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ESTD Newsletter

Volume 2, issue 1, November 2011

EDITORIAL BOARD/ MARTIN DORAHY ONNO VAN DER HART ORIT BADOUK-EPSTEIN OLAF HOLMS DOLORES MOSQUERA ISABELLE SAILLOT VALERIE SINASON

EUROPEAN SOCIETY FOR TRAUMA AND DISSOCIATION 1STE HOGEWEGz 16-A, 3701 HK ZEIST THE NETHERLANDS EMAIL: INFO@ESTD.ORG WEBSITE: WWW.ESTD.ORG

ESTD NEWSLETTER
Editors: Martin Dorahy & Onno van der Hart

GRAPHIC DESIGN/ FRANK MYKLESTAD

Volume 2,

issue 1, November 2011

Table of contents
Letter From The President > Delegates Views From The ISSTDs Annual Conference > News From Romania By Anca Sabau > Film Review > Quandry Corner > Recent Articles And Books Of Interest > Dates For Your Diary In 2012 > Estd Contacts In Your Region >

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Table of contents >

ESTD Newsletter Volume 2, issue 1, November 2011

LETTER FROM THE PRESIDENT

Dear Colleagues and fellow members of ESTD. am writing this between 2 important events: One thats just passed, the ISSTDs Annual Conference in Montreal, and the other taking place in Paris in December, The First European Workshop supported by ESTD.
The Conference in Montreal was a delight. Their 28th! Representatives of your Board, Manoelle Hopchet, ESTD President Elect; Eli Somer, Immediate Past President, and myself got together over a working lunch with the ISSTDs Executive Board. This is the second year running that we have established this annual contact since ESTD and ISSTD agreed to go their separate ways in terms of joint membership. We have clearly a lot to offer each other and our meeting helped reinforce this. The areas of discussion included the following: The sale in the US of ESTDs new training DVD A Logical Way of Being produced by First Person Plural (A UK Survivor led organisation), with the participation of three clinicians. The potential use in Europe of ISSTDs updated Professionals Training Courses. The whole area of training in Europe is one of the tasks the ESTD Board will be looking at as a medium to long term project. To continue to encourage presenters at each others conferences. To continue to offer discounts at each others conferences. To establish more frequent dialogue through quarterly Conference Calls.

Rmy Aquarone
ESTD President

For those of you unfamiliar with the ISSTDs Annual Conferences, I thought it would be really helpful and refreshing to get the views of ESTD delegates there. So I have listed below those that kindly responded to my request. Some are from seasoned attendees, others first time visitors to such an event. The comments are varied and I believe represent a good cross section of views. Finally congratulations to those members of ESTD who were presented an award at the Conference. They are: First Person Plural: Audio Visual Award for their DVD A Logical Way of Being Suzette Boon and Onno van der Hart: Pierre Janet Award for their book: Coping with trauma-related dissociation I wish everyone a peaceful and enjoyable holiday season.

Remy Aquarone.
President, ESTD

ESTD Newsletter Volume 2, issue 1, November 2011

DELEGATES VIEWS FROM THE ISSTDS ANNUAL CONFERENCE

This was the first ISSTD conference either of us had
attended, and we will definitely be attending again next year. It was a remarkable experience, to be with clinicians from all over the world, who are all working with trauma, dissociation and DID. For once, there was no need to make the case that dissociative disorders including DID exist! Presenters brought a wealth of clinical and research experience in the field. It was inspiring to hear the extent of the data being collected at a research level, which will help us make the case for the treatment of trauma and DID, to funders and health care services. As attachment-based therapists, we were particularly encouraged by the centrality of attachment theory to so many of the clinical presentations, and by the clear understanding that a secure base and relational approach are essential to clinical work in this field. Attachment really was in the air! The warm, collegial atmosphere and opportunities for meeting, sharing and networking all added to making this an exceptional conference. This work can often be isolating, but this experience made it clear that all ISSTD and ESTD members are part of a vibrant, skilled and pioneering professional community.
Dr. Joseph Schwartz and Rachel Wingfield Schwartz

well organised, the conference did not feel very welcoming, in that the early start each day began with no introduction to the conference, or end with a thanks, or a summing up. The final day meandered to an end with no clear message from ISSTD regarding conclusions overall from the conference, or providing reasons why we as an audience should join ISSTD. Having been at Belfast in 2009, the feel of the ESTD conference there was more friendly and welcoming, with greater opportunities for getting to know what ESTD are doing in the field. I look forward to Berlin!
Mike Lloyd

