Approaching Dissociative Disorder Patients Difficulties with Positive Events and Feelings


Dissociative disorder patients' journey towards recovery is often a long-term process with many obstacles along the way. Clinicians often experience being 'stuck' in the therapy together with the patient, although the treatment conditions seem to be 'good'. The patients often show difficulties with positive experiences and feelings, such as deserving to get help, being allowed to get better, eating and sleeping properly, receiving praise, building of alliance with the therapist, experiencing any pleasure. This is important, as the clinical literature suggests that traumatized individuals' tolerance for positive affect is a prognostic factor. Research findings indicate that the patients' is two-sided:

  1. Deficits in the ability to experience positive affect
  2. Negative affect in response to positive affect.

These findings suggest that treatment should include a focus on patients' negative affective responses to positive stimuli, in addition to a focus on patients' hedonic deficits. This workshop will focus on dissociative disorder patients' internal conflicts regarding positive experiences and feelings. The main focus will be strategies in treatment for working with these conflicts. The workshop will also include issues of: How to understand the patients' difficulties from perspectives of attachment-, trauma-, and dissociation theories.

Timed Outline
10 Minutes - Introduction
60 Minutes - In search of an optimized treatment for DD-patients, including statement of the problem
20 Minutes - Clinical approaches
50 Minutes - Clinical approaches, continued
15 Minutes - Future directrions
10 Minutes - Concluding remarks
15 Minutes - Question and answer (with original live audience)

This session was originally presented as a live conference session in October 2020.

Target Audience


Learning Objectives

At the conclusion of this presentation, participants will be able to: 

  • Address negative affective interference in dissociative disorder patients
  • Discuss research and clinical literature on traumatized individuals' difficulties with positive events and stimuli
  • Link themes of attachment, trauma and dissociation to the problems of negative affective interference
Course summary
Available credit: 
  • 3.00 ISSTD Certificate Program
    This program is eligible for 3.00 credits in the ISSTD Certificate Program.
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Presenter: Ellen K. K. Jepsen, PhD
Presenter Bio: Ellen K. K. Jepsen, M.D., Ph.D., has been affiliated with the Department for Trauma Treatment and Research Institute at Modum Bad Psychiatric Center in Norway since 2002. She specializes in assessment, treatment and research on adult patients with complex dissociative disorders. In addition to trauma-oriented therapies, she is trained in general psychodynamic and cognitive and behavioral psychotherapies. As a clinician, she has more than 18 years of experience in the treatment of adult inpatients suffering from complex conditions related to early relational trauma, in particular dissociative disorders. As researcher, she defended her thesis “Inpatient Treatment of Early Sexually Abused Adults: Dissociation and Outcome” in 2014 for the PhD-degree. The main focus of the thesis was the impact of pathological dissociation on the treatment of adults suffering from a variety of disorders related to early sexual abuse. She frequently gives workshops in the assessment and treatment of complex PTSD and dissociative disorders and is a board member and national contact person for the European Society for Trauma and Dissociation (ESTD).

Available Credit

  • 3.00 ISSTD Certificate Program
    This program is eligible for 3.00 credits in the ISSTD Certificate Program.


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"Your Price" above reflects your final price based on your membership status and career level. 

  • ISSTD defines a student as those enrolled in a program of study leading to a degree or certification in the mental health field and who have an interest in trauma and dissociation. 
  • ISSTD defines an emerging professional as mental health professionals who have completed an advanced degree and are in the first three years of their career (or first three years after graduation for researchers).
  • If you do not fall into one of the above categories please register as Professional/Retired. 

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