Complex Trauma and Dissociation: What Psychiatrists Need to Know … but May Not

This three hour interactive session is designed specifically for psychiatrists, but is relevant and open to all disciplines. Its aim is to enhance participants’ understanding of complex trauma, particularly dissociative disorders which are common in psychiatric populations but challenging to diagnose and effectively treat. Additionally challenging in psychiatry is the influence of stigma-related barriers in residency training and psychiatric treatment settings.

The seminar will begin with three expert presentations. Presenters will first define trauma, complex trauma, complex PTSD, and dissociative disorders, highlighting their prevalence in treatment-seeking populations. They will then focus in on the symptom of dissociation, providing a summary of the latest research findings on the neurobiology and pathogenesis of DID, including the latest research findings and what is known about how the dissociative process can shape a person's psychological state over time. Attendees will learn to identify key signs and symptoms of dissociation, how dissociative symptoms can be mistaken for other psychiatric disorders, and how psychiatrists can use validated tools to enhance diagnostic accuracy for PTSD and dissociative disorders. A particular focus will be teaching practical strategies to distinguish between DID and psychosis, a differentiation of critical importance given its implication for treatment.

Case studies will be used to show common patient presentations, and how these differ from media portrayals. Presenters will discuss their thoughts about what makes DID particularly prone to stigma across history and explore the particular form stigma takes amongst psychiatrists. They will discuss the toll of stigma on research funding, publication, residency training, systems of care, and the lived experience of patients with DID. Finally, presenters will emphasize why it is essential for all psychiatrists to acquire the skills necessary to diagnose and begin treatment for this disorder. Finally, they will present research demonstrating treatment efficacy and review APA practice guidelines.

The last third of the workshop will feature a dynamic question and answer period with the speakers and members of the audience, including other ISSTD Psychiatry Task Force members. Questions will be collected on index cards throughout the presentation as well as solicited directly from the audience. Attendees will be encouraged to engage in the discussion, ask questions, and share their own experiences, fostering a collaborative learning environment. By the end of the seminar, participants will have a stronger understanding of DID and other trauma-related disorders, a greater awareness of the controversies surrounding dissociative disorders, and will be equipped with practical tools to improve diagnosis and treatment outcomes for patients with trauma-related disorders and dissociative symptoms.

Timed Outline
10 Minutes - Case Introduction
15 Minutes - Recognition of prevalence of trauma, complex trauma, and trauma-related disorders in psychiatric patients
30 Minutes - Signs and symptoms of DID and differentiate it from other psychiatric disorders and from common media portrayals
20 Minutes - Neurobiology and pathogenesis of dissociative disorders (DD)
15 Minutes - Tools for diagnosing PTSD and DD
30 Minutes - Break
45 Minutes - Stigma and controversy about DD impact the research, diagnosis, treatment, and lived experience of patients with dissociative symptoms
45 MInutes - Discussion/Q&A