Therapeutic and Research Innovations for the Treatment of Complex Post Traumatic Conditions (2022 New York Regional Conference)
This event will be an in-person event and we do not plan to livestream or record this presentation at this time.
ISSTD is monitoring local, state and federal regulations regarding masking, vaccinations, and testing. We will provide final details of our COVID-19 policy approximately two weeks before the conference. ISSTD may require participants to wear face masks and provide proof of vaccines and/or negative test. We ask that everyone be respectful of the different beliefs of each person regarding these mitigation strategies and understand that each person has a different level of comfort at this time. Our primary goal is to keep everyone attending safe and healthy.
Join us in New York City from September 8-9, 2022 for our second New York Regional Conference, featuring Richard Loewenstein, Lou Himes, Eva Young, and Faige Flakser. This event will kick off with a full-day presentation from Richard Loewenstein that will focus on an introduction of the framework to the new ISSTD Adult Treatment Guidelines. The second day will feature three 90 Minute Workshops on Shame, Children and Adolescents, and those identifying as LGBTQIAA+. These presentations will be information-rich, combining the new treatment recommendations with Dr. Loewenstein’s commentary. The conference will conclude with in an “Ask Anything” session, where participants can ask questions, present cases, and generally discuss issues that are on their minds, in an open-ended, non-recorded space.
Below please find the schedule for the conference as well as abstracts each presentation. Additional details about each presentation will be available
Day One Schedule
|8:30 - 9:00 AM||Registration and Light Continental Breakfast|
|9:00 - 10:30 AM||The Logic of Dissociative Identity Disorder (DID): Essential Concepts for Successful Treatment (Loewenstein)|
|10:30 - 11:00 AM||Break|
|11:00 AM - 12:30 PM||The Logic of Dissociative Identity Disorder (DID): Essential Concepts for Successful Treatment (Loewenstein) - continued|
|12:30 - 1:30 PM||Lunch Break - Provided|
|1:30 - 3:00 PM||The Logic of Dissociative Identity Disorder (DID): Essential Concepts for Successful Treatment (Loewenstein) - continued|
|3:00 - 3:30 PM||Break|
|3:30 - 5:00 PM||The Logic of Dissociative Identity Disorder (DID): Essential Concepts for Successful Treatment (Loewenstein) - continued|
Day Two Schedule
|8:30 - 9:00 AM||Registration and Light Continental Breakfast|
|9:00 - 10:30 AM||At the Intersections of Gender & Trauma: Depth Orientation Therapy with Transgender Youth (Himes)|
|10:30 - 11:00 AM||Break|
|11:00 AM - 12:30 PM||Shame and the Unbearable Lightness of Being (Flakser)|
|12:30 - 1:30 PM||Lunch Break - Provided|
|1:30 - 3:00 PM||Parts in Play: From “Us Me” to “The Me”- In the Treatment Room with a Young Dissociative Boy (Young)|
|3:00 - 3:30 PM||Break|
|3:30 - 5:00 PM||Ask Anything (All)|
The Logic of Dissociative Identity Disorder (DID): Essential Concepts for Successful Treatment
Richard Loewenstein, MD
AbstractDr. Loewenstein will review concepts for successful long-term psychotherapy of dissociative identity disorder (DID). Despite the often-chaotic presentation of DID individuals in treatment, there is almost always a trauma-based/dissociation-based logic that underlies symptoms, life predicaments, and interactions during therapy. The workshop begins with a discussion of discrete behavioral states theory (DBST), a transtheoretical, translational theory of human consciousness. Discrete behavioral states are so ubiquitous in normal and pathological human behavior as to be invisible. States can be understood simultaneously at many levels of analysis – as isomorphs (e.g., sleep states have been studied from cellular states to organismic states, and even shared social states of people sleeping together). DBST can be applied to normal human development and attachment systems, altered states of consciousness, and as an organizing framework for many psychiatric disorders as “state-change” disorders, including bipolar and mood disorders, panic and anxiety disorders, substance-use and addictive disorders, trauma-and-stressor-related disorders, and dissociative disorders (DD. All current theories of dissociation and dissociative disorders are fundamentally based on the states concept. DBST is the over-arching framework for affect theory. Tracking of discrete behavioral states has been described as a model for understanding psychotherapy.
