachment and its consequences
Understanding the effect of disorganized attachment on the therapeutic relationship
Traumatic transference challenges
The therapist as a trigger and a neurobiological regulator
Using the social engagement system to overcome the challenges

V. Session V: The Role of Dissociation in Trauma-Related Disorders

A. Dissociation: normal versus pathological dissociation

B. Dissociative states versus structural dissociation

C. Understanding the structural dissociation model as a trauma model

D. Using mindfulness techniques to identify emotional and behavioral responses as ‘parts’

E. Recognizing internal conflicts as survival-related conflicts driven by structurally dissociated parts

F. Mindfulness-based interventions to strengthen client resources and prefrontal functioning

G. Developing empathic relationships to one’s parts

H. Resolving inner conflicts and healing the past

IV. Session VI: Working with Shame, Fear and Anger

The role of emotion in trauma treatment
Shame as a survival strategy
Using somatic and mindfulness-based interventions to address the effects of shame
Fear as an animal defense response
Changing client relationships to fear
Anger as an animal defense response
Re-framing anger as a ‘bodyguard’ or protection
Using somatic and mindfulness-based interventions to address fear and anger

Program Information

Target Audience

Psychologists
Counselors
Social Workers
Addiction Counselors
Case Managers
Marriage & Family Therapists
Nurses
Psychotherapists
Other Mental Health Professionals

Objectives

Session I - Trauma and the Body

Demonstrate knowledge of three neurobiologically-based trauma responses and articulate how this information may inform choice of treatment interventions.
Appraise how the somatosensory and autonomic effects of trauma exacerbate symptoms of PTSD in clients.
Assess the role and treatment implications of procedural learning and memory in client presentations.
Incorporate sensorimotor interventions into treatments to decrease symptoms of PTSD in clients.

Session II - Working with the Complications of Dysregulation: Addictions, Eating Disorders, & Self-Destructive Behavior

Assess the relationship between autonomic dysregulation and addictive or self-destructive behavior in relation to assessment and treatment planning.
Articulate the necessity for an integrated treatment of trauma and addictive or suicidal behavior to improve treatment outcomes.
Assess appropriate cognitive-behavioral techniques for treating autonomic dysregulation in clients.
Specify three somatic techniques for regulating autonomic arousal traumatic reactions in clients.

Session III - Working with Traumatic Memory: Principles and Techniques

Determine ‘implicit memory’ and break down its role in post-traumatic stress disorders as it relates to treatment outcomes.
Determine potential complications of addressing narrative memories of traumatic events in treatment sessions.
Specify three interventions that address these complications and put to practical use in session.
Analyze the efficacy of these interventions and distinguish the signs that traumatic memory has been sufficiently processed.

Session IV - Disorganized Attachment and the Traumatic Transference

Outline the root causes of ‘disorganized attachment’ status in children and its clinical implications.
Specify difficulties associated with disorganized attachment for symptom management.
Articulate the role of disorganized attachment on therapeutic transference/countertransference.
Utilize clinical strategies that reduce the complications of traumatic attachment in clients.

Session V - The Role of Dissociation in Trauma-Related Disorders

Differentiate ‘dissociative states’ versus ‘structural dissociation’ as symptoms of trauma and express their treatment implications.
Evaluate the role of structural dissociation in the treatment of complex trauma and personality disorders.
Diagnose common trauma-related internal conflicts and determine their impact on clients as it relates to case conceptualization.
Utilize mindfulness-based interventions to address resolution of internal conflicts in clients.

Session VI - Working with Shame, Fear and Anger

Articulate the role of shame as an adaptation to trauma and its treatment implications.
Specify the roles of fear and anger as animal defense survival responses to traumatic experiences in clients.
Demonstrate use of both somatic and cognitive interventions to decrease shame, fear and anger in clients.
Determine the role of re-framing in the successful treatment of post-traumatic emotional responses in clients.

Outline

Session I: Trauma and the Body

How the body and brain respond to threat
Implicit remembering as the hallmark of trauma-related disorders
Triggers and triggering
The long-term somatosensory and psychological effects of traumatic experiences
Understanding trauma-related procedural learning
Working with the traumatized nervous system
Restoration of precortical functioning
Increasing client ability to regulate the nervous system and tolerate triggering

Session II: Working with Complications of Dysregulation

The consequences of autonomic dysregulation
Addictive behavior
Eating Disorders
Suicidal and self-harming behavior
Post-traumatic complications of abstinence and sobriety
An integrated treatment for trauma and unsafe/addictive behavior
Top-down approaches to regulating dysregulation
Bottom-up somatic approaches to regulating dysregulation
Differentiating unsafe versus ‘safer’ versus safe behavior

Session III: Working with Traumatic Memory: Principles and Techniques

What brain science has taught us about traumatic memory
Recognizing and understanding implicit memory in client presentations
Do we treat traumatic events? Or do we treat their consequences?
Remembering vs. reprocessing vs. repairing
‘Telling the story’
Resolving the implicit memories
How do we know when memories have been adequately resolved?
Creating a healing story

