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CPD Credits
Event Type
Live Online Event
Zoom & Recording for 365 days
10:00 am - 1:00 pm
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Friday, June 14, 2024

Working with Dissociative Clients

Clinical Insights from Valerie Sinason

With Valerie Sinason

Working with dissociation is complex, and an area that requires a trauma-informed approach. In this comprehensive live webinar, Valeria Sinason will help us to grapple with difficult but fundamental questions including ‘what is trauma in the first place?’, ‘how do we respond to it?’ and ‘why do we dissociate?’ to increase confidence in working with dissociative, traumatised states therapeutically.

In many cases, dissociation can be a natural response to help us navigate the stresses of daily life, when it does not feel safe to be fully present. For example, we might ‘zone out’ when we are bombarded with devastating news stories on social media. Or we might ‘compartmentalise’ when we are faced with the disappointment of a rejection. But dissociation is also a response to trauma, neglect and abuse, which may often start in childhood and results in neurological changes in the brain. In many cases, it can take on more severe forms, such as depersonalisation and derealisation. In cases of Dissociative Identity Disorder (DID), people can experience fragmented ego states. Research demonstrates a person’s attachment patterns can impact the severity of the dissociative states they experience.

Overall, we can think of dissociative states as a set of related mental phenomena. Understanding the mechanisms of those affected by major states of dissociation, such as DID, can inform us about less severe states of dissociation, and vice versa. While dissociation is an adaptation to protect us in traumatic circumstances, it becomes problematic when it continues to be used after the experience of ‘trauma’ has ended, and a person becomes stuck in a dissociative state.

So how do we build therapeutic relationships that can empower clients to revisit their unbearable experiences in a way that is tolerable, and help them to exist more in the ‘present’, without risk of re-experiencing trauma or re-entering severe dissociative states? Valerie will share her wealth of experience and expertise in traumatology, including case examples, to provide strategies and ideas for working with dissociation effectively and compassionately in practice. There will be time for questions and discussion after each session.


10.00 (UK) Introductions and Zoom Housekeeping
10.10 Understanding Dissociation

Dissociation is a coping mechanism that disconnects one's thoughts, identity, or consciousness from their surroundings, emotions, or memories. It's particularly relevant to trauma, where it can serve as a defence against overwhelming experiences. Derealization, a subtype of dissociation, warps an individual's perception of reality, making the world seem unreal or distorted. Amnesia between personality states, a defining feature of quaternary structural dissociation, involves distinct self-states with fragmented memories. Primary structural dissociation separates the core self from trauma-related parts, while secondary structural dissociation divides trauma fragments from non-traumatic experiences. Understanding these nuances in dissociation is crucial for clinicians in providing effective treatment for those grappling with the complex aftermath of trauma.

11.00 Break
11.15 Unpacking Dissociative Mechanisms 

In this session, Valerie will share some case material to reveal the impact of dissociative defence mechanisms in coping with trauma. Understanding why these mechanisms develop varies from genetics to environmental stressors. It often stems from the need to protect one's mental wellbeing when confronted with overwhelming experiences. Dissociation, although maladaptive in the long term, initially serves as a survival tool, allowing individuals to compartmentalize trauma. Unveiling these hidden defence mechanisms enables therapists to guide patients towards healthier coping strategies and healing.

11.45 Q&A
12.00 Break
12.15 Working with Therapeutic Challenges

Patient unfolding in therapy is vital, especially for clients with severe childhood trauma. Establishing and nurturing trust is fundamental, given their vulnerability. Addressing regression and ruptures in the therapeutic relationship is part of the process, demanding empathy and patience. Strategies involve creating a safe environment, clear communication, and adapting therapeutic approaches. Additionally, therapists must recognise and manage the emotional toll these cases may have on their own wellbeing, seeking support when necessary. Ultimately, navigating these intricacies with sensitivity and skill is key to helping survivors of childhood trauma on their path to healing and recovery.

12.45 Q&A
13.00 End