The treatment of dissociative disorders is perhaps the most confusing and difficult of all psychotherapies. Dissociation itself is often misunderstood and mis-characterized. Dissociative clients typically have experienced pervasive developmental trauma that affects virtually every arena of life, and is especially detrimental to their regulatory, relational, and reflective capacities. Psychodynamic and psychoanalytic “treatment as usual” is often insufficient for these clients, since they often lack words to describe their traumatic experiences, but also re-live them in their bodies. The therapist often needs to be more active and verbal than usual, while simultaneously working with implicit and somatic communication more directly. We will explore the intrapsychic organization of dissociation based on disorganized attachment, its highly concretized manifestations in dissociative parts (self-states), and integrative ways to work with the client’s dissociative organization. This workshop will emphasize the integration of interventions that are derived from a wide range of non-traditional psychotherapy approaches, including working with the body, hypnotic imagery, and practical skills building to manage dissociation. The embedded suffering of the client is often transferred to the therapist, so the therapist’s own body is a rich source of information about what is happening in the treatment. Thus we will also explore the implicit conversations that occur between therapist and client, and within the client’s inner dissociative world.

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