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Complex-Trauma
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Complex Trauma and Structural Dissociation
Complex Trauma and Structural Dissociation

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Important message:
Ill and hospitalized
28 februari 2015

#cannouncement   #dissociation   #PTSD #NiqueDisja
www.complex-trauma.nl

I'm so sorry to tell you all.....

I'm not gone, but I'm in the hospital for somatic problems and it probably will take a week or 5 until I'm out of here.

I would be very grateful if some of you will keep it going here until I'm back. But please 'no Ads, or promotions for own provider practices.

greetings and much love and health to you all
Nique

Keep it informative 
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PSYCHOPHYSIOLOGICAL CHARACTERISTICS OF PEDIATRIC POSTTRAUMATIC STRESS DISORDER DURING SCRIPT-DRIVEN TRAUMATIC IMAGERY
Published: 5 February 2015

DISCUSSION
This study investigated self-reported anxiety and psychophysiological functioning of children and adolescents with a trauma history during exposure to an idiosyncratic trauma script. We found significant differences between children and adolescents with and without PTSD in self-reported anxiety and in the script contrast of the facial EMG, but not in the autonomic psychophysiological responding during the trauma script experiment. Thus, our expectation that children and adolescents with PTSD would show specific baseline levels or a characteristic psychophysiological reactivity to trauma reminders could not be confirmed, with the exception of facial EMG. During the experiment, study participants with PTSD reported more anxiety already at baseline, that is, without exposure to their trauma script, compared to traumatized children and adolescents without PTSD. As expected, children and adolescents with PTSD then reacted to their trauma script with greater anxiety than their non-PTSD counterparts, evident in both reactivity and script contrast measures.

Concerning psychophysiological variables, we found higher script contrast of the activity of the corrugator supercilii muscle in children and adolescents with PTSD compared to controls without PTSD. The muscle is involved in frowning and is regarded as the principal muscle in the facial expression of unpleasant affects, varying as a function of intensity and sociality of emotional stimuli. It is also interpreted as an indicator of emotional information processing (Wilhelm, Schneider, & Friedman, 2006; Tassinary & Cacioppo, 1992). It corresponds to the diagnostic criterion of emotional burden at exposure to trauma reminders (American Psychiatric Association, 2000) and mirrors the intersection between overt behavior and psychophysiological reactions. Corrugator supercilii EMG has previously been described as specific to adults with PTSD during exposure with idiosyncratic trauma reminders (Pole, 2007). Our study groups did not differ in EMG reactivity to the trauma script referenced to baseline. This indicates that the direct script contrast (trauma script referenced to neutral script) is more sensitive for detecting characteristic facial affective response to the trauma script as it controls for individual differences in facial EMG reactivity when listening to a story and producing mental imagery.

In contrast to results from adults, no psychophysiological group differences were found in HR, RSA, SCL and NSF, although study groups differed considerably both in diagnosis and the amount of PTSD symptoms. HR is considered to be a particularly strong putative peripheral marker for anxiety (Wilhelm & Orr, 1998), but PTSD was not associated with HR in our study group, or in previous studies with pediatric populations. Thus, higher HR at exposure seems to be specific to adults, but not to children or adolescents with PTSD. It is not associated with current symptoms but with individual trauma history (Kirsch, Wilhelm, & Goldbeck, 2011; Buckley & Kaloupek, 2001). RSA is often interpreted as an index of affect regulation capacity therefore suggesting a strong relation with PTSD (Wilhelm, Schneider, & Friedman, 2006). In contrast to this suggestion, and consistent with a study of Scheeringa et al. (2004), our study did not find differences in RSA dependent on PTSD, either at baseline or in response to trauma reminders.

Developmental and clinical differences might contribute to the obvious discordance between marked psychophysiological alterations in adult patients with PTSD and absent or only low psychophysiological reactions in children and adolescents with PTSD. Age-dependent characteristics, such as a higher resting HR and less sympathetic reactivity in children and adolescents compared to adults may cause divergent findings of autonomic reactions (Quigley & Stifter, 2006). Another explanation might be that the severity of psychophysiological alterations may depend on trauma history, for example, amount and diversity of experienced trauma types, amount of symptoms, or duration of PTSD (D’Andrea et al., 2013; Langeland & Olff, 2008). Possibly, psychophysiological alterations show differential patterns according to time since trauma and trauma history. The experimental setting of having the psychologist nearby the children and adolescents during the investigation might be another explanation for low psychophysiological reactions, as studies found that the presence of another human decreased the perceived threat (Coan, Schaefer, & Davidson, 2006).