I always like to attend the ISSTD conferences be-

Having just returned from the ISSTD conference in

Montreal I can reflect on what an interesting and educational experience it was. There was a vast range of presentations and workshops to choose from and a selection of plenary talks that looked at both current research into trauma and dissociation as well as political and media-orientated issues. As an audience, we were offered workshops, video presentations (including one from a survivor group), research updates, neuroscience findings, cross-cultural issues and topics covering the whole age spectrum. The Hilton Bonaventure Hotel provided beautiful rooms, clear signposting and helpful staff. While many talks were enlightening, the manner of presentation was not always spot-on, with many speakers choosing to deliver their talks from a pre-prepared script rather than talk freely to the audience. This was sometimes associated with inadequate time (if any, on occasion) for questions, so I and others could not explore topics off-script. While

cause I have made some good friends among regular attendees and many of the other faces have become familiar, so in many ways it is not unlike a large family encounter, where you do not get to have meaningful conversations with everyone, only with some, but the general sense is one of comfort and familiarity. It was clear, this year, that the hosts of this family gathering are hurting financially, because between-session snacks and drinks were very limited and so was the food provided during the Presidents Reception. It was reassuring to learn during the business meeting, that these and other measures have helped reverse the financial downward spiraling the ISSTD found itself in until very recently. One lesson learnt from this years attendance was related to the number of parallel sessions. The Montreal conference had about 440 attendees, but with so many parallel sessions, many new presenters (that are, therefore, not well known) and presenters of research, found themselves speaking to a very small audience. While the scientific committee is often reluctant to reject submissions by the stars of our profession, because they draw the registrants, we may have to balance that interest with the need to provide a positive conference experience for all presenters.
Eli Somer

The ISSTD 28th Annual Conference will always be

one of the highlights in my life. First Person Plurals training DVD

ESTD Newsletter Volume 2, issue 1, November 2011

28th isstd conference in was held in Montreal

A Logical Way Of Being received the Audio Visual Award. This recognition alongside many individual complimentary comments from people who I hold in high esteem made it a slightly surreal three days. We are now working together to get subtitles in French, Spanish, German and English on the DVD ready for the ESTD conference. Many people find it hard to understand that this has been a collaborative venture, led by First Person Plural, but involving the whole team who discussed every decision made. Surely a good role model. Healthy and integrated! At the conference it felt like a paradigm shift has taken place from talking about how the brain works to incorporating this alongside practical ways of enabling healing. I have found the development in understanding the neurological process fascinating but frustrating; how was this actually going to impact in the therapy room and at times a feeling of therapists hiding behind this scientific information and losing sight of the reality in the moment. The papers on Creative Therapy, PTSD during the Childbearing

Years and Couples and Family demonstrated how this is beginning to become an integrated process, benefitting all concerned. I think it feels appropriate for both the therapist and client if the neurological understanding is used as part of the psychoeducation during the first stage of the three stage model and then practically. The research and high level of academic presentations, along with the practical seem to be moving closer together. I suspect we have needed these years to arrive at this point where the hard work that has been happening in a fragmented way will directly benefit those working therapeutically in this field and most importantly the clients.
Melanie Goodwin

