Thursday 21st March, 2-5pm Workshops
In Conversation – switching, stabilisation and so much more
The production of the film used during this workshop has long been an ambition of Remy’s but posed many ethical considerations.
Circumstances and careful preliminary exploration has now made it possible and this is the result, a 1 1/2 hr conversation between a clinician and a high functioning professional living with DID. It demonstrates both subtle and clear switches between adults parts and internal child parts. It involved a day of filming and editing with the person filmed fully in control throughout. She was and remains supported as and when required.
The film naturally mirrors the various stages of the therapeutic journey, slowly getting to know each other with the client beginning to share her story. The client demonstrates a level of self- regulation through talking about her present life and her hopes and fears of entering therapy; grounding her in the here and now. The final part shows a lot more switching as the relationship is developing and many parts of this client’s system feel ‘safe’ enough to talk.
Throughout Remy demonstrates the importance of boundaries and containment that is never experienced as rejecting. It is a journey that is replicated at many levels in a long term, developing therapeutic relationship.
This workshop will give you an opportunity to see and discuss the impact of a client being ready and able to enter therapy and the need for boundaries, containment and establishing stabilising techniques. Recognising and understanding why clients switch is important and will be considered as a factor while looking at it as part of the much wider context.
Melanie will offer insights into how this might have felt for the client and what helps at these times.
Remy Aquarone is an Analytical Psychotherapist, Director of Pottergate Centre for Dissociation and Trauma and a past president of the ESTD. He has worked in this area for over thirty years and uses his substantial clinical experience throughout his training.
Melanie Goodwin is an expert by experience and co-founder of First Person Plural. She has experienced ‘good’ DID focussed therapy and uses her personal understanding to help make the theory easier to contextualise.
Developing Trauma Informed Care
Sarah Robinson - Accredited Psychological Therapist/EMDR/CB and Emma Groves and Jade Warner
Trauma informed care – Lessons learned through the implementation of a pilot within a female 8 bedded medium secure inpatient admissions ward where incidents of self-harm and violence were a daily occurrence.
A pilot which introduced a trauma informed approach to a ward which was prolific in being known for having the highest incident rates of service users harm to self and others, and high turnover of staff. This workshop will look at the journey so far into this pilot. The highs and lows of design and implementation. The lessons learned and the need for service users empowerment and co-production. Staff burnout and improving wellbeing being a central focus through building compassion through training and supervision. The outcomes will be shared and interpreted and focus of exercises will be on generating ideas regarding further roll out throughout the service to make it more idiosyncratic to individuals and on scrutinising the environmental factors which hinder the service users sense of safety.
Case study – A service users experience of her journey, being cared for under trauma informed care on a low secure female Learning Disabilities in patient setting.
The focus on the care being inherently focussed on encouraging co design and collaborative care to ensure the lady is fully involved in decisions made within the MDT. This workshop will also focus on the psychologists and trauma informed care team’s struggles to break through the medical model approach to something which is more trauma focussed and less labelling/diagnosis focussed. Exercises will hopefully generate discussion and ideas surrounding the difficulty that dismissing dissociation creates in our services users understanding of their experiences, whilst the treatment focusses on understanding what would appear to be trauma symptoms as indicative of schizophrenia and treated with high dose anti psychotics or enforced treatments.
Sarah has worked for TEWV for 19 years. Her core profession is nursing however she ventured into psychological therapies in 2005 completing a masters in CBT and then in 2009 completing her basic training in EMDR.
Her career has been varied, finding her delivering psychological therapies in all steps of the stepped care model. Her speciality has been trauma, complex trauma and dissociation since 2010. In 2014 she became a consultant supervisor in EMDR and started a small private practice. Sarah has been working in Forensic services since 2017, recently being appointed as the trauma lead which requires her to lead the design and implementation of Trauma informed care throughout secure services, and outpatient services for both mental health and learning disabilities. In 2018 she became appointed EMDR Professional lead for the trust.
Sarah has presented as several national and international conferences, such as the BIGSpd, and Prison Counselling Conference and is currently leading research around the transition of Trauma informed care within secure services.
Her passion for trauma and recovery has recently seen her be nominated for clinician of the year within her local trust award ceremony. She remains committed to co-production and peer mentoring within her service throughout the journey of TIC.
