Summary speakers The Self behind the Self

Summary speakers The Self behind the Self
Thursday May 21th, 2015
Theatre Odeon Zwolle
Andrew Moskowitz
Could schizophrenia be a dissociative disorder? Three historical enigmas (and one
contemporary one)
From the time the concept of schizophrenia was first proposed by EugenBleuler in 1908,
there have been numerous surprising links to dissociation. Bleuler’s term schizophrenia is
strongly linked to dissociation not only in name and definition, but also in the related concepts
of splitting and complexes. Kurt Schneider’s 1 rank symptoms of schizophrenia, particularly
various forms of voice hearing, were heavily weighted in all major diagnostic systems for the
past 1/3 of a century, despite evidence for their frequency in Dissociative Identity Disorder.
And Gregory Bateson’s long disparaged double bind theory of the etiology of schizophrenia
shows striking similarities to new conceptions of disorganized attachment, which are linked to
the development of dissociation. Finally, studies of voice hearing over the past several
decades show robust correlations with measures of dissociation, in a wide range of clinical
and non-clinical populations. Are all of these connections simply coincidences? Or do they
suggest that schizophrenia could possibly represent some variant of a dissociative disorder?
Andrew Moskowitz, Ph.D., is Professor of Clinical Psychology at Aarhus University in
Denmark, and head of the Attachment, Dissociation and Traumatic Stress (ADiTS) research
unit. He has published widely on historical, theoretical and empirical connections between
psychological trauma, dissociation and schizophrenia, and is the lead editor of the influential
book, 'Psychosis, trauma and dissociation: Emerging perspectives on severe
psychopathology' (Wiley, 2008), which is going into its 2nd edition. He is on the executive
board of both the European Society for Trauma and Dissociation (ESTD) and the
International Society for Psychological and Social Approaches to the Psychoses (ISPS).
Onno van der Hart
Dissociative psychosis implies a division of the personality amendable by psychotherapy
Although Dissociative Psychosis (DP) is not not currently recognized as a formal diagnostic
category or syndrome, specialists in the field of trauma-related dissociation have argued that
doing so has great clinical value. Originally called hysterical psychosis, this syndrome has
been documented in a number of traumatized patients with diagnoses ranging from
posttraumatic stress disorder to dissociative identity disorder (DID). From the perspective of
the theory of structural dissociation of the personality it has been proposed that for a
psychotic disorder or episode to be recognized as DP, it should be embedded in a
dissociation of the personality, and, by definition, dissociative symptoms should be present.
Psychotic symptoms are dissociative in nature when they pertain to goal-directed actions or
other important features of one or more emotional parts of the personality that the patient as
apparently normal part of the personality can, therefore, not control. In this presentation the
dissociative nature of DP will be described, as well as its various forms and ways of resolving
the psychosis using psychotherapy (often including elements of hypnosis).
Onno van der Hart, PhD, is emeritus professor of psychopathology of chronic traumatization,
Utrecht University. He has a small psychotherapy practice in Amstelveen, the Netherlands,
and he is involved in consultation, teaching and research in the area of diagnostics and
treatment of patients with complex trauma-related disorders, including the dissociative
disorders. With Ellert Nijenhuis and Kathy Steele, he wrote The haunted self: Structural
dissociation and the treatment of chronic traumatization. New York/London: Norton, 2006.
With Suzette Boon and Kathy Steele, he wrote Coping with trauma-related dissociation: Skills
training for patients and therapists. New York/London: Norton, 2011. His website is:
Colin A. Ross
Catatonia, autism, dissociation, and cross-cultural syndromes
In this talk, Dr. Ross will describe the overlap and similarities between catatonia, autism,
dissociation, and cross-cultural syndromes. The DSM-5 criteria cannot differentiate some
cases of childhood-onset schizophrenia, with predominant negative and catatonic symptoms
from autism. Dr. Ross hypothesizes that there may be a subgroup of autism cases which
represent a trauma-freeze response, just as is true for catatonia. Additionally many crosscultural syndromes are widely regarded as being dissociative in nature, but include an array
of catatonic symptoms; Dr. Ross will present evidence that “cross-cultural syndromes” can be
observed in Caucasian, English-speaking American patients with dissociative disorders, and
that catatonic symptoms are very common in this population. Thus, there is more overlap
between these symptom categories that is commonly appreciated. The relationship between
trauma, dissociation and catatonia will be illustrated through case examples from the
nineteenth century Salpetriere hospital, plus a current case example.
Colin A. Ross received his M.D. from the University of Alberta in 1981 and completed his
psychiatry training at the University of Manitoba in 1985. He has been running a Trauma
Program in Dallas, Texas since 1991 and consults to two other Trauma Programs in Michigan
and California. He is the author of 27 books and 180 professional papers and is a Past
President of the International Society for the Study of Trauma and Dissociation.
Yolanda Schlumpf
Neurobiological findings in dissociative identity disorder
In accordance with the Theory of tructural Dissociation of the Personality (TSDP), dissociative
identity disorder (DID) is a severe form of posttraumatic stress disorder and encompasses
different dissociative subsystems of the personality.
A primary classification is the “Emotional Part” (EP) and the “Apparently Normal Part” (ANP).
Tw of MRI studies and an eye-tracking study, in which DID patients were measured as ANP
and EP, will be presented. The studies demonstrate that EP and ANP have different
biopsychosocial reactions to supra liminally und subliminally trauma-related cues (i.e., facial
stimuli). In line with TSDP, as EP but not as ANP, patients emotionally engaged in these
stimuli and were hypervigilant. Furthermore, the perfusion pattern in a task-free condition (i.e.,
resting-state) was also dependent on the dissociative part which was dominant during theme
asurement. The reactions of genuine DID patients could not be mimicked by actors. The
findings contradict the view that DID phenomena involve suggestion, fantasy proneness, and
Ellert R.S. Nijenhuis
Enactive trauma therapy: Laying down a path in walking together
Trauma, dissociation, psychosis: third-person concepts crafted to capture and grasp
perplexing first-person phenomena. Technical tools to physically judge "objects of
investigation", they cannottell“what it is like” to be traumatized, to dissociate, or be psychotic.
That understanding takes a first-person perspective, an “I” who has and phenomenally judges
his or her experience. Grounded in this basic insight, enactive trauma therapyis the
collaboration of two intrinsically embrained, embodied, and environmentally embeddedliving
systems to create new actions and new meaning. One system is the injured individual who
engages a first-person perspective (a phenomenal “I”) and second-person perspective (a
phenomenal “I-You” relationship). The other system is the therapist who encompasses and
ideally integrates his or her first-person, second-person (empathic phenomenal judgment
grounded in an “I-You” relationship), and third-person perspective. This dance of two lifeworlds takes attunement, resonance, timing, sensitivity to balance, movement and rhythm, as
well as dedication and courage to follow and lead.
Ellert R.S. Nijenhuis, Ph.D., is a psychologist, psychotherapist, and researcher. He engaged
in the diagnosis and treatment of severely traumatized patients for more than three decades,
and now teaches and writes extensively on the themes of trauma-related dissociation and
dissociative disorders. He is a research consultant at ClieniaLittenheid, Switzerland, and is
co-director of Psychotraumatology Institute Europe, Duisburg, Germany. His publications
include the book Somatoform Dissociation. With Onno van der Hart and Kathy Steele he coauthored the book The Haunted Self: Structural Dissociation and the Treatment of Chronic
Traumatization. The first two volumes of the trilogy The Trinity of Trauma: Ignorance, Fragility
and Control will be released in the spring of 2015.