Although little is known about response coherence between different emotional systems, results of recent studies suggest a certain concordance between physiology and experience, affected by some parameters like age of the study population, amount and valence of elicited emotion (Lench, Flores, & Bench, 2011; Mauss, Levenson, McCarter, Wilhelm, & Gross, 2005). The obvious discordance between increased self-reported anxiety and mostly absent physiological reactivity in our study group may therefore be explained by the mentioned parameters. Another interesting explanation is suggested by findings of subgroups in adult PTSD, reporting subjective distress without any observable psychophysiological responses (Pineles et al., 2013). This is worth of further investigations as there may exist groups with different needs in psychotherapy.

There are some limitations to the interpretation of our results: We powered the study for large effect sizes, as reported in adult studies. Therefore, the sample size was small and statistical power was not sufficient to detect small or moderate effects. Effect sizes suggest that there may be a rather weak or moderate association between psychophysiological parameters and PTSD. The variability of trauma types or time since trauma was large. Moreover, a control group without a history of traumatic events was not included, although in previous trauma script studies, the most significant differences were reported for comparisons of children and adolescents with vs. without a trauma history, regardless of PTSD. Therefore, we cannot answer the question whether just experiencing a traumatic event might explain the variance in psychophysiological reactions, instead of developing PTSD.

CONCLUSIONS
Our finding of a more negative emotional reaction to idiosyncratic trauma script exposure indicated by a higher script contrast of the facial EMG should be further evaluated in longitudinal studies with a larger sample. The assessment of facial EMG is a non-invasive method, which is easy to realize, even during a treatment session (Wilhelm & Grossman, 2010). Future studies should utilize larger samples to allow for subgroup analyses regarding the effects of trauma type, sex or age groups on psychophysiology, as there remain open questions regarding the relationship of psychophysiological alterations and diagnostic criteria in pediatric PTSD.

http://www.ejpt.net/index.php/ejpt/article/view/25471/pdf_10


re-shared by Nique
www.complex-trauma.eu
#dissociatie #complex_trauma  #CPTSD  #CPTSS  #GGz  #Dissociation  #PTSD  #PTSS  #celevt  #TRTC, #structural_dissociation #structurele_dissociatie #dissociatieve_identiteitsstoornis #DIS #DID #dissociative_identity_disorder #post_traumatic_stress_disorder #complex-trauma.eu
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PSYCHOPHYSIOLOGICAL CHARACTERISTICS OF PEDIATRIC POSTTRAUMATIC STRESS DISORDER DURING SCRIPT-DRIVEN TRAUMATIC IMAGERY
Published: 5 February 2015

DISCUSSION
This study investigated self-reported anxiety and psychophysiological functioning of children and adolescents with a trauma history during exposure to an idiosyncratic trauma script. We found significant differences between children and adolescents with and without PTSD in self-reported anxiety and in the script contrast of the facial EMG, but not in the autonomic psychophysiological responding during the trauma script experiment. Thus, our expectation that children and adolescents with PTSD would show specific baseline levels or a characteristic psychophysiological reactivity to trauma reminders could not be confirmed, with the exception of facial EMG. During the experiment, study participants with PTSD reported more anxiety already at baseline, that is, without exposure to their trauma script, compared to traumatized children and adolescents without PTSD. As expected, children and adolescents with PTSD then reacted to their trauma script with greater anxiety than their non-PTSD counterparts, evident in both reactivity and script contrast measures.