Session IV: Disorganized Attachment and the Traumatic Transference

Attachment and trauma
The effect of having attachment figures who are neglectful or abusive
“Frightening and frightened” parenting
Disorganized attachment and its consequences
Understanding the effect of disorganized attachment on the therapeutic relationship
Traumatic transference challenges
The therapist as a trigger and a neurobiological regulator
Using the social engagement system to overcome the challenges

Session V: The Role of Dissociation in Trauma-Related Disorders

Dissociation: normal versus pathological dissociation
Dissociative states versus structural dissociation
Understanding the structural dissociation model as a trauma model
Using mindfulness techniques to identify emotional and behavioral responses as ‘parts’
Recognizing internal conflicts as survival-related conflicts driven by structurally dissociated parts
Mindfulness-based interventions to strengthen client resources and prefrontal functioning
Developing empathic relationships to one’s parts
Resolving inner conflicts and healing the past

Session VI: Working with Shame, Fear and Anger

The role of emotion in trauma treatment
Shame as a survival strategy
Using somatic and mindfulness-based interventions to address the effects of shame
Fear as an animal defense response
Changing client relationships to fear
Anger as an animal defense response
Re-framing anger as a ‘bodyguard’ or protection
Using somatic and mindfulness-based interventions to address fear and anger

PART TWO

Program Information

Objectives

Session I - Introduction to the Treatment of Dissociation

Determine three signs or symptoms of ‘complex trauma’ as it relates to case conceptualization.
Differentiate dissociative compartmentalization vs. alterations in consciousness.
Apply the Structural Dissociation model as related to clinical treatment.
Determine signs of altered consciousness in traumatized clients.
Discriminate symptoms caused by activity of trauma-related parts.
Discriminate signs of voices found in dissociative disorder versus schizophrenic clients.
Specify therapist interventions that increase patient ability to identify and determine dissociated parts to improve client level of functioning.
Articulate role of mindfulness-based techniques in the treatment of dissociation.

Session II - Increasing Awareness of Dysregulated Parts and Dissociative States

Determine signs of dissociative parts in the therapy hour.
Determine manifestations of parts observed in physical presentation and facial expression in session.
Differentiate characteristics of fight, flight, freeze, attach and submit parts.
Utilize the term ‘blending’ as it applies to structurally dissociated parts for symptom management.
Implement parts language as an intervention in the therapy of dissociative and dysregulated clients.
Determine and analyze dissociative “switching” to improve client engagement.
Utilize clinical strategies to increase internal communication in clients.
Determine the therapist’s role in ‘coaching’ internal dialogue skills to improve treatment outcomes.

Session III - Working with Traumatic Memory in DID: Implicit Memory and Animal Defense Survival Responses

Determine the distinction between trauma-related explicit memory and implicit memory for purpose of client psychoeducation.
Differentiate implicit memories versus situational emotional responses.
Determine the complications of treating event memories with dissociative disorder clients to improve clinical outcomes.
Utilize clinical strategies to determine the role of animal defense survival responses in dissociative disorders and their relationship to traumatic memory.
Determine characteristic trauma-related internal conflicts found in trauma-related disorders as related to clinical treatment.
Utilize clinical strategies to develop client’s ability to determine internal conflicts as struggles between parts to improve clinical outcomes.
Determine indications and best practices for processing traumatic memories to inform the clinician’s choice of treatment interventions.
Apply the meaning of the term “integration” in the treatment of dissociation as it relates to case conceptualization.

Session IV - Traumatic Attachment and the Treatment of Dissociative Disorders

Apply the concept of “controlling strategies” as a complication of disorganized attachment to improve client level of functioning.
Determine the implications of the controlling strategies in dissociative disorders as related to clinical treatment.
Differentiate the interaction between traumatic attachment and self-destructive behavior to improve treatment outcomes.
Articulate the effects of traumatic/disorganized attachment on the transference.
Demonstrate uses of right brain-to right brain communication to address attachment-related issues.
Utilize interventions for enhancing internal collaboration.
Apply the use of the social engagement system (Porges) to improve client engagement.
Facilitate increased access to states of self-compassion to improve client level of functioning.

Session V - Working with Regression, Aggression and Passivity

Articulate the role of regression and aggression as survival responses to threat.
Analyze personality disorder diagnoses in the light of research on disorganized attachment in clients.
Specify verbal and somatic interventions for working with client dependency as related to clinical treatment.
Demonstrate use of somatic and cognitive interventions to ameliorate devaluing and verbally aggressive behavior.
Articulate the role of depression as an adaptation to trauma.
Specify cognitive and somatic interventions for addressing chronic depressive states in clients.
Determine how to address depression and passivity as a part to improve client level of functioning.
Apply the use of positive re-framing in work with parts of the personality as it relates to treatment outcomes.

Session VI - Integration and Healing

Articulate the traditional view of integration used in dissociative disorders treatment.
Evaluate the complications of a focus on ‘integration’.
Demonstrate interventions for increasing internal communication and cooperation among parts.
Demonstrate internal collaboration as an alternative to traditional models of integration in a clinical setting.
Determine how “healing” has been defined historically as it relates to clinical practice.
Articulate ‘bottom-up’ approaches to healing that have developed over the past ten years.
Determine the ‘negativity bias’ and its effects on psychological health and resilience in clients.
Outline the role of self-acceptance and compassion in the healing process to improve clinical outcomes.