Dr. Loewenstein reviews the foundational importance of psychodynamic psychotherapy principles for DID treatment, as well as understanding hypnosis and hypnotizability. He will discuss how our language about the mind is inherently metaphorical. In particular, metaphors for the phenomenology of DID are often reified, mechanical, and physicalistic. He will review data to conceptualize DID as a specific posttraumatic developmental disorder of self-integration, with its own unique personality organization. The latter combines marked, typically idiosyncratic posttraumatic reactivity along with preservation of crucial resiliencies that underlie the DID individual’s potential positive responses to psychotherapy (e.g., capacities for logical thinking and insight). DID psychotherapy must attend not only to individual self-states, but to the organization of self-state systems, as well as addressing the mind of the “whole human being”. Dr. Loewenstein will discuss the complex relationship of the concepts of self-states to identity-states and their relationship to the construct of personality. He discusses DID self-states as logical posttraumatic adaptations (e.g., reframing “malevolent introject” self-states as paradoxical protectors and/or “underground freedom fighters”). Working in this framework from the beginning of treatment can help navigate many pitfalls of concretely reifying DID self-states based on superficial labels that pattern how we view self-states (e.g., “persecutory” vs. “helper”). All DID self-states are trauma-based attempts at adaptation by the DID child – “problem solvers” - to unpredictably malevolent attachment figures. Dr. Loewenstein will discuss type-D attachment and betrayal trauma as isomorphs. Also, he will discuss the role of shame and disgust, especially around malevolent attachments, as well as the importance of understanding coercive control. Throughout, Dr. Loewenstein will describe traumatic posttraumatic and dissociative aspects of transference/countertransference in DID treatment, as well as mind-control transference, negative therapeutic reaction, and the ubiquity of unconscious flashbacks and multi-level reenactments during psychotherapy.
At the Intersections of Gender & Trauma: Depth Oriented Therapy with Transgender Adults
Lou Himes, PsyD
This presentation explores depth-oriented considerations for working with transgender adults—whose very existence is, at best, stressful (i.e., Minority Stress) and at worst compounded by complex, systemic, and multiple “single-incident” traumas. This presentation will explore the complexities of working with such individuals while also navigating the often unfamiliar (and scary) territory of medical intervention. Topics covered will include transference/counter-transference, clinical judgment regarding transition-related concerns, and the dynamics of surgical support letter-writing. Case vignettes and participant questions will be utilized to address a/typical presenting concerns and psychodynamic considerations of working with transgender adults.
Shame and the Unbearable Lightness of Being
Faige Flakser, LCSW
This presentation will explore shame, as it relates to complex trauma. The presentation will define shame, and unpack the many elements of shame, with a focus on how to recognize its presence in therapy. Distinctions will be made between shame and disgust, shame and self-hate, and shame and low self-esteem. Shame will be examined as existing in connection to others, including enactments that may come up in the therapy relationship. The presentation will also analyze the pathways linking trauma to shame, both those in which shame was an intentional part of the trauma, and those in which shame was a byproduct of trauma. The presentation will show how shame serves as a defense mechanism, protecting the core wound by inhibiting, avoiding, hiding and covering up, and how stripping away that defense leads to unbearable shame, a potential collapse of the nervous system, and even possible suicidality. There will also be opportunity to learn how shame can be camouflaged as its opposite: narcissism and arrogance, adding a complex layer of defense over the defense, presenting as strong and tough, while keeping the shame, and the wound it protects, invisible and untouchable, while it continues to corrode the core sense of worthiness inside. Attendees will learn how to approach shame delicately and with care, handle it skillfully and work with the shame as its own treatment goal; since ignoring it, or mishandling it, will consistently lead to treatment failure. Furthermore, the presentation will explain how the deep understanding and acceptance in the therapy relationship cools the burning shame to a level that can be observed, discussed, unpacked and diffused. Only then can the vulnerability beneath the shame be accessed and true healing can begin, fulfilling the mission of trauma treatment; for while we cannot change what happened, we can change the meaning we make of it.
Parts in Play: From “Us Me” to “The Me”- In the Treatment Room with a Young Dissociative Boy
Eva T. Young, MFA, MPS, ATR-BC, LCAT
“It is in playing and only in playing that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self.” (Winnicott, D.W. 1971,p. 54) This case presentation follows the treatment of a severely dissociated young boy who survived repeated organized abuse outside his home. Symptoms included the presence of compartmentalized, dissociated self-states. Session vignettes from treatment, beginning when Andrew was 5 years old and ending just before his 9th birthday, will illustrate how the treatment room became the reliable play space, holding the potential for discovery, expression and healing for the young boy and his parents.