Concerning psychophysiological variables, we found higher script contrast of the activity of the corrugator supercilii muscle in children and adolescents with PTSD compared to controls without PTSD. The muscle is involved in frowning and is regarded as the principal muscle in the facial expression of unpleasant affects, varying as a function of intensity and sociality of emotional stimuli. It is also interpreted as an indicator of emotional information processing (Wilhelm, Schneider, & Friedman, 2006; Tassinary & Cacioppo, 1992). It corresponds to the diagnostic criterion of emotional burden at exposure to trauma reminders (American Psychiatric Association, 2000) and mirrors the intersection between overt behavior and psychophysiological reactions. Corrugator supercilii EMG has previously been described as specific to adults with PTSD during exposure with idiosyncratic trauma reminders (Pole, 2007). Our study groups did not differ in EMG reactivity to the trauma script referenced to baseline. This indicates that the direct script contrast (trauma script referenced to neutral script) is more sensitive for detecting characteristic facial affective response to the trauma script as it controls for individual differences in facial EMG reactivity when listening to a story and producing mental imagery.

In contrast to results from adults, no psychophysiological group differences were found in HR, RSA, SCL and NSF, although study groups differed considerably both in diagnosis and the amount of PTSD symptoms. HR is considered to be a particularly strong putative peripheral marker for anxiety (Wilhelm & Orr, 1998), but PTSD was not associated with HR in our study group, or in previous studies with pediatric populations. Thus, higher HR at exposure seems to be specific to adults, but not to children or adolescents with PTSD. It is not associated with current symptoms but with individual trauma history (Kirsch, Wilhelm, & Goldbeck, 2011; Buckley & Kaloupek, 2001). RSA is often interpreted as an index of affect regulation capacity therefore suggesting a strong relation with PTSD (Wilhelm, Schneider, & Friedman, 2006). In contrast to this suggestion, and consistent with a study of Scheeringa et al. (2004), our study did not find differences in RSA dependent on PTSD, either at baseline or in response to trauma reminders.

Developmental and clinical differences might contribute to the obvious discordance between marked psychophysiological alterations in adult patients with PTSD and absent or only low psychophysiological reactions in children and adolescents with PTSD. Age-dependent characteristics, such as a higher resting HR and less sympathetic reactivity in children and adolescents compared to adults may cause divergent findings of autonomic reactions (Quigley & Stifter, 2006). Another explanation might be that the severity of psychophysiological alterations may depend on trauma history, for example, amount and diversity of experienced trauma types, amount of symptoms, or duration of PTSD (D’Andrea et al., 2013; Langeland & Olff, 2008). Possibly, psychophysiological alterations show differential patterns according to time since trauma and trauma history. The experimental setting of having the psychologist nearby the children and adolescents during the investigation might be another explanation for low psychophysiological reactions, as studies found that the presence of another human decreased the perceived threat (Coan, Schaefer, & Davidson, 2006).

Although little is known about response coherence between different emotional systems, results of recent studies suggest a certain concordance between physiology and experience, affected by some parameters like age of the study population, amount and valence of elicited emotion (Lench, Flores, & Bench, 2011; Mauss, Levenson, McCarter, Wilhelm, & Gross, 2005). The obvious discordance between increased self-reported anxiety and mostly absent physiological reactivity in our study group may therefore be explained by the mentioned parameters. Another interesting explanation is suggested by findings of subgroups in adult PTSD, reporting subjective distress without any observable psychophysiological responses (Pineles et al., 2013). This is worth of further investigations as there may exist groups with different needs in psychotherapy.

There are some limitations to the interpretation of our results: We powered the study for large effect sizes, as reported in adult studies. Therefore, the sample size was small and statistical power was not sufficient to detect small or moderate effects. Effect sizes suggest that there may be a rather weak or moderate association between psychophysiological parameters and PTSD. The variability of trauma types or time since trauma was large. Moreover, a control group without a history of traumatic events was not included, although in previous trauma script studies, the most significant differences were reported for comparisons of children and adolescents with vs. without a trauma history, regardless of PTSD. Therefore, we cannot answer the question whether just experiencing a traumatic event might explain the variance in psychophysiological reactions, instead of developing PTSD.