Outline

Session I: Introduction to the Treatment of Dissociation

What distinguishes ‘complex trauma’ symptoms from the symptoms of simple PTSD?
The Structural Dissociation model as a trauma model
Assessment and diagnosis of dissociative symptoms
Assessment questions and measures
Mindfulness-based techniques in the treatment of dissociation
Teaching mindfulness skills to fragmented individuals
Differentiating structurally dissociated parts of the personality
Using the language of parts

Session II: Increasing Awareness of Dysregulated Parts and Dissociative States

Treatment challenges in working with complex trauma and dissociation
Identifying signs and symptoms of dissociative parts
Differentiating the presence of fight, flight, freeze, attach and submit parts
Increasing dual awareness
Dissociative switching and “blending”
Helping clients increase their ability to “unblend” from trauma-related parts
Helping clients decrease dissociative “switching”
Distinguishing psychotic versus dissociative symptoms

Session III: Working with Traumatic Memory in DID: Implicit Memory and Animal Defense Survival Responses

Memory systems: explicit and implicit, voluntary versus involuntary
The role of procedural memory in complex trauma
Helping clients differentiate implicit and procedural memories from situational responses
Dissociative compartmentalization as a complication in memory processing
Loss of a sense of time and place due to fragmentation
Re-thinking the role of witnessing client’s traumatic experiences
Discuss indications and best practices for processing traumatic memories in this population

Session IV: Working with Regression, Aggression and Passivity

Traumatic attachment and animal defenses
The “controlling strategies” in individuals with disorganized attachment
Regression and aggression as controlling strategies driven by trauma-related parts
Working with regressive states and child parts
Aggression in therapy: devaluing and self-destructive behavior
Working with verbally abusive and devaluing parts
Depressive states as an adaptation to trauma
Interventions for addressing chronic depressive states

Session V: Traumatic Transference in the Treatment of Dissociative Disorders

Stimulation of the attachment system in therapeutic relationships
Effects of traumatic/disorganized attachment on the transference
Why some clients become more dysregulated rather than less
Co-regulation and right brain-to right brain communication
How therapists can use contingent co-regulation in treatment
Internal attachment versus self-alienation
Using the social engagement system
Rupture and repair: visualization techniques for repairing childhood attachment failure

Session VI: Integration and Healing

‘Integration’ as the goal of dissociative disorders treatment
What does it mean to be “integrated”?
The evolution of treatment models for dissociative disorders
Identify interventions for increasing internal communication and cooperation among parts
Markers of progress in fragmented individuals
How should clients and therapists define “healing”?
Self-acceptance and compassion in the healing process
Best practices in trauma treatment

Target Audience

Psychologists
Counselors
Social Workers
Addiction Counselors
Case Managers
Marriage & Family Therapists
Nurses
Psychotherapists
Other Mental Health Professionals

Bonus: Trauma Defined: Bessel van der Kolk on The Body Keeps the Score

Program Information

Target Audience

Addiction Counselors, Counselors, Marriage and Family Therapists, Nurses, Psychologists, Social Workers and other Mental Health Professionals

Outline

The Latest Clinical Research Surrounding:

The impact of trauma on brain activity
Neurofeedback, EMDR and “body work” on symptom reduction
The effectiveness of movement, mindfulness and theater activities in trauma treatment

Objectives

Evaluate how trauma influences the activity of the key areas of the brain and how that dictates behavior patterns in clients.
Articulate the clinical research surrounding the effectiveness of yoga, mindfulness meditation, and theater in healing trauma in clients.

Bonus: Overcoming Trauma-Related Shame and Self-Loathing with Janina Fisher, Ph.D.

Program Information

Target Audience

Psychologists, Counselors, Social Workers, Case Managers, Addiction Counselors, Marriage & Family Therapists, Nurses, and other Mental Health Professionals

Objectives

Discriminate the clinical implications of physiological and cognitive contributors to shame.
Determine cognitive-behavioral, ego state, and psychoeducational interventions to address shame in clients.

Outline

The Neurobiology of Shame

The role of shame in traumatic experience
Shame as an animal defense survival response
Effects of shame on autonomic arousal

Shame’s Evolutionary Purpose

Shame and the attachment system
Rupture and repair in attachment formation

Making Meaning of Shame

Feelings of disgust, degradation, and humiliation are interpreted as “who I am”
Cognition and the body
Internal working models predict the future and determine our actions

Working from the “Bottom Up”

The role of procedural learning and memory
Physiological effects of mindful dual awareness
Using mindfulness-based techniques to inhibit self-judgment

A New Relationship to the Shame: Acceptance and Compassion

Re-contextualizing shame as a younger self or part
Bringing our adult capacity to our childhood vulnerability
Healing shame through compassionate acceptance

The Social Engagement System and the Healing of Shame

Social engagement and the ventral vagal system (Porges)
The incompatibility of shame and social engagement
The therapist’s own social engagement system as a healing agent