Themes included a) permanent and generalised distrust and disconnection, b) expectation of hurt and/or of punishment, c) impact of abuse and neglect on memory, relationships, mental health, adult functioning and self-concept, d) self-protective or protective behaviour, e) slow and difficult healing, f) significant relationships with the other parent and siblings, and g) resilience. Implications of the findings of long-term and intergenerational impacts of child abuse and neglect will be discussed, including an exploration of resilience within survivors’ experiences.
The debate between proponents of the Trauma vs. Fantasy Models of dissociation has recently been advanced by thorough reviews of the literature and published discussion between proponents of both models. In this plenary talk, Dr Brand will provide an overview of the research addressing this debate. Proponents of the Fantasy Model argue that iatrogenic and cognitive variables cause dissociation and DID, and that DID treatment is harmful to patients. Contrary to these hypotheses, the preponderance of the evidence indicates that trauma causes dissociation and that DID treatment that is consistent with expert consensus guidelines is beneficial to patients. Using results from the Treatment of Patients with Dissociative Disorders (TOP DD) study, Dr Brand will address the notion that DID treatment is harmful to patients.
The study and the treatment of the dissociative disorders has generated a plethora of newer theories and approaches, none of which have demonstrated effectiveness superior to the models they are put forward to replace. I will argue that while conceptually-driven patterns of intervention have certain strengths, the fact that no model advanced to date actually addresses the full range of dissociative phenomena guarantees that each will fall short of providing optimal guidance to the clinician. Instead, I will describe how the intense study of selected clinical phenomena and clinical research suggest insights that in turn facilitate the development of new treatment interventions.