CONCLUSIONS
Our finding of a more negative emotional reaction to idiosyncratic trauma script exposure indicated by a higher script contrast of the facial EMG should be further evaluated in longitudinal studies with a larger sample. The assessment of facial EMG is a non-invasive method, which is easy to realize, even during a treatment session (Wilhelm & Grossman, 2010). Future studies should utilize larger samples to allow for subgroup analyses regarding the effects of trauma type, sex or age groups on psychophysiology, as there remain open questions regarding the relationship of psychophysiological alterations and diagnostic criteria in pediatric PTSD.

http://www.ejpt.net/index.php/ejpt/article/view/25471/pdf_10


re-shared by Nique
www.complex-trauma.eu
#dissociatie #complex_trauma  #CPTSD  #CPTSS  #GGz  #Dissociation  #PTSD  #PTSS  #celevt  #TRTC, #structural_dissociation #structurele_dissociatie #dissociatieve_identiteitsstoornis #DIS #DID #dissociative_identity_disorder #post_traumatic_stress_disorder #complex-trauma.eu
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re-shared by Nique, www.complex-trauma.eu & dissociatie.wordpress.com 
SHAME ON U.S.
January 2015
Failings by All Three Branches of Our Federal Government
LEAVE ABUSED AND NEGLECTED CHILDREN VULNERABLE TO FURTHER HARM

The Scope and Impact of Abuse and Neglect on the Child Victims
During 2012, at least 686,000 American children were the victims of maltreatment (abuse or neglect).
1 A conservative estimate of the number of those children who were killed that year by abuse or neglect is 1,6402 meaning that abuse or neglect leads to the death of at least 4–5 children every day in the U.S. Sadly, the real numbers of both child abuse/neglect victims and fatalities are much higher, due in part to unreported abuse. 3 According to the U.S. Department of Health and Human Services (HHS), “abuse and neglect can have consequences for children, families, and society that last lifetimes, if not generations.”4 Such long-term consequences may be 
• physical (e.g., impaired brain development, poor physical health);
• psychological (e.g., low self-esteem, depression, anxiety, relationship difficulties);
• behavioral (e.g., juvenile delinquency, adult criminality, teen pregnancy, low academic achievement, alcohol and drug use, mental health problems, abusive behavior); and
• societal (e.g., direct costs associated with maintaining a child welfare system to investigate and respond to allegations of child abuse and neglect, as well as expenditures by the judicial, law enforcement, health, and mental health systems, and indirect costs associated with juvenile and adult criminal activity, mental illness, substance abuse, domestic violence, loss of productivity due to unemployment and underemployment, the cost of special education services, and increased use of the health care system).5 During 2012, states served about 638,000 foster children, including 252,000 abused or neglected children who entered into the foster care system that year.6 In order to serve those children, state courts became their legal parents, assuming the authority to determine where they should live, where they will attend school, who they may see, and countless other details of their lives. This extraordinary governmental intervention into family affairs is intended not to punish parents or other caretakers — but to protect children from abuse and neglect, and to temper negative consequences.
End quote..//

CHILDHOOD TRAUMA LEADS TO BRAINS WIRED FOR FEAR
Last week, a report by the University of San Diego School of Law found that about 686,000 children were victims of abuse and neglect in 2013. Traumatic childhood events can lead to mental health and behavioral problems later in life, explains psychiatrist and traumatic stress expert Bessel van der Kolk, author of the recently published book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Children’s brains are literally shaped by traumatic experiences, which can lead to problems with anger, addiction, and even criminal activity in adulthood, says van der Kolk. Sound Medicine’s Barbara Lewis spoke with him about his book. 
src: http://soundmedicine.org/post/childhood-trauma-leads-brains-wired-fear


