States of Abject Shame and Self-Loathing: Compartmentalization, Dissociation and Enactments

November 20, 2021

Dissociative processes that stem from cumulative developmental relational trauma and neglect frequently manifest in signs including autistic defenses, dissociation, chaotic relationships, disorganized attachment, split-off affective states, and vulnerability to disintegration. These phenomena typically exist side by side with apparent ego strength and high functioning, even in non-abused patients. Developmental trauma stemming from uncontained distress and failed dependency can persist throughout the lifespan, creating ripples of dysfunction that mask as character distortion and contribute to therapeutic impasse. In those exhibiting Dissociative Identity Disorder, compartmentalization and shame work together to achieve a form of self-regulation that keeps affects dis-enlivened resulting in chronic abject states of relentless despair which shame-based self-loathing keeps hidden. The concept of abject states needing to be exposed and worked through relationally will be emphasized in this presentation, as well as the self-regulatory function of chronic shame in DID.

Potential to Distress: Yes

Target Audience


Learning Objectives

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

  • Identify typical manifestations of cumulative 
  • Employ an understanding of transference/countertransference dynamics in treating those Suffering from abject states of despair
  • Recognize dynamics of chronic shame in DID that serve as regulatory functions
  • Engage self states that assume functions of internal shaming
Course summary
Available credit: 
  • 3.00 ISSTD Certificate Program
    This program is eligible for 3.00 credits in the ISSTD Certificate Program.
Course opens: 
Course expires: 
Event starts: 
11/20/2021 - 10:00am EST
Event ends: 
11/20/2021 - 1:30pm EST
ISSTD Member cost:

Presenter: Rick Hohfeler, PsyD
Presenter Bio: Dr. Rick Hohfeler is a clinical psychologist who has maintained a private practice in the Milwaukee, Wisconsin area for the past 30 years. He has specialized in psychological trauma since 1986 as co-manager of an inpatient program treating survivors of abuse at Rogers Memorial Hospital where he also co-managed an inpatient program treating children and adolescents until 1995. He continues to treat adults, children, and adolescents suffering from disorders associated with severe developmental trauma including a special emphasis on dissociative disorders in private practice, as well as with the Wisconsin Department of Corrections. He has provided supervision and consultation to therapists and case managers from a variety of agencies in the Milwaukee area for the past 20 years with consultation affiliations having expanded internationally. Rick is a faculty member of the Wisconsin School of Professional Psychology in Milwaukee, Wisconsin where he teaches courses in trauma and dissociation. He is a member of ISSTD and was elected to their Board of Directors in 2016. Since 2014 he has acted as moderator for the Virtual Book Club sponsored by ISSTD. He has presented professionally on topics related to trauma and dissociation locally, nationally, and internationally.

Presenter: Kathleen Adams, PhD
Presenter Bio: Kathleen Adams, PhD received her doctorate in Psychology at the University of Texas in 1976, with a specialization in child clinical psychology. She has been in private practice since 1977, but until 1988 also served within outpatient and inpatient treatment facilities teaching, developing group therapy programs, and supervising individual therapy of interns and residents. Her current area of specialization is the high functioning patient (adult, adolescent or child) who nonetheless ‘falls into the abyss’ periodically, struggling with a bewildering mix of competence, loneliness, and anxiety. She also works with children who struggle with reactive attachment disorder, developmental trauma, aspergers disorder, gender identity issues, anxiety and loneliness. She has an additional focus with chronic pain patients.

Available Credit

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


ISSTD Member cost:
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