ESTD Newsletter

Volume 2, issue 1, November 2011

Id like to take this opportunity to share with you Rich-

ard Klufts Preconference Workshop entitled Orchestrating the Strategic and Tactical Aspects of the Treatment of DID. Richard Kluft is a leading figure in the field of DID. He has an encyclopaedic knowledge of the subject and moreover has important advice to offer on appropriate therapeutic approaches for this client group. He was critical, in his presentation, of the lack of direction in many treatments: that many treatments are too focused on particular theories and particular schools of thought, without including a pragmatic theory or a realistic treatment plan specific to DID This was followed by an expos of the various models and concepts outlined by the major contributors in the field: Brauns Bask Model, Watkinss Ego State Therapy, the various concepts outlined by Cardea, Putnam, Damasio, Van der Hart, Nijenhuis, Steele, Loewenstein, as well as Luborskys Core Conflictual Relationship Themes and Langs Communicative Fields and models. His objective was to underline the importance of clearly defined therapeutic strategies. He invited us to reflect critically on a particular case we were treating. Kluft is clear that it is important to address alters more directly, giving 20 arguments to defend this statement. The day was too short to be able to integrate this experience and to have time for discussion. He is an excellent speaker, sometimes too critical of certain theories (even though he promised to be more constructive in future). It was a real pleasure to be part of this workshop.
Manolle Hopchet

ESTD Newsletter Volume 2,

issue 1, November 2011

THE ART OF BEING HONEST

Honesty Is such a lonely word Everyone is so untrue Honesty Is hardly ever heard And mostly what I need from you.
(Billy Joel: Honesty)

By Michaela Huber

There are some rules in our professional work that are explicit and some that are implicit. Perhaps it is sometimes helpful to look at the implicit rules that determine our way of relating to our patients, as well as the expectations we have concerning this special relationship. Expectations that underlie our thinking but may be totally different to what our patients have experienced in other relationships before.

I can always find someone Who say they sympathize If I wear my heart out on my sleeve But I dont want some pretty face To tell me pretty lies All I want is someone to believe
(Billy Joel: Honesty)

ESTD Newsletter

Volume 2, issue 1, November 2011

Rule No I: Be honest to yourself Maybe the most challenging new

rules for every patient in therapy are the implicit rules to be honest in two ways: honest to him/herself in the inner world, and honest to the therapist. If one cannot be honest in the inner communication then it will be very frightening to experience honest moments in therapy. Those moments then will be a shock, and sometimes they result in disbelief, denial, dissociation, intense fear, or even suicidal impulses. At the same time most of our patients long for honesty, for someone to believe, as singer-songwriter Billy Joel put it. Why should we be careful with the rule be honest to yourself?

You cannot expect a patient to be honest unless you are. But what kind of sincerity or honesty is necessary for
us therapists? It is not the honesty to talk about our private lives (at least we should be very, very careful to do so; most of us would not disclose a single private detail in the first stages of therapy); it is not the honesty to sob when we are touched by the descriptions of our patients pains, even though it may be very necessary to show them that we are moved. What most of our patients expect from us is a kind of honesty that is hard to find, as Billy Joel writes in his song Honesty: We should be truthful to them as we are truthful to ourselves. A therapist is not a perfect person, not even a better person than her or his client. We are fellow women and men to our patients, with expertise but also with our own sins and melancholies and our dark spots inside. We have learnt a lot of techniques, we are extra careful not to hurt but to do everything that can be helpful to let the client grow in his or her personality. We accept whatever is in us, as well as whatever is in the patient. At least we should do.

Complex traumatized and dissociative patients have ex-

perienced attachment figures (e.g. parents, partners) that could not distinguish between themselves and the other, between their own impulses and the feelings of the other. They interrupted the integrity of our patients and acted against their needs in abusing and neglecting them. And they forced them to dissociate or deny the betrayal. Jennifer Freyd (see her book Betrayal Trauma) has described the misery of the abused child: the child is forced to suppress (dissociate) the part within that could detect the evil in the abusing parent, because it is a priority for the child, (i.e. biologically imperative), to maintain the attachment.

We try to make him/her understand that what is there is

there, and it makes sense that its there. We meet each other in one room, our brains and our hearts and our bodies communicate in deep respect to create an atmosphere of openness, acceptance, attunement and personal growth. As therapists we should expect to change in every encounter with our patients, even though we (and they!) often want us to stay the same. What a challenge for all of us! Our client (and sometimes we as therapist) will be deeply afraid to really engage in such an honest communication.