quote//..
Shame on U.S., a report by the Children’s Advocacy Institute of the University of San Diego School of Law, in collaboration with First Star, discusses how the federal government is failing to properly enact, monitor, interpret, and enforce federal child welfare laws — and in so doing is allowing states to fall below minimum floors with regard to appropriately detecting and protecting children from child abuse and neglect and complying with minimum federal child welfare requirements and outcomes.   
Each branch of our federal government plays an integral role in the child welfare system, and when even one fails to perform its role in an appropriate manner, children are put at risk of harm.  Because all three branches must be performing optimally to ensure a well-functioning child welfare system, this report discusses the performance of each branch in this arena.  Specifically, the report:
• provides an overview of the scope and purpose of major child welfare laws as enacted by Congress, and to what extent current laws meet the needs of children;
• examines how the judicial branch has interpreted those laws;
• discusses to what extent the executive branch implements and enforces those laws;
• comments on the potential efficacy of each branch’s scope and reach;
• provides examples of shortcomings in all three branches with regard to their respective roles vis-à-vis the child welfare system;
• discusses issues where the purpose or intent of child welfare laws are being openly violated by some states;
• calls for more robust activity from all three branches — and particularly enforcement by the executive branch charged with enforcing Congressional intent and, when necessary, withholding federal funding or imposing penalties where states are clearly not meeting minimum standards; and
• makes several recommendations for all three branches of federal government, all of which are necessary in order to ensure a well-functioning child welfare system.
..//End quote
src:
http://www.caichildlaw.org/Shame_on_US.htm


Full rapport 
http://www.caichildlaw.org/Misc/Shame%20on%20U.S._FINAL.pdf



shared by Nique
www.complex-trauma.eu
#complex_trauma  #CPTSD  #CPTSS  #GGz  #Dissociation  #PTSD  #PTSS  #celevt  #TRTC, #dissociatie #structural_dissociation #structurele_dissociatie #dissociatieve_identiteitsstoornis #DIS #DID #dissociative_identity_disorder #post_traumatic_stress_disorder #complex-trauma.eu
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re-shared by Nique, www.complex-trauma.eu & dissociatie.wordpress.com 
SHAME ON U.S.
January 2015
Failings by All Three Branches of Our Federal Government
LEAVE ABUSED AND NEGLECTED CHILDREN VULNERABLE TO FURTHER HARM

The Scope and Impact of Abuse and Neglect on the Child Victims
During 2012, at least 686,000 American children were the victims of maltreatment (abuse or neglect).
1 A conservative estimate of the number of those children who were killed that year by abuse or neglect is 1,6402 meaning that abuse or neglect leads to the death of at least 4–5 children every day in the U.S. Sadly, the real numbers of both child abuse/neglect victims and fatalities are much higher, due in part to unreported abuse. 3 According to the U.S. Department of Health and Human Services (HHS), “abuse and neglect can have consequences for children, families, and society that last lifetimes, if not generations.”4 Such long-term consequences may be 
• physical (e.g., impaired brain development, poor physical health);
• psychological (e.g., low self-esteem, depression, anxiety, relationship difficulties);
• behavioral (e.g., juvenile delinquency, adult criminality, teen pregnancy, low academic achievement, alcohol and drug use, mental health problems, abusive behavior); and
• societal (e.g., direct costs associated with maintaining a child welfare system to investigate and respond to allegations of child abuse and neglect, as well as expenditures by the judicial, law enforcement, health, and mental health systems, and indirect costs associated with juvenile and adult criminal activity, mental illness, substance abuse, domestic violence, loss of productivity due to unemployment and underemployment, the cost of special education services, and increased use of the health care system).5 During 2012, states served about 638,000 foster children, including 252,000 abused or neglected children who entered into the foster care system that year.6 In order to serve those children, state courts became their legal parents, assuming the authority to determine where they should live, where they will attend school, who they may see, and countless other details of their lives. This extraordinary governmental intervention into family affairs is intended not to punish parents or other caretakers — but to protect children from abuse and neglect, and to temper negative consequences.
End quote..//

CHILDHOOD TRAUMA LEADS TO BRAINS WIRED FOR FEAR
Last week, a report by the University of San Diego School of Law found that about 686,000 children were victims of abuse and neglect in 2013. Traumatic childhood events can lead to mental health and behavioral problems later in life, explains psychiatrist and traumatic stress expert Bessel van der Kolk, author of the recently published book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Children’s brains are literally shaped by traumatic experiences, which can lead to problems with anger, addiction, and even criminal activity in adulthood, says van der Kolk. Sound Medicine’s Barbara Lewis spoke with him about his book. 
src: http://soundmedicine.org/post/childhood-trauma-leads-brains-wired-fear


