Inside-out: Uncovering Hidden Worlds of Children and Teens with Dissociative Disorders

Abstract
The internal world of children and teens with dissociative disorders is often hidden even from the youth themselves. They are perplexed by their own behavior and yearn to be “seen” and understood. Caregivers and other adults, without knowledge of dissociation or the inner world of the child, are confused and frustrated by dysregulation in dissociative children and teens; they experience the ever-shifting moods, behaviors, and relationship ruptures as impossible to manage. Children are often referred to mental health treatment by desperate adults, often by foster and adoptive parents or child welfare workers. Symptoms of dissociation are easily misinterpreted even by well-meaning adults as: oppositionality, defiance, and manipulation, or are misdiagnosed by well-meaning clinicians as: psychosis, extreme mood disorders, emerging personality disorders, OCD, factitious disorder, or other severe conditions. This workshop introduces attendees to the signs and symptoms of developmental trauma disorder (DTD) and severe dissociative disorders by making visible the internal world of youth through case examples as well as glimpsing youth through the lens of their caregivers. Demonstrations making the invisible visible using various clinician friendly tools and techniques will give attendees needed resources to discover and understand dissociative symptoms in their young clients. Formal screening tools such as the Child Dissociative Checklist, the Adolescent Dissociative Experiences Scale, The Imaginary Friends Questionnaire and the Somatoform Disorders Questionnaire will be used in case examples along with less formal techniques leveraging art techniques. The etiology of dissociative disorders will be elucidated through discussion of both disorganized attachment and the emerging construct detailing criteria for developmental trauma disorder. Finally, issues of symptom overlap with other mental health diagnoses, differential diagnoses, and co-occurring diagnoses will be discussed. Through this workshop, attendees will know where to go for the most up to date information on assessing and treating childhood dissociation and handouts of ready-to-use resources will be distributed. Attendees will leave this workshop with increased confidence that they can help make the invisible become visible!