When we meet a complex traumatized person in ther-

apy, we often have the underlying assumption in our discourses that she or he is determined to be honest to her-/himself. That she will be ready to explore more or less in depth what is going on inside; that he will little by little come to the necessary conclusions that will enable him to change his life. But perhaps we must first tell her or him that there is a challenging rule in psychotherapy: Be honest to yourself. Or: You can delude others, but here in therapy I expect you to not delude yourself. Take a closer look at this implicit therapeutic rule: Many patients could only survive up till now with a lot of (possible) delusions: My mom loves me, I have a good father, My partner really cares for me (and vice versa: I am a good mom, etc.). In highly dissociative patients there are parts who are convinced that this is true, while others have memories or convictions of the opposite. They all long for truth but often they cannot stand it. Moreover they have an intolerance for ambiguity, which means that they can hardly tolerate difficult, confusing, and contradictory material. So they test us in the beginning of therapy: The everyday personality (host, ANP, or whatever you call her/him) comes and talks to us about her symptoms while other parts of the personality stay behind; some may make internal comments (e.g. as voices in the head), others are not inclined to engage in the therapeutic interaction at all, still others only want to be lovingly cared for by us. And they all want to see if we, the therapists, are honest. When we are, they try to be, more and more, sincere to themselves. That means:

When Im deep inside of me Dont be too concerned I wont ask for nothing while Im gone But when I want sincerity Tell me where else can I turn Because youre the only one that I depend upon
(Billy Joel: Honesty)

ESTD Newsletter Volume 2, issue 1, November 2011

Rule No II: You can keep secrets inside and say stop Honesty often is relative. Therapists and clients are more

or less sincere. If honesty hurts, it should be dealt with care. Thats why most of us have a second implicit rule in therapy. If we would talk it out loud we could say: You are allowed to keep secrets inside, even hide knowledge to some parts of you or the everyday personality if the truth would be too hurtful for the moment. If you protect (parts of) you this way it is ok for me, I even encourage you to find out what is all right to think and feel and tell, and what is not. We will establish stop signals, and I will note them and act accordingly by stopping and asking you what we should do next. This often implicit rule also is contradictory to the experiences of most complex traumatized persons in their past or ongoing private attachments. In destructive attachments the perpetrator does not allow stop signals or hidden thoughts and feelings or even secrets. Perpetrators want to have complete control over their victim. Many patients are at least astonished if not confused or distrustful when they learn that implicit rule in therapy, so we often should make it an explicit rule that we communicate and talk about. And here too, it is valid that a patient will not learn to respect inner and outer limits of communication unless you do.

Most of the time we are role models for our patients. So

I ask you as colleagues: Are you ready to keep at least some secrets to yourself that would hurt you or the patient if you disclosed them too early (for instance thoughts and feelings concerning the patient, interpretations, etc.)? Do you know what kind of secrets there are inside you when you communicate with the patient (e.g., do you consult your hidden observer before you speak)? Do you know when to say stop, and do you accept your own stop signals? And if you think about these questions: Isnt it an enormous challenge to ask this from your patient? In addition: in dissociative clients, the inner world is much more confusing than for most of us: There are parts that want to tell it all and others who are threatening to kill the body if secrets are disclosed. So it is crucial for many therapies that the implicit rule: Here in this room you are allowed and even encouraged to keep things inside and say stop, is discussed and will be lived. Complex traumatized clients will test you to see if you really adhere to this rule yourself, and in communicating with them. If we can be honest, but also honestly withhold our honesty when it would be damaging, the client will hopefully learn in an atmosphere of trust, respect, and personal growth.