quote//..
Shame on U.S., a report by the Children’s Advocacy Institute of the University of San Diego School of Law, in collaboration with First Star, discusses how the federal government is failing to properly enact, monitor, interpret, and enforce federal child welfare laws — and in so doing is allowing states to fall below minimum floors with regard to appropriately detecting and protecting children from child abuse and neglect and complying with minimum federal child welfare requirements and outcomes.   
Each branch of our federal government plays an integral role in the child welfare system, and when even one fails to perform its role in an appropriate manner, children are put at risk of harm.  Because all three branches must be performing optimally to ensure a well-functioning child welfare system, this report discusses the performance of each branch in this arena.  Specifically, the report:
• provides an overview of the scope and purpose of major child welfare laws as enacted by Congress, and to what extent current laws meet the needs of children;
• examines how the judicial branch has interpreted those laws;
• discusses to what extent the executive branch implements and enforces those laws;
• comments on the potential efficacy of each branch’s scope and reach;
• provides examples of shortcomings in all three branches with regard to their respective roles vis-à-vis the child welfare system;
• discusses issues where the purpose or intent of child welfare laws are being openly violated by some states;
• calls for more robust activity from all three branches — and particularly enforcement by the executive branch charged with enforcing Congressional intent and, when necessary, withholding federal funding or imposing penalties where states are clearly not meeting minimum standards; and
• makes several recommendations for all three branches of federal government, all of which are necessary in order to ensure a well-functioning child welfare system.
..//End quote
src:
http://www.caichildlaw.org/Shame_on_US.htm


Full rapport 
http://www.caichildlaw.org/Misc/Shame%20on%20U.S._FINAL.pdf



shared by Nique
www.complex-trauma.eu
#complex_trauma  #CPTSD  #CPTSS  #GGz  #Dissociation  #PTSD  #PTSS  #celevt  #TRTC, #dissociatie #structural_dissociation #structurele_dissociatie #dissociatieve_identiteitsstoornis #DIS #DID #dissociative_identity_disorder #post_traumatic_stress_disorder #complex-trauma.eu
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210515 TRTC, The Self behind the Self

INTERNATIONAL CONFERENCE GGz Drenthe TRTC the Netherlands The Self behind the Self Thursday May 21th, 2015 The conference is held to honour and thank dr. Ellert Nijenhuis for his outstanding work as a psychotherapist and researcher of trauma-related…
210515 TRTC, The Self behind the Self
210515 TRTC, The Self behind the Self
dissociatie.wordpress.com

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Interdisciplinair symposium De weg naar heelwording: gidsen in het landschap van trauma, dissociatie en zingeving Vrijdag, 27-02-2015 Aanvang: 10:00 u  Eindtijd 17:00 u Conferentiecentrum Mennorode, Elspeet – www.mennorode.nl Hoofdsprekers zijn: dr. Onno…
De Weg naar Heelwording 170215
De Weg naar Heelwording 170215
dissociatie.wordpress.com

Post has attachment
Psychologically-Trauma & Dissociation The ANP  and EP   handling-system Literally Trauma means ‘injury’ An event causes Injury Injury causes pain Pain causes physically and psychologically suffering Psychologically suffering can cause…

Post has attachment
INTERNATIONAL CONFERENCE  INTERNATIONAL CONFERENCE GGzDrenthe TRTC the Netherlands The Self behind the Self Thursday May 21th, 2015 Theatre Odeon, Zwolle, The Netherlands The conference is held to honour and thank dr. Ellert Nijenhuis for his outstanding…
The Self behind the Self 210515
The Self behind the Self 210515
dissociatie.wordpress.com

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Nique TRTC | The Self behind the Self
www.complex-trauma.eu
#ellert_nijenhuis   #dissociatie   #Topreferent_trauma_centrum   #conference   #GGz   #Dissociation   #psychological_trauma   #TRTC #complex_trauma   #complexe_PTSD   #complexe_PTSS    

INTERNATIONAL CONFERENCE GGzDrenthe TRTC the Netherlands
Summary speakers The Self behind the Self
Thursday May 21th, 2015
Theatre Odeon, Zwolle, The Netherlands

The conference is held to honour and thank dr. Ellert Nijenhuis for his outstanding work as a psychotherapist and researcher of trauma-related mental disorders during the past three decades at our hospital.

