Dilemmas in the treatment of dissociative disorder clients
withSuzette A. Boon
Video recording available after the event
Available without time limits
Available in Italian (simultaneous translation), English


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The vast majority of clinicians agree that clients with complex dissociative disorder should be treated according to the three-phase model. After a careful diagnostic process and good case conceptualization, a phase of stabilization and symptom reduction usually follows. But what do we need to stabilize and for how long? Therapists often have many questions about this phase: “How do I prioritize and begin treatment? How do we engage a patient who desperately demands help, but also views me with distrust and fear? How can I be in charge of the therapy while still making a collaborative effort with the patient? How do I work with different kinds of dissociative parts, such as extremely dependent, avoidant, angry, or persecutory ones? How do I deal with different intense transference feelings and my own countertransference?”.

In recent years, there also have been colleagues who believe that it is not necessary to stabilize. They argue for an immediate focus on trauma processing. Do therapists have to stabilize at all and how do they know that they have completed enough stabilizing work in preparation for Phase 2?

In this webinar, Suzette Boon will offer practical answers to these and other questions. The first evening, she will focus on treatment that is going relatively smoothly, often with clients having not too severe attachment problems. The second evening, she will focus on the more challenging or ‘difficult’ dissociative clients. Didactic presentations, case vignettes and video clips will be included.

About the Speaker

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Suzette A. Boon
Patients with trauma-related complex dissociative disorders usually suffer from many symptoms, including depression and suicidality, both of which may be accompanied by severe self-harming behaviours. These symptoms may be the main presenting problem, with the underlying dissociative disorder often not even identified. They may put the therapeutic relationship under enormous pressure when the therapist needs rescue. This presentation will explore reasons for self-harm and suicidal behaviour in such patients, transference and countertransference, and ways to help the client stop PROGRAM these behaviours. Self-harm and suicidality may be related to different factors such as shame, abandonment, despair, a wish to be seen and understood by others, fear to realise what has happened in the past, and/or a way of coping with unbearable feelings. Treatment often includes medication for depression, somatic approaches, and cognitive behavioural approaches that are often used to explore and change related negative cognitions. However, the more complex the dissociation of the personality, the fewer patients may benefit from these techniques, as emotions and cognitions are often “held” by different dissociative parts of the personality and are perceived to be ego-dystonic. Specific interventions, especially those using imagery, will be highlighted so that treatment of dissociation becomes an integral part of standard-of-care approaches to serious self-harm and suicidality in traumatised individuals.


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