IAC Webinar Series
Presenter: Valentina Chichiniova, MA
Fee: Free for IAC Members (see IAC Membership) / $35 (Canadian Dollars) for non-IAC members

Description: Dissociation is a complex psychophysiological process that alters the accessibility of memory and knowledge, integration of behavior, and sense of self (Putnam, 1994).  Detecting the presence of dissociative symptoms is important for effective therapeutic process.  Numerous studies have shown that addressing dissociative symptoms results in greater improvement in therapy (e.g. Gonzlez & Mosquera, 2012).  Yet, recent international research and clinical standards have identified substantial underreporting and/or underdiagnosis of dissociative symptoms in medical, mental health, and general populations (Sar, 2010). 

Addressing these clinical gaps can be especially challenging when addressing groups of people who have recently migrated/immigrated, whose background reflects traditional cultures, or groups with lower participation in the mainstream health care systems (e.g., the poor).  For example, epidemiological studies indicate that some dissociative disorders and syndromes are more prevalent in the developing countries, yet those may be manifested in culturally patterned manner and remain undetected (Chand et al., 2000; Somer, 2006).

The under-detection of dissociative symptoms is related to a number of factors, including (a) low levels of awareness by clients; (b) low specificity because dissociative symptoms are found in a wide range of psychological disorders and presenting problems; and (c) unusual clinical presentations (e.g., low levels of distress when reporting traumatic experiences may reflect successful coping or unremitting dissociation) (van der Kolk, 2002; Brand et al, 2012).

Furthermore, research suggests that mental health providers do not receive systematic training about trauma and dissociation in their training programs (Courtois, C. A., & Gold, S. N. (2009).  Thus, mental health providers lack the understandings of the phenomenon and skills to affectively recognise and address it in therapy.

In this presentation, we will provide epidemiological data on dissociation, describe the clinical presentation of dissociation in the different stages of the therapeutic process using case examples, and offer some suggestions of how to address dissociation in session. We will also review some of the available resources and summarize suggestions for continuing education and counsellor training.  For example, micro-level attunement as a clinical skill could be learned/ and or further developed, helping the client to more accurately identify his or hers affective states by "seeing them" in the therapist attuned responses (Bradshaw, Cook, and McDonald, 2011). 

Underreported Dissociation - Implications for Assessment and Treatment

  • Monday Sep 11 2017, 12:00 PM - 1:00 PM
  • Online