Speakers:

Andrew Moskowitz
Could schizophrenia be a dissociative disorder? Three historical enigmas (and one contemporary one)
From the time the concept of schizophrenia was first proposed by EugenBleuler in 1908, there have been numerous surprising links to dissociation. Bleuler’s term schizophrenia is strongly linked to dissociation not only in name and definition, but also in the related concepts of splitting and complexes. Kurt Schneider’s 1st rank symptoms of schizophrenia, particularly various forms of voice hearing, were heavily weighted in all major diagnostic systems for the past 1/3 of a century, despite evidence for their frequency in Dissociative Identity Disorder. And Gregory Bateson’s long disparaged double bind theory of the etiology of schizophrenia
shows striking similarities to new conceptions of disorganized attachment, which are linked to the development of dissociation. Finally, studies of voice hearing over the past several decades show robust correlations with measures of dissociation, in a wide range of clinical and non-clinical populations. Are all of these connections simply coincidences? Or do they suggest that schizophrenia could possibly represent some variant of a dissociative disorder?

Bio
Andrew Moskowitz, Ph.D., is Professor of Clinical Psychology at Aarhus University in Denmark, and head of the Attachment, Dissociation and Traumatic Stress (ADiTS) research unit. He has published widely on historical, theoretical and empirical connections between psychological trauma, dissociation and schizophrenia, and is the lead editor of the influential book, 'Psychosis, trauma and dissociation: Emerging perspectives on severe psychopathology' (Wiley, 2008), which is going into its 2nd edition. He is on the executive board of both the European Society for Trauma and Dissociation (ESTD) and the International Society for Psychological and Social Approaches to the Psychoses (ISPS).

Onno van der Hart
Dissociative psychosis implies a division of the personality amendable by psychotherapy
Although Dissociative Psychosis (DP) is not not currently recognized as a formal diagnostic category or syndrome, specialists in the field of trauma-related dissociation have argued that doing so has great clinical value. Originally called hysterical psychosis, this syndrome has been documented in a number of traumatized patients with diagnoses ranging from posttraumatic stress disorder to dissociative identity disorder (DID). From the perspective of the theory of structural dissociation of the personality it has been proposed that for a psychotic disorder or episode to be recognized as DP, it should be embedded in a dissociation of the personality, and, by definition, dissociative symptoms should be present. Psychotic symptoms are dissociative in nature when they pertain to goal-directed actions or other important features of one or more emotional parts of the personality that the patient as apparently normal part of the personality can, therefore, not control. In this presentation the dissociative nature of DP will be described, as well as its various forms and ways of resolving the psychosis using psychotherapy (often including elements of hypnosis).

Bio
Onno van der Hart, PhD, is emeritus professor of psychopathology of chronic traumatization, Utrecht University. He has a small psychotherapy practice in Amstelveen, the Netherlands, and he is involved in consultation, teaching and research in the area of diagnostics and treatment of patients with complex trauma-related disorders, including the dissociative disorders. With Ellert Nijenhuis and Kathy Steele, he wrote The haunted self: Structural dissociation and the treatment of chronic traumatization. New York/London: Norton, 2006. With Suzette Boon and Kathy Steele, he wrote Coping with trauma-related dissociation: Skills training for patients and therapists. New York/London: Norton, 2011. His website is:www.onnovdhart.nl

Colin A. Ross
Catatonia, autism, dissociation, and cross-cultural syndromes
In this talk, Dr. Ross will describe the overlap and similarities between catatonia, autism, dissociation, and cross-cultural syndromes. The DSM-5 criteria cannot differentiate some cases of childhood-onset schizophrenia, with predominant negative and catatonic symptoms from autism. Dr. Ross hypothesizes that there may be a subgroup of autism cases which represent a trauma-freeze response, just as is true for catatonia. Additionally many crosscultural syndromes are widely regarded as being dissociative in nature, but include an array of catatonic symptoms; Dr. Ross will present evidence that “cross-cultural syndromes” can be observed in Caucasian, English-speaking American patients with dissociative disorders, and that catatonic symptoms are very common in this population. Thus, there is more overlap between these symptom categories that is commonly appreciated. The relationship between trauma, dissociation and catatonia will be illustrated through case examples from the nineteenth century Salpetriere hospital, plus a current case example.