ESTD Newsletter

Volume 2, issue 1, November 2011

NEWS FROM ROMANIA by Anca Sabau

The theme of the conference was Trauma and dissociation, bringing theory to everyday practice
We are glad to report that in June a very special trauma and dissociation teaching event was held in Romania featuring psychoanalyst Kathryn Chefetz and former ISSTD President Richard Chefetz, of Washington, D.C., USA. The theme of the conference was
Trauma and dissociation, bringing theory to everyday practice and the presentation included both basic information for those who are unfamiliar with the phenomenon of dissociation and complex trauma, as well as interesting presentations of cases with a specific emphasis on the role of the therapeutic relationship.

This sponsored training opportunity was particularly valuable to Roma-

nian clinicians, as despite the many psycho-social challenges in Romania, we have been trying to cope here with a poor infrastructure for professional continued education training, in general, and a lack of structured trauma training programs, in particular. Although, in the last few years we have profited from a few ESTD- and other sponsored seminars that broke the ice, knowledge regarding trauma and dissociation among our clinicians remains quite basic.

The recent conference by Kathryn and Richard Chefetz were attended

by 400 Romanian clinicians, psychology students and resident doctors in child and adult psychiatry (about 150 from Timisoara, in Western Romania and 250 in Bucharest) and was very well received. The initiator of this conference sessions was an old friend of Romania, Eli Somer, who had also delivered a training in Timisoara on Acute Trauma some 2 years ago.

Richard and Kathryn Chefetz

were at their second meeting with the Romanian clinicians. The first event took place a year ago, with the support of Inocenti Foundation and Sensiblu Foundation in Bucharest. The organizing committee for this years conference in Timisoara included representatives from ESTD, the West University (where the conference was held), the Family Therapy Institute, Dianoia, who have taken part in organizing many events and trainings in the last 3 years, and the Student Union in Psychology, who are very eager to complete their studies with an understanding of trauma. This year the Inocenti Foundation and Sensiblu Foundation had more support in organizing the conference. The school of psychology from Spiru Hared University hosted the event. We were also surprised to see professors and doctors participating to the conference. The need for understanding trauma and how to deal with is so big, that the audience could have stayed a week with our guest in order to do more work that will help each of them within their own clinical setting.

With the assistance of Richard and Kathryn Chefetz, conferences such

as these are allowing Romania clinicians to develop new understandings of the trauma process and therapy, both for the treatment of children and adolescents and for the adult population.

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ESTD Newsletter Volume 2, issue 1, November 2011

10

Film Reviews

by Orit Badouk Epstein

A LOGICAL WAY OF BEING

A logical way of being: The reality of Dissociative Identity Disorder & other Complex Dissociative Conditions
An introductory training DVD from FPP (First Person Plural) in association with CWP (Cheshire & Wirral Partnership) NHS & The Pottergate Centre, England 2011. Made by Serious media.com been diagnosed with DID often leave clinicians on the receiving end of their clients behaviour feeling overwhelmed and confused and at other times feeling omnipotent and all-knowing. The wonders of the mind and its protective mechanisms, is at the core of this condition. As one of the interviewees in this film (Oriel) points out: With DID, behaviour always makes sense. The chaotic nature of working with severely traumatised individuals including those with DID is typical of disorganised attachment. I once heard Jeremy Holmes talking about this. He said that the role of therapy is to make sense and organise the internal mayhem of the severely traumatised and confused individual.

Working with clients who have

A Logical way of Being is a well organized introductory documentary that explains DID with great clarity. It is a useful tool

to all: from mental health practitioners and workers in the care system to survivors themselves. It explains the condition in a way that is comprehensible to a layman who may never have come across someone with DID. The film contains interviews with both experts-by-experience: Kathryn Livingstone, Melanie Goodwin & Oriel, as well as mental health professionals: Dr. Mike Lloyd, Remy Aquarone & Sue Richardson. It educates us and brilliantly explains the condition and helps de-stigmatise the stereotyped and sensationalised image of Hollywood from such films as Sybil and three faces of Eve. Logical yet sensitive, the film contains moving accounts of most aspects of the condition as well as the symptoms that people with DID have.

