R4 - Required Module Four - Psychopharmacology and medical consequences of complex trauma and dissociative disorders
R4 - Psychopharmacology and medical consequences of complex trauma and dissociative disorders
Content Level: Advanced
Contributors: Richard Loewenstein, MD, Su Baker, MEd, Joan Turkus, MD; John O’Neil, editor
The psychopharmacology is by webinar; the medical consequences are by published text.
Psychopharmacology: Many patients with complex trauma and dissociative disorders seek relief of symptoms (including depression, intrusive and hyperarousal symptoms, sleep disorders, etc.) with medications, not necessarily prescribed by physicians with knowledge of the field. Dr Loewenstein bases this webinar on 35 years of experience in the medication management of severely traumatized dissociative individuals. The webinar addresses the role of psychopharmacology and somatic treatments such as electroconvulsive therapy (ECT) in the treatment of patients with complex trauma and
dissociative disorders, in particular dissociative identity disorder (DID).
Medical consequences: For close to 25 years, the ACE studies have been collecting and analyzing data on the outcomes of trauma, abuse and neglect in childhood and its impact on health and illness in the adult population. Many of our patients have co-morbid chronic health issues which complicate their lives, threaten their livelihoods, and impact their families. Most do not recognize that their illnesses may be related to their childhood traumas. Educating these patients in the medical outcomes of trauma, abuse and neglect, as discussed in the ACE studies, can have a powerful effect on patients and their doctors. This part of the module gives an overview of the ACE studies and some ideas for educating others, including patients, doctors and other health and educational professionals.
1. Identify and discuss the use of medication in the treatment of complex trauma and dissociative disorders
2. Discuss the effects of childhood trauma and neglect on physical and mental health across the lifespan
3. Discuss the impact of understanding the role of trauma on medical sequelæ shared with clients with complex trauma and dissociative disorders
Readings and Webinars
A. Lowenstein, R (2016). Rational and irrational psychopharmacology for complex trauma and dissociative disorders. ISSTD webinar 102204. (to be viewed on one’s own, before the class, not during class time).
B. Middlebrooks, J. S., Audage, N. C. (2008). The effects of childhood stress on health across the lifespan. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta GA.
C. Kendall-Tackett, K., Klest, B. (2009). Causal mechanisms and multidirectional pathways between trauma, dissociation and health (editorial). Journal of Trauma and Dissociation, 10, 129–134.
D. Oral, R., Rameriz, M., Coohey, C., Nakada, S., Walz, A. Kuntz, A., Benoît, J., Peek-Asa, C. (2016). Adverse childhood experiences and trauma-informed care: the future of health care. Pediatric Research, 79(1), 227-233.
30 minutes: Discussion of Webinar A
60 minutes: Discussion of Readings B and C
30 minutes: Discussion of Reading D
30 minutes: Discussion of student’s disguised cases, or further discussion of webinar and readings A, B, C and D if no case material available.
- 2.50 APAThe 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.