Bio
Colin A. Ross received his M.D. from the University of Alberta in 1981 and completed his psychiatry training at the University of Manitoba in 1985. He has been running a Trauma Program in Dallas, Texas since 1991 and consults to two other Trauma Programs in Michigan and California. He is the author of 27 books and 180 professional papers and is a Past President of the International Society for the Study of Trauma and Dissociation.

Yolanda Schlumpf
Neurobiological findings in dissociative identity disorder
In accordance with the Theory of tructural Dissociation of the Personality (TSDP), dissociative identity disorder (DID) is a severe form of posttraumatic stress disorder and encompasses different dissociative subsystems of the personality.
A primary classification is the “Emotional Part” (EP) and the “Apparently Normal Part” (ANP). Tw of MRI studies and an eye-tracking study, in which DID patients were measured as ANP and EP, will be presented. The studies demonstrate that EP and ANP have different biopsychosocial reactions to supra liminally und subliminally trauma-related cues (i.e., facial stimuli). In line with TSDP, as EP but not as ANP, patients emotionally engaged in these stimuli and were hypervigilant. Furthermore, the perfusion pattern in a task-free condition (i.e., resting-state) was also dependent on the dissociative part which was dominant during theme asurement. The reactions of genuine DID patients could not be mimicked by actors. The findings contradict the view that DID phenomena involve suggestion, fantasy proneness, and role-playing.

Ellert R.S. Nijenhuis
Enactive trauma therapy:
Laying down a path in walking together Trauma, dissociation, psychosis: third-person concepts crafted to capture and grasp perplexing first-person phenomena. Technical tools to physically judge "objects of investigation", they cannottell“what it is like” to be traumatized, to dissociate, or be psychotic.
That understanding takes a first-person perspective, an “I” who has and phenomenally judges his or her experience. Grounded in this basic insight, enactive trauma therapyis the collaboration of two intrinsically embrained, embodied, and environmentally embeddedliving systems to create new actions and new meaning. One system is the injured individual who engages a first-person perspective (a phenomenal “I”) and second-person perspective (a phenomenal “I-You” relationship). The other system is the therapist who encompasses and ideally integrates his or her first-person, second-person (empathic phenomenal judgment grounded in an “I-You” relationship), and third-person perspective. This dance of two lifeworlds takes attunement, resonance, timing, sensitivity to balance, movement and rhythm, as well as dedication and courage to follow and lead.

Bio
Ellert R.S. Nijenhuis, Ph.D., is a psychologist, psychotherapist, and researcher. He engaged in the diagnosis and treatment of severely traumatized patients for more than three decades, and now teaches and writes extensively on the themes of trauma-related dissociation and dissociative disorders. He is a research consultant at ClieniaLittenheid, Switzerland, and is co-director of Psychotraumatology Institute Europe, Duisburg, Germany. His publications include the book Somatoform Dissociation. With Onno van der Hart and Kathy Steele he coauthored the book The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. The first two volumes of the trilogy The Trinity of Trauma: Ignorance, Fragility and Control will be released in the spring of 2015. 

Program
https://www.ggzdrenthe.nl/wp-content/uploads/Program.pdf

Hotels
https://www.ggzdrenthe.nl/wp-content/uploads/Hotels.pdf

To register for the symposium
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Main info page
https://www.ggzdrenthe.nl/selfbehindtheself/

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#PTSD   #PTSS   #celevt   #structural_dissociation #structurele_dissociatie #dissociatieve_identiteitsstoornis #DIS #DID #dissociative_identity_disorder #post_traumatic_stress_disorder #Ellert_Nijenhuis #Colin_Ross   #Andrew_Moskowitz #Yolanda_Schlumpf  #Onno_van_der_Hart  #complex -trauma_eu
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