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ForwardTrauma & Attachment: Developmental Trauma, Personality & Dissociative Disorders
Abstract
Evidence is mounting that complex PTSD, borderline (BPD) and narcissistic (NPD) personality disorders, and severe dissociative disorders (DD) are caused by a combination of interpersonal trauma and disrupted attachment. In childhood, these conditions produce similar symptoms, described by developmental trauma disorder (DTD), a meaningful diagnosis, despite its rejection by the DSM 5. These disorders are characterized as much by disturbances in the ability to form healthy relationships, as by post-traumatic symptoms.
Chronic relational trauma and insecure or disorganized attachment, interact to create the characteristics of DTD and cPTSD
- Pervasive dissociative symptoms: amnesia, identity alteration or fragmented self-states, depersonalization/derealization, trance, intrusive memories/flashbacks and
- Disturbances of self: affect or somatic dysregulation;
- Alterations in
a. self-perception – helplessness, shame, feeling worthless;
b. relations with others – withdrawal, distrust, alienation, failure to self-protect;
c. systems of meaning – despair, loss of faith.
These characteristics are also present in BPD, NPD and DDs. Persons with BPD and NPD experience alternating, partially dissociated, idealizing and devaluing self-states, and suffer from core feelings of shame, worthlessness, distrust, alienation and despair. Increasing evidence shows that interpersonal trauma and disrupted attachment contribute to development of BPD and NPD.
Longitudinal studies showed that disorganized attachment in early childhood predisposed subjects to dissociative symptoms through childhood and early adulthood, even without overt trauma. Treatment of traumatic sequelae alone does not change attachment patterns or build healthy relationship skills. Recognizing disrupted attachment, as well as trauma, in the development of severe personality and dissociative disorders may enable more comprehensive, effective treatment.
Potential to Distress: No
Target Audience
Intermediate
Learning Objectives
At the conclusion of this presentation, participants wiil be able to:
- Describe the antecedents of Developmental Trauma Disorder
- Explain how disrupted attachment leads to relationship difficulties
- Discuss how disorganized attachment contributes to dissociated self-states
- Describe the careful pacing of integration of dissociated states to prevent decompensation
- Explain how dissociated self-states may serve to sustain attachment, self-protection and integrity of self-structure
Ruth A. Blizard, PhD
Ruth A. Blizard, PhD, is a psychologist practicing in the Binghamton, NY, area with over 40 years of experience in treating persons with severe trauma, dissociation, and personality disorders. She received her BA in psychology from the University of Colorado, Boulder, and her PhD in clinical psychology from Alliant University, Fresno. She has presented internationally and published articles and chapters including, “Therapeutic alliance with abuser alters in DID: The paradox of attachment to the abuser,” “The role of double-binds, reality testing and chronic relational trauma in the genesis and treatment of borderline personality disorder,” “Masochistic and sadistic ego states: Dissociative solutions to the dilemma of attachment to an abusive caretaker,” “Disorganized attachment, development of dissociated self states, and a relational approach to treatment,” “Double binds, dissociation and attachment to the perpetrator in families and oppressive groups,” “Lost-in-the-Mall: False Memory or False Defense?” (with Morgan Shaw) and “Chronic relational trauma disorder: A new diagnostic scheme for borderline personality and the spectrum of dissociative disorders,” (with Elizabeth Howell). She has taught the official ISSTD course, “Diagnosis and Treatment of Dissociative Disorders.” She is on the editorial board of the Journal of Trauma and Dissociation, and is past editor of the ISSTD News and Division 56 of the APA, Trauma Psychology News. She is currently on the ISSTD Scientific Committee, and has served on the Executive Board, Program and Membership Committees. She enjoys folk music, hiking, bicycling, kayaking, and most of all, being a grandmother.
Available Credit
- 1.50 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.
- 1.50 ASWB ACEThe 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 ProgramThis program is eligible for 1.50 credits in the ISSTD Certificate Program. No certificate of completion is generated for this type of credit.
Early registration ends September 30, 2024 at 5:00 PM US Eastern Time. Prices will increase for emerging professional and professional/retired rates at that time by $50.
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Cancellations must be received in writing via email or fax. A processing fee of $45 will be charged for cancellations received on or before Friday, October 25, 2024 at 5:00 PM ET. No refunds will be issued for no-shows. Refund requests will not be accepted after October 25, 2024. Not all requests will be granted. Substitutions for attendees are accepted until November 1, 2024.
Grievance Policy
ISSTD is fully committed to conducting all activities in strict conformation with the APA and ASWB grievance procedures.
During this conference, conference organizers, presenters and staff will address any concerns that arise. Every effort will be made to address the concerns during the conference when possible. If these individuals are unable to address the participant’s concerns, the complaints and grievances shall be presented in writing to ISSTD Headquarters at [email protected]. These will be forwarded on for review by the Virtual and Regional Conference Committee.
Social Workers: Should social workers have a specific grievance, these grievances will be addressed by D. Michael Coy, LICSW. In situations where the social worker would have a conflict of interest, then, Christine Forner, MSW will review the grievance.
ISSTD strives to resolve grievances in a manner that is in the best interest of the participant. All complaints and grievances are reviewed within 5 working days. Formal grievances are required to be written and emailed as directed above and will be responded to within 15 business days.
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We would be happy to accommodate your ADA needs. Please contact ISSTD Headquarters via email at [email protected] or via phone at 844.994.7783 for assistance.
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Phone: 844.994.7783
Fax: 888.966.0310