Dr Emma Groves
Emma has worked in Learning Disability and Forensic Learning Disability services for much of her career. She began her career working for a private secure hospital, specialising in working with men with autism and/or learning disability and moved into the NHS to work in a similar setting with women with extensive trauma and offending histories.
Since qualifying as a Clinical Psychologist in 2016, Emma has worked in the Forensic Learning Disability Service, based at Roseberry Park. She is a qualified Dialectical Behaviour Therapist and currently undertaking training in Radically Open Dialectical Behaviour Therapy and EMDR. Emma is also taking a lead on implementing Trauma informed Care into the female service, which currently entails training staff, offering supervision and encouraging collaboration and co-production. She is a regular presenter at relevant conferences and undertakes research exploring the impact of trauma on service users and those around them. Emma is passionate about improving services for people with a Learning Disability, as well as working to improve the under-recognition of complex trauma within this population.
Jade is currently a Higher Assistant Psychologist at HMP Low Newton on the Psychologically Informed Planned Environment (PIPE) unit. She previously worked at Roseberry Park Hospital in the Acute Adult and Forensic Mental Health (FMH) services and in the Forensic Outreach Service (FOS), as well as working in various other services prior to this. She was first introduced to trauma-informed care whilst working in the Acute Adult Mental Health service and her passion for trauma-informed care has only continued to grow. She was the Trauma Champion in FMH and FOS and currently holds this role on PIPE. Jade was involved in the evaluation of implementing trauma-informed care on the female medium secure ward in the FHM service, working alongside Sarah Robinson. She continues to promote the importance of trauma-informed care in mental health services.
Perpetrator- imitating personalities: A framework for understanding & practice
This workshop will explore the difficulties and dilemmas for both therapist and client of recognising and connecting with parts who have internalised their external perpetrators. These parts are often solated internally, externally, relationally, psychologically and spiritually. They present as powerful
and are challenging to address. The workshop aims to increase understanding of their origins and identify any messages from practice which give hope for change. It will combine presentation, participation & discussion designed to promote sharing. Participants should have some experience of working with this issue and the workshop will be especially relevant to those who work with survivors of organised abuse and mind control.
Sue is a UKCP accredited psychotherapist and supervisor with over 30 years experience in the helping professions and a special interest in the impact of childhood trauma, including organised abuse and mind control. She is a founder member of the UK network of the ESTD and a member of the ESTD UK training group. A regular contributor to national and international conferences, Sue is the author & co-author of 2 books and a number of papers in the trauma and attachment fields. Her work includes taking part in 2 educational DVD’s on complex trauma and dissociation made by First Person Plural and an online attachment-based training module for ESTD UK. In recognition of her work in partnership with experts by experience, she has been made an honorary member of First Person Plural, a UK organisation for dissociative survivors and their allies.
More complex cases in working with children
“Stuck” – Analysis of the ‘stuck experience’ in treating Dissociative Children and Adolescents
Dr Renée P Marks
This presentation will mainly focus on complex problems that might be encountered in the treatment of children and adolescents suffering from complex trauma and dissociation. Major resistance to access the traumatic information or total denial of the existence of the dissociative states, might cause confusion as the child’s external presentation in therapy and elsewhere might be disruptive. The complexity of the dissociative system might at times be such that no progress is made in therapy and in some cases, there is a sense that therapy cannot move out of the starting blocks. An apparent full integration might be followed with, behavioural or emotional problems, just to find that a significant dissociative state was missed in the treatment process.
These and many other similar familiar scenarios will be analysed and discussed. The main focus of this training will be to equip the therapist with some therapeutic tools in order to enable the child to progress effectively through the therapeutic process. The presentation will focus on external as well as internal factors, which might cause a stagnation in the therapeutic process. It will also focus on the child’s internal psychological system and the potential reasons for the inability to progress in therapy.
The training will focus specifically on therapeutic tools and techniques which might enable the therapist to identify the cause of the therapeutic ‘stuckness’. The training will also provide practical ways to move from a place of being ‘stuck’ to insight and change in the child’s internal system and dissociative functioning.
Renée Potgieter Marks
Renée Potgieter Marks is Clinical Lead at Integrate Families, National Centre for Child Trauma and Dissociation and specialises in children with complex trauma and high levels of dissociation. Renée is a national and international trainer on attachment, emotional regulation, complex trauma and dissociation and also provides on-line training with BICTD.