Suicidality and Self Harm in Clients with Complex PTSD and Dissociation

Abstract
Working with severely traumatized people, people on the edge of life and death, demands an intense amount of focus, energy, and skill. The process is challenging for both the client and the therapist, requiring both to deal with serious issues for extended periods of time.

When people have complex trauma, and dissociative issues, the challenge becomes far more complicated. People don't always have access to what causes them to self harm or be caught up in suicidal thoughts, feelings, and behavior. Often, those thoughts and behaviors come from self-states which may or may not be co-conscious with the rest of the person, and man, or may not be involved in the therapy. The behavior and beliefs may also be influenced by a multitude of influences in the person's life - their families, communities, faiths, sexuality, cultures, and history.

Suicidal and self harm behaviors almost always have a purpose, and in most cases the goal is not to die, but to end suffering, to stop the pain - both physical and emotional. Self harm and suicidality serve a purpose, and it is very helpful to discover what that purpose is, in a non-shaming manner, so that client and therapist can work together to find more life-affirming ways to manage their extreme distress.

This workshop will focus on working with clients whose self-harm and suicidality are chronic, and complex. It will cover some ways to understand the purpose behind some of these behaviors, and how the therapist and client can navigate the danger, and collaborate to discover ways to be able to live and heal.

Also, we will discuss the impact on the therapists who work with these people. Therapists working with this population have to deal with the reality that while they have influence, (often, quite a lot), they don't have control over their clients. No one does, so we will also talk about what happens when a client does suicide. How that impacts the therapist, and how the therapist can deal with that very sad reality.

This workshop will also include working with transference and countertransference issues, working with the growing awareness of bias - conscious and inherent - that impacts the therapeutic relationship.and dealing with all-too-familiar feeling of being 'deskilled', and the need for support for the therapist.

Potential to Distress: Yes

This program was originally recorded in March 2024 as part of the 2024 ISSTD in person conference.

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 presentation is at the Advanced Learning Level. 

Learning Objectives

Upon Completion of this webinar, participants will be able to:

  • Discuss the difference between self harm and suicidal feelings in dissociative and non-dissociative people
  • Use their countertransference to help their client learn to manage their self harm and suicidal feelings
  • Identify resources within the client that work towards life and health
  • Explain how self harm and suicidal thoughts and feelings may be used to regulate affect
  • Plan for their own self-care while working with clients who deal with self harm and suicidal feelings
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: 
01/31/2025
Course expires: 
12/31/2050
Part of: 
Perspectives from ISSTD Past Presidents Recorded Content Package
Rating: 
0

Presenter: Lynette S. Danylchuk, PhD
Presenter Bio: Lynette Danylchuk, PhD., is a Clinical Psychologist. She received her Masters Degree from Princeton Theological Seminary, and her Doctorate from The California Graduate School of Family Psychology (now Argosy). She interned in VA Vet Centers and University of California, Berkeley Psychology Department. She has worked in the field of trauma and dissociation for over 30 years. She has worked with people struggling with PTSD, Complex PTSD, and Dissociative Disorders. She had a private practice in San Mateo for several decades. She has been a member of ISSTD since 1996. For seven years, she was been the Director of ISSTD's Professional Training Program, and is currently Co-Chair of ISSTD's Center for Advanced Studies. She served on the Board of ISSTD, and a term as ISSTD President in 2015. She is now a Past President of the International Society for the Study of Trauma and Dissociation, and received ISSTD’s Lifetime Achievement Award in 2019. She is currently continuing to give presentations in person and online focused on working with people who have dissociative challenges. She is also doing consultation work with therapists around the world. She and Kevin Connors co-authored, ‘Treating Complex Trauma and Dissociation: A Practical Guide for Navigating Therapeutic Challenges’. They have just recently completed the second edition of that book which was published in 2023. In her spare time, she reads (often several books a week), dances (hula), sings (any tune that catches her attention), walks all over the hills around her home , and plays with her grandchildren whenever possible.

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.
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  • 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. 
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