The in-depth interviews

Dissociative amnesia Depersonalisation Derealisation Identity Confusion Identity alteration

with the experts give a thorough explanation of the 5 types of dissociation. This all helps build a greater understanding of the condition. These are:

Sue Richardson also sheds some light into the relatively new and slightly obscure sister phenomena of the Dissociative disor-

der not otherwise specified (DDNOS) diagnosis. This documentary captures the essence of the condition and how challenging it can be to everyone involved. Remy Aquarone sums up extreme Dissociation with a metaphor that it is like a submarine that is absolute and without leakage. I found Melanie Goodwins comments about what helped her recovery particularly moving: For me it was only my relationship with my therapist after 10 years

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Volume 2, issue 1, November 2011

when I began to be stimulated enough for me to understand what missing someone really meant.

This film not only gives great transparency about the condition but also offers hope for progress and recovery for those who
have DID. This DVD is a must-have addition to your library collection.

The DVD is also available at a low cost price for all Eastern European countries from the ESTD website. Translating it to Spanish,
French and English subtitles may offer the possible of a more wider resource for European practiticioners. The DVD can be purchase from: www.firstpersonplural.org.uk

Project Nim (JAMES MARSH, 201 1)

This is a sobering documentary about a 1970s social linguistic experiment that was carried out on a chimpanzee called Nim who was raised as a human child in order to prove that chimpanzees could learn to communicate in sign language with humans if they were raised in a human environment.
fostered first by a family of hippy academics where he was breast fed by the family matriarch and even given a joint. Nim gradually began to show signs of aggression and was transferred to various other academic parents, mainly students, who, apart from one caring individual, had no experience of raising a chimpanzee or a child and adopted different parenting styles. As he got older Nim became more violent and eventually was sent to an animal testing laboratory when the scientist that started the experiment had finished his project. Nim was finally purchased by a refuge for animals in Texas after a huge court case on animal rights. The director, James Marsh (who also made Man on a Wire), shows his audience the most harrowing film footage of Nims mistreatment in the research facility, giving glimpses into mankinds darker capabilities in its treatment of our closest primate relatives.

After cruelly being taken away from his mother at an early age, Nim was

This unsettling documentary is less about language and its aetiology than about the emotional and physical abuse of a

young mammal. Just like a young child that has been raised with numerous disruptive attachments and who had experienced maternal deprivation and constant misattunement, Nim displayed many of the symptoms of abuse and neglect. What we learn is not about the wonders of language but the attachment style similarities between the great apes and humans.

From the moment of separation from his mother, Nim showed signs of emotional distress with his first caregiver and behaved

in ways that parallel the ambivalent/preoccupied attachment pattern. As he experienced further loss and separation, and the mishandling by clueless care-givers, Nim began to develop all the classic symptoms of disorganized attachment. As a result Nims aggression increased to a point of full blown psychosis.

ESTD Newsletter Volume 2, issue 1, November 2011

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Viewed through the lens of Attachment Theory, despite his painful encounters with humans, Nim developed a bond with one compassionate person who genuinely cared about him and fought to preserve some dignity in his tortured life. Unfortunately their bond was continuously disrupted by further experiments, depriving the two from developing a secure attachment. One of the most moving scenes is when they have an emotional reunion in the primate sanctuary after many years of separation.

Apart from all the ethical and moral issues this documentary raises, we are left with the classic themes that typify the argument between nature versus nurture, namely: you give a human upbringing to an animal that could potentially kill you? Can so, is Nims aggressive behaviour a product of his nature or of his trauma? If we recognise the signs of PTSD in Nims behaviour? Can we go further and see a chimpanzee displaying symptoms of DID? Can

Above all this film is a tragic reflection of a powerless chimpanzee caged by humans who, in the name of science, have abandoned their humanity.