Children express themselves through action…Thru play they explore conflicting feelings and gain a sense of control in their lives. (Landreth, G.L. 2001). Trauma disrupts a child’s natural use of play, resulting in difficulty identifying and communicating feelings and needs. Children like Andrew create relationships and engage in play that can be described as disorganized and chaotic. The sensitive therapist will invite all the ways of being into the play space, while also allowing the child to set the pace. Beginning in his first session, the therapist provided a variety of mediums to facilitate collaborative self-expression. Art materials became a bridge for communication, promoting meaningful discoveries about the dynamics underlying the young child’s dissociative system.
The role of the therapist, as an “organizing, enhancing and engaged play partner” (Slade, 1994. pp.81) will be emphasized. General treatment principles recommended by the ISSTD (2004) and currently in revision will be discussed, highlighting the significance of the therapist’s authentic presence and playfulness, regardless of technique or clinical orientation.
Through the hard work of play, the child’s capacity to recognize and move seamlessly between affect-states increased as he developed the capacity to sustain a sense of cohesion within himself and in relationships. In a treatment room that promoted self-expression, respect and hope, Andrew and his parents created meaningful connections, leading to the development of alternate coping strategies and an increased capacity to regulate and be in charge of his emotions while utilizing age-appropriate resources in his world.
“We play with kids to help solve mysteries-mysteries of betrayal, mysteries of experience, mysteries of meaning, and mysteries of life itself…The chance to enter the (child’s world) of fear and pain exists in our ability to join in. We play right along... We think “sideways”. And the wonder of all this: we have fun” (Webb, N.B. 2015, pp.xi)
4W43 Event Space
Presenter: Richard J. Loewenstein, MD
Presenter Biography: Richard J. Loewenstein MD is Clinical Professor of Psychiatry at the University of Maryland School of Medicine, Baltimore, MD. He is the founder of, and from 1987-2020 was the Medical Director of, The Trauma Disorders Program at Sheppard Pratt, Baltimore, MD. He is rated by U.S. News and World Report as among America’s top 1 % of psychiatrists. Dr. Loewenstein did a research fellowship at the National Institute of Mental Health in Bethesda, MD. In the past he was a faculty member of the Departments of Psychiatry at Yale University, New Haven, CT; George Washington University, Washington, DC; and University of California, Los Angeles, CA. He is the author of approximately 100 papers and book chapters on dissociation, dissociative disorders, and trauma disorders, among others. He is the Section Editor, Dissociative Disorders, of the American Psychiatric Association (APA), DSM-5 Text Revision (DSM-5TR), to be published in Spring, 2022. He is co-editor of the 4th Revision (in preparation) of the International Society for the Study of Trauma and Dissociation (ISSTD) Guidelines for Treatment of Dissociative Identity Disorder in Adults. Since 2000, he has been an author of the Dissociative Disorders chapter in Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. He is leading the revision of the Dissociative Disorders chapter for the upcoming (11th) edition of this textbook. He is distinguished life fellow of the APA and, among other awards, has received the Lifetime Achievement Award of the ISSTD.
Presenter: Faige Flakser, LCSW
Presenter Biography: Faige Flakser, LCSW, graduated from Simmons College with a Master’s degree in social work and is licensed in both New York and New Jersey. She has been working in the field of trauma her entire social work career, starting with foster care and domestic violence and now works with adult survivors of childhood abuse, including former cult members and individuals with Dissociative Disorders, including DID.
Faige has studied extensively the art and science of trauma work and graduated from the Institute of Contemporary Psychotherapy’s Trauma Studies Program before coming to ISSTD. Faige has also trained in specific modalities that treat trauma, including EMDR, Somatic Attachment, Polyvagal, and IFS, where she also facilitates trainings for other clinicians. Faige continues to learn and bring cutting edge research to her work.
As Faige’s clinical experience and trainings developed, she was met with increasingly complex trauma cases, further along on the spectrum of dissociation. ISSTD became the base, where she studied at their Advanced Studies for Trauma and Dissociation, eventually joining the faculty as well. Faige also co-chairs the Vicarious Trauma SIG at ISSTD and is secretary of ISSTD’s Committee to the UN and secretary of the Organized and Extreme Abuse (OEA) SIG.
Faige’s social work experience ranged from agency work, community clinics, group practice and private practice. Prior to becoming a social worker, Faige earned a Master’s degree in Special Education through Touro College and worked with children with developmental delays. Faige combines her knowledge, experience, passion and skills to help her supervisees, trainees, and most of all, her clients.
