Dissociative Attunement: Being in Rhythm With Individuals Experiencing Complex PTSD

Abstract: 
Psychotherapeutic work with individuals who experience dissociated self-states is challenging and often confusing. Both stabilization and healing can be facilitated by attunement in the therapeutic relationship. Attunement emerges from the therapeutic process. Attuned therapists are like tuning forks that resonate with client/patient shifting states. This shifting attunement is not always noticed and often not well understood. It takes great effort to move beyond the concepts of transference and countertransference so embedded in our training as therapists. Too often attunement with dissociated self-states is mistaken as countertransference and mis-attunement. When that happens, we lose an opportunity to understand more about dissociated self-states and increase the risk of vicarious traumatization. Attunement is an embodied rhythmic encounter that can be understood, in part, through the science and philosophy of entrainment. Entrainment, a natural process by which our biological systems synchronize within an environment, is part of everyday life. We do not need to understand the complex science of rhythmic entrainment to notice and appreciate the felt sense of being in rhythm. However, some knowledge of the neuroscience and the physics of information flow can help us listen to intuition in an informed and critical way. Often, in dissociated states, we lack words to describe experience while much of what we feel and sometimes enact in the treatment process holds meaning. When we notice information communicated without words we facilitate and enhance our therapeutic work. Mindfulness of dissociated attunements can be used as guidance in treatment decisions. Learning to listen is a lifelong project. In this workshop we will use poetry, music and video to explore and enhance our capacity to listen. This will open up possibilities of thinking differently about therapeutic encounters. We will review some current neuroscience research on dissociation that helps us to better understand shifting self-states and that informs concepts of somatic therapeutic treatment. Experiential exercises will be adapted to a virtual context to illustrate embodied ways of listening and knowing. Brief case vignettes will demonstrate pivotal moments in treatment when dissociated attunement facilitated growth and healing.
 
Potenital to Distress: No
 
This presentation was originally presented as a live conference session in October 2023.
 

Target Audience

Intermediate

Learning Objectives

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

  • Define the concept of dissociative attunement.
  • Discuss the role of attunement in psychotherapeutic treatment of Complex PTSD
  • Identify the difference between transference/countertransference and dissociative attunement
  • Identify nonverbal self-state communications
  • Describe the ways that dissociative attunement can lead to vicarious traumatization.
Course summary
Available credit: 
  • 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: 
07/18/2023
Course expires: 
12/31/2050
ISSTD Member cost:
$35.00
Your Price:
$55.00
Part of: 
(Re)building Hope, (Re)orienting Safety, and (Re)stabilizing Treatment with Complex Trauma and Dissociation - Day One
Rating: 
4

Presenter: Karen Hopenwasser, MD
Presenter Bio: Karen Hopenwasser, MD, is Clinical Associate Professor of Psychiatry at Weill Cornell Medicine and is a psychiatrist in private practice treating adults with complex PTSD and dissociative disorders for more than three decades. In 2008 her publication in the Journal of Trauma & Dissociation, “Being in Rhythm: Dissociative Attunement in Therapeutic Practice” addressed the neurobiology and neurophysics of dissociative states in relation to the therapeutic process. Her book chapter “Dissociative Attunement in a Resonant World” appeared in The Dissociative Mind in Psychoanalysis, edited by Howell and Iztkowitz (2016), She has published a number of journal articles and book chapters about clinical work with individuals who identify the lived experience of dissociated self-states, as well as on the subject of intergenerational transmission of trauma. Currently, in press, is a book chapter about climate change, trauma, dissociation and youth mental health, with a focus on eco-neglect as institutional child neglect.

Since 2015 she has been active in global mental health issues. She is Chair of the ISSTD United Nations Committee and is a member of the Executive Committee of the NGO Committee on Mental Health in consultative relationship with the United Nations, where she is also co-convener of the NGO Committee on Mental Health’s Trauma working group. At Weill Cornell she is an active faculty member in the Center for Human Rights, where she participates regularly in psychological evaluations of individuals applying for asylum in the United States.

In 2019 she received the ISSTD President’s Award of Distinction and in 2021 became a fellow of ISSTD. She is a Distinguished Life Fellow of the American Psychiatric Association.

Available Credit

  • 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.

Price

ISSTD Member cost:
$35.00
Your Price:
$55.00
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