QUANDARY CORNER
After only 8 months in treatment, a DID client presenting in an Apparently Normal Personality (ANP), who is still being abused by family members, comes to therapy proudly stating that despite her fear, she has gone to the police after being assaulted by a family member on Halloween. Having been ordered never to approach a police officer as well as being warned that she would never be believed and would only be seen as a psychiatric case, this was particularly daring. The therapist noted how much stronger this action had made her feel. Towards the end of the therapy session an Emotional part of the Personality (EP) shamefully stated that there was definitely no assault but there was a flashback of past abuse and during the flashback she, the EP, had self-injured. The EP, a withdrawn 10 year old, was then shocked to find that the ANP had registered this as an external assault and was scared she could be imprisoned for her badness. The EP was terrified that her private moment of self-injury was being experienced as an external attack worthy of police contact. This added to her deep feeling of badness and made her feel suicidal. She also did not want the ANP to be told, fearing it would destroy their relationship as well as humiliating the ANP, who had never dared to go to the police before. Indeed, she was concerned it could cause the ANPs own suicide. After the session the therapist was rung by the police asking if she thought the injury was fictitious or not. She gained time by saying she needed to gain permission of her client before responding and now she is left with this quandary.

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RECENT ARTICLES AND BOOKS OF INTEREST

Books
Sinason, V. (Ed.) (2011).

Mental handicap and the Human Question, An Analytic Approach to Intellectual Disability, 2nd Edition. Free Association Books. [This book now includes a chapter on intellectual disability and DID]

Sinason, V. (Ed.) (2011).

Attachment, Trauma and Multiplicity, 2nd Edition. London: Routledge.

Sinason, V. (Ed.) (2011).

Trauma, Dissociation and Multiplicity, Working with identity and Selves. London: Routledge.
Chu, J. A. (2011).

Rebuilding shattered lives: treating complex PTSD and dissociative disorders, 2nd Edition. New Jersey; Wiley.
Howell, E. F. (2011).

Understanding and treating dissociative identity disorder: A relational approach. New York: Routledge.
Van Dijke, A. (2011).

Dysfunctional affect regulation in borderline personality disorder and somatoform disorder. Doctoral thesis.

ESTD Newsletter Volume 2, issue 1, November 2011

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Journal article
Majohr, K-L., Leenen, K., Grabe, H. J., Jenewein, J., Nuez, D. G., & Rufer, M., (2011).

Alexithymia and its relationship to dissociation in patients with panic disorder. Journal of Nervous and Mental Disease, 199(10), 773-777. Abstract:
Conditions that impede the regulation of emotional arousal, such as alexithymia and dissociation, may underlie panic attacks. This study aimed to evaluate the relationship between alexithymia and dissociation in patients with panic disorder (PD). We assessed 95 PD outpatients with regard to alexithymia (20-item Toronto Alexithymia Scale), dissociation (Dissociation Experience Scale), and overall psychological distress (Symptom Checklist 90-Revised, Global Severity Index). Regression analyses revealed a positive correlation between alexithymia and dissociation, even when the Global Severity Index was controlled for. A specific link was observed between difficulty in identifying feelings and depersonalization/derealization. Patients who showed the pathological form of dissociation had higher levels of alexithymia, with particular regard to difficulty in identifying feelings and, to a smaller extent, difficulty in describing feelings. These results support a strong relationship between alexithymia and dissociation in patients with PD. Assessing alexithymia and dissociation at the outset of therapy may be helpful for individualized therapy planning. Fan, Q., Yu, J., Ross, C. A., Keyes, B. B., Dai, Y., Zhang, T., Wang, L., & Xiao, Z. (2011).

Teaching Chinese psychiatrists to make reliable dissociative disorder diagnoses. Transcultural Psychiatry, 48(4), 473-483. Abstract:
The aim of the study was to assess the outcome of an educational effort by two North American experts in dissociative disorders to teach Chinese psychiatrists to make reliable dissociative disorder diagnoses. In the final phase of the educational effort, 569 patients at Shanghai Mental Health Center completed the Chinese version of the Dissociative Experiences Scale (DES). Patients were then randomly selected in different proportions according to their DES scores: 96 selected patients were then assessed with the Dissociative Disorders Interview Schedule (DDIS) and clinical diagnostic interviews based on DSM-IV criteria. According to the clinical diagnostic interviews, 28 (4.9%) patients were diagnosed as having dissociative disorders.

