Enactments in the Psychotherapy of Complex Trauma

Abstract
Enactments involve felt sense experiences between client and therapist that offer a somatic story about the history or both client and therapist. That is, they are implicit - at least at the beginning - and have no narrative. The therapist must create a narrative based on felt affective experience and awareness of both their own and the client's histories. In enactments we receive information through implicit rather than explicit, conscious channels. They emerge from unconscious and dissociative fields, providing a rich source of experiential information about trauma, the therapeutic relationship and relational patterns. While they are enactments of traumatic relational patterns, they differ from flashbacks in that they are not recognized by the client and have no cognitive or visual aspects. Rather the client and therapist experience each other through an invisible lens of unresolved history. Enactments in therapy are mostly inevitable: Many cannot be avoided. Rather, they should be welcomed by the therapist as they emerge. However, we will discuss an important focus on compassionate curiosity and affective attunement to minimize unecessary enactments. Given the fact that some enactments cannot be successfully worked through and do not end well, we will discuss what therapists can learn from these painful experiences. We will explore how to recognize enactments through felt sensory and affective experiences, and how to work with them to resolution. Therapists should be aware that enactments are not only about the client’s unresolved history, but also of their own. Thus, we need a humble approach to acknowledging our own countertransference, history, limitations, and vulnerabilities as therapists. We will discuss how enactments bring hidden trauma and other dysfunction relational patterns onto the playing field of the relationship, and how to work with them, whether implicitly or whether they are made conscious to the client. Participants are encouraged to bring examples of enactments from their clinical cases.

Potential to Distress: No

This recorded conference session was originally presented as part of a live conference in March 2025.

Target Audience

Those seeking to participate in this webinar must be licensed mental health professionals (psychiatrists, psychologists, clinical social workers, mental health counselors, accredited psychotherapists, etc.). ISSTD staff will audit license information prior to the start of the course and may request additional documentation for your license.

We do accept students 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. Students must submit proof of student status such as a transcript or registration record. For those who have completed their degree and are currently in the pre-licensure stage practicing under the license of another clinician, you must provide the name and license information for the person you are working with. Documentation should be sent to ISSTD staff at [email protected] before registering. 

This webinar content is at the beginning/introductory level.

Learning Objectives

Learning Objectives

At the conclusion of this session participants will be able to:

  • Identify enactments in their clinical cases
  • Name felt sense experiences that likely alert therapists to an enactment
  • Employ at least three strategies to successfully work through an enactment
  • Deconstruct an enactment that could not be successfully processed from their clinical cases, and discuss what they learned from the experience
  • Determine whether or not to explicitly discuss an enactment with the client and give rationale for their decision

Course summary

Available credit: 
  • 1.50 APA
    The International Society for the Study of Trauma and Dissociation is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Society for the Study of Trauma and Dissociation maintains responsibility for this program and its content.
  • 1.50 ASWB ACE
    The International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/20/2024 – 08/20/2027. Social workers completing this course receive 1.50 continuing education credits.
  • 1.50 ISSTD Certificate Program
    This program is eligible for 1.50 credits in the ISSTD Certificate Program. No certificate of completion is generated for this type of credit.
Course opens: 
01/21/2025
Course expires: 
12/31/2050
ISSTD Member cost:
$35.00
Your Price:
$55.00
Part of: 
From Invisible to Visible - Day One
Rating: 
0

Timed Outline
15 Minutes - Introduction; definition of enactments
15 Minutes - Relationship of enactments to relational defenses
60 Minutes - How do we know if we are in an enactment?/Dynamics of enactments
30 Minutes - Break
15 Minutes - Attachment styles and enactments
60 Minutes - Treatment approaches
15 Minutes - Q&A

Kathy Steele, MN, CS

Kathy Steele, MN, CS has been in private practice in Atlanta, Georgia since 1985. She is also an Adjunct Faculty at Emory University. She graduated from the University of South Carolina with a Bachelors in Nursing in 1978 and from Emory University with a Masters in Psych/Mental Health Nursing in 1983. She worked at Grady Memorial Hospital for several years in her early career in psychiatric triage as well as outpatient work with severely mentally ill clients, with a focus on schizophrenia. From 1991-1995 she was Clinical Director of an inpatient program for trauma and dissociation at CPC Parkwood Hospital in Atlanta. Subsequently, she was Clinical Director for a nonprofit low cost psychotherapy clinic in Atlanta, Metropolitan Counseling Services, from 1995-2016. Kathy is a Fellow and a past President of the International Society for the Study of Trauma and Dissociation (ISSTD), and also served two terms on the Board of the International Society for Traumatic Stress Studies. Since 2008 she has served on the editorial board of the Journal of Trauma and Dissociation. She is the recipient of several awards for her clinical and published works, including the 2010 Lifetime Achievement Award, the Cornelia Wilbur Award, and the Pierre Janet Writing Award from ISSTD. She received a Distinguished Alumni Award from Emory University in 2006. She has authored numerous publications in the field of trauma and dissociation, including three books, and many book chapters and peer-reviewed journal articles. She is sought as a consultant and supervisor, and as an international lecturer on topics related to trauma, dissociation, attachment, and psychotherapy.

Available Credit

  • 1.50 APA
    The International Society for the Study of Trauma and Dissociation is approved by the American Psychological Association to sponsor continuing education for psychologists. The International Society for the Study of Trauma and Dissociation maintains responsibility for this program and its content.
  • 1.50 ASWB ACE
    The International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/20/2024 – 08/20/2027. Social workers completing this course receive 1.50 continuing education credits.
  • 1.50 ISSTD Certificate Program
    This program is eligible for 1.50 credits in the ISSTD Certificate Program. No certificate of completion is generated for this type of credit.

Price

ISSTD Member cost:
$35.00
Your Price:
$55.00
Please login or register to take this course.

"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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