Presenter: H.L. Himes, PsyD
Presenter Biography: Dr. H.L. "Lou" Himes (they/them/theirs) is a licensed clinical psychologist who specializes in gender and LGBTQIA experiences. Lou is among the first group of health professionals to be recognized by the World Professional Association for Transgender Health (WPATH) as a GEI-certified gender specialist in mental health. Lou maintains a private practice near NYC where they work nearly exclusively with transgender individuals and provide consultation and educational seminars related to transgender competency in mental health. Lou has several publications related to the impact of oppressive policies on LGBTQIA individuals in religiously-affiliated institutions of higher education; they will be presenting on trauma-informed work with transgender individuals at the 2021 World Congress on Intergenerational Trauma and a webinar through ISSTD on trauma-informed therapy with transgender individuals in 2021. They are currently working toward a certificate in complex trauma and dissociation through ISSTD and learn every day from their clients--the greatest teachers.
In their free time, Lou enjoys woodworking, gardening, and cooking for their spouse and son. Lou is the proud dog-parent of a very anxious chihuahua-miniature pinscher mix, Loki, who often serves as a test subject for Lou's trauma-informed therapeutic techniques.
Presenter: Eva Teirstein Young, MFA, MPS, ATR-BC, LCAT
Presenter Biography: Eva Teirstein Young, MFA, MPS, ATR-BC, LCAT is a licensed Creative Arts Therapist with a private practice in New York City. She treats children,
adolescents and adults and specializes in the treatment of Dissociative Disorders and DID. Eva T. Young holds an Advanced Trauma Certificate from the Center for Advanced Studies in Trauma and Dissociation awarded by the ISSTD. She is a founding member of the Creative Arts Therapy SIG of the ISSTD and co-chair of the Child & Adolescent Guidelines Task Frce. She is a graduate of the Child and Adolescent Psychoanalytic Psychotherapy Program at The William Alanson White Institute where she is currently on faculty. Eva Young is an Assistant Professor in the Graduate Creative Arts Therapy Department at Pratt Institute in Brooklyn, NY. She has presented clinical work at various institutes and conferences including the ISSTD annual conference, The William Alanson White Institute, Institute for Contemporary Psychotherapy, NY Center for Children and Pratt Institute.
Information about approvals for the full conference is included below. Participants attending the full conference will receive 10.5 APA and ASWB continuing education credits and 9 credits for all New York state-specific credits. Below is a list of sessions that are not available for one or more type of credits:
- "Ask Anything" session is not available for any continuing education.
- "At the Intersections of Gender & Trauma: Depth Orientation Therapy for Transgender Youth" session is not available for New York State Education continuing education credits in any discipline at this time.
ISSTD is partnering with CE Learning Systems to offer New York State Education continuing education for multiple disciplines. Below please find the approvals for each discipline available:
Board of Psychology
CE Learning Systems dba CE-Credit.com & AddictionCounselorCE.com is recognized by the New York State Education Department's State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0016.
Board of Marriage and Family Therapy
CE Learning Systems dba CE-Credit.com & AddictionCounselorCE.com is recognized by the New York State Education Department's State Board for Marriage and Family Therapy as an approved provider of continuing education for licensed marriage and family therapists #MFT-0045.
Board for Mental Health Counselors
CE Learning Systems, LLC is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0072.
Board of Creative Arts Therapy
CE Learning Systems (d/b/a CE-credit.com), is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed creative arts therapists. #CAT-0008
Board of Social Work
CE Learning Systems SW CPE is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #0060.
- 10.50 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.
- 10.50 ASWB ACEThe International Society for the Study of Trauma and Dissociation (ISSTD), #1744, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. ISSTD maintains responsibility for this course. ACE provider approval period: 08/20/2021 – 08/20/2024. Social workers completing this course receive 10.50 continuing education credits.
- 12.00 ISSTD Certificate ProgramThis program is eligible for 12.00 credits in the ISSTD Certificate Program.
Early registration ends August 25, 2022 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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Registration is available for one or two days for this event. If you wish to register for one day, click the day you wish to attend at the top of this page to take you to registration for that day.
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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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ISSTD is monitoring local, state and federal regulations regarding masking, vaccinations, and testing. We will provide final details of our COVID-19 policy approximately two weeks before the conference. ISSTD may require participants to wear face mask and provide proof of vaccines and/or negative test. We ask that everyone be respectful of the different beliefs of each person regarding these mitigation strategies and understand that each person has a different level of comfort at this time. Our primary goal is to keep everyone attending safe and healthy.
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, June 3 at 5:00 PM ET. No refunds will be issued for no-shows. Refund requests will not be accepted after June 3, 2022. Not all requests will be granted. Substitutions for attendees are accepted until June 15, 2022.
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 firstname.lastname@example.org. 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.
Disability Policy (ADA)
We would be happy to accommodate your ADA needs. Please contact ISSTD Headquarters via email at email@example.com or via phone at 844.994.7783 for assistance.
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