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Volume 2, issue 1, November 2011

Dates for your diary in 2012

ESTD 3rd ANNUAL CONFERENCE
Berlin, Germany 29th-31th March, 2012 www.estd2012.org

ISSTD 29TH ANNUAL CONFERENCE

Long Beach, California Pre-conference, October 18th & 19th Conference, October 20th 22nd, 2012 www.isst-d.org

ESTD Newsletter Volume 2, issue 1, November 2011

ESTD CONTACTS IN YOUR REGION

Country Contact person E-mail

Austria

Sonja Laure Sylvia Wintersperger

sonja.laure@nadua.at sylvia.wintersperger@eunet.at

Belgium

Manolle Hopchet Serge Goffinet

manhopchet@scarlet.be sergegoffinetpsy@msn.com

Czech Republik

Jan Soukup Petr Bob Marek Susta

honzasoukup@yahoo.com petrbob@netscape.net m.susta@proverbs.cz

Denmark

Helle Spindler Andrew Moskowitz

hellesp@psy.au.dk andrew@psy.au.dk

Estonia Finland

Maire Riis

maire@lastekriis.ee

Pivi Saarinen Anne Suokas Cunliffe

paivi.saarinen@traumaterapiasarastus.fi anne.suokas@traumaterapiakeskus.com

France

Hlne Dellucci Isabelle Saillot

helene.dellucci@wanadoo.fr institut@pierre-janet.com

Georgia Germany

Manana Sharashidze

manana@gamh.org.ge

Bettina Overkamp Michaela Huber

bettina.overkamp@web.de Huber_Michaela@t-online.de

Greece Iceland Ireland

Niki Nearchou

fnearcho@psy.auth.gr

Gyda Eyjolfsdottir

salarafl@gmail.com

Eileen Noonan

eileennoonan1@ireland.com

Country

Contact person

E-mail

Isral

Eli Somer Liora Somer

somer@research.haifa.ac.il liora@somer.co.il

Italy

Barbara Gallo Giuseppe Miti

babagallo@gmail.com giuseppe.miti@libero.it

Latvia Netherlands

Ilze Damberga

damberga.ilze@gmail.com

Suzette Boon Ellert Nijenhuis Onno van der Hart Astrid Steenhuisen Marika Engel

sab@euronet.nl e.nijenhuis@home.nl o.vanderhart@uu.nl a.steenhuisen@planet.nl engel.bremers@hccnet.nl

Norway

Arne Blindheim Ellen Jepsen

ar-blind@online.no ellen.jepsen@modum-bad.no

Poland

Agnieszka Widera-Wysoczanska

instytut@psychoterapia.wroclaw.pl

Romania Serbia

Anca Sabau

ancavsabau@yahoo.com

Vesna Bogdanovic

vesnabgd@virgilio.it

Slovakia Spain

Hana Vojtova

hanavojtova@seznam.cz

Anabel Gonzalez Dolores Mosquera

anabel_gonzalezv@hotmail.com doloresmosquera@gmail.com

Sweden

Doris Nilsson Anna Gerge

Doris.Nilsson@liu.se anna@insidan.se

ESTD Newsletter Volume 2, issue 1, November 2011

Country

Contact person

E-mail

Switzerland

Eva Zimmermann Jan Gysi

eva.zimmermann@bluewin.ch jan.gysi@rs-e.ch

Turkey

Vedat Sar Erdinc Ozturk Cigdem Yumbul

sar@klinikpsikoterapi.com erdincozturk@klinikpsikoterapi.com cigdem.yumbul@gmail.com

Ukraine

Oleh Romanchuk

olerom@ukr.net

United Kingdom

Remy Aquarone Colin Howard Mike Lloyd Christopher Findlay

remyaquarone@dissociation.co.uk colin@harrishoward.com mike.lloyd@cwp.nhs.uk christopher.findlay@btinternet.com

European Society for Trauma and Dissociation E.S.T.D. 1ste Hogeweg 16-a 3701 HK Zeist The Netherlands Email: info@estd.org Website: www.estd.org