Universidad de Salamanca Trauma and Violence Course
Understanding and Treating Complex Developmental Trauma: Attachment Disruption, Dysregulation, and Dissociation
This three day course will be held in English with consecutive translation to Spanish.
Adults who experienced chronic relational trauma as children often develop a wide array of symptoms and problems that can be confusing and difficult to manage for therapists. These can be understood as manifestations of closely related neurobiological changes, attachment disturbances, regulatory difficulties, and dissociation. The concept of Complex Developmental Trauma Disorders along a continuum of severity is a helpful way to make sense of serious comorbidity and symptoms. In other words, trauma has interfered with, and even shaped the individual’s development over time, leading to entrenched maladaptive patterns in regulation, empathy, perception of safety and threat, cohesion and coherence of self and experience, and relationships. The resolution of traumatic memory is thus only part of a much more comprehensive and step-wise treatment, and standard exposure treatments for PTSD are contraindicated until after a period of stabilization. Phase-oriented treatment is the accepted standard of care for these individuals, stressing the need for regulation of arousal, reflective functioning, stabilizing skills, management of dissociation, and a secure therapeutic relationship. Day 1 will include (1) a brief overview of the child’s responses to trauma that are reflected in the adult’s struggles; (2) a description of dissociation, dysregulation, and attachment disruptions in complex trauma; and (3) basic assessment strategies for dissociation and type and pacing of treatment needed. Day 2 will include (4) the essential principles and goals of phase-oriented treatment; and (5) trauma-related phobias and their treatment; and (6) selected practical approaches to treatment, particularly of dissociation, dysregulation and attachment problems in the stabilization phase of treatment. Day 3 will address (7) a brief overview of pacing and titration of traumatic memory work; (8) the therapeutic relationship that simultaneously attends to the patient’s need and fear of the therapist, and which acknowledges and contains dependency needs; and (9) practical approaches to deal with common resistances in treatment.
Contact: Professor José Navarro Góngora at jgongora@usal.es
Sponsor: Universidad de Salamanca