ESTD - AFTD Conference 2023

When Attachment Meets Trauma:
Disorganization and Dissociation From Childhood to Adulthood.

Preconference Workshops and Conference

DoubleTree Brussels Hotel, 9 - 11 March 2023 - Brussels

Pre-conference Workshops

The workshops are organized on Thursday, March 09th, 2023, in the Doubletree Hotel Brussels Congress Centre. The organization has defined full-day workshops and half-day workshops. Venues for each workshop will be allocated on a “first come, first served” basis. At the end of this first day, we propose to meet for dinner at the comic book museum, which will be reserved for the occasion.

Overview Workshops

How to choose your Workshop?


As you will be able to discover, we are offering 3 workshops that take a full day to complete and 4 half day workshops.

You can choose a full day workshop or you can decide to participate in 2 half day workshops: one in the morning and one in the afternoon.


The full day workshops are Workshop 1 , 2 or 3


Regarding the half day workshops:

In the morning you have the choice between workshops no. 4 (in English) or 5 (in French).

In the afternoon you have the choice between workshop 6 (in English) or 7 (in French).


Please find here an overview of the workshops and the language in which they will be offered.


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Full Day Workshops

Thursday 9 March

Room 1

09:30 - 16:30

Workshop 1

How to Set up Resources for the Reparenting of Inner Children

Emmanuel Contamin (workshop in French)
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Biography:
Psychiatrist and child psychiatrist, EMDR supervisor for adults and children/adolescents. He works in private practice in Lyon. His main interests lie in the fields of psychoeducation, resources – especially for patients with complex traumas – and EMDR groups for the socially disadvantaged. He has written several books: Guérir de son passé avec l’EMDR et des outils d'auto-soin (Healing from your Past with EMDR and Self-care Tools) (Odile Jacob, 2017), Prenons soin de nous! Guide pratique d’auto-thérapie (Let’s Take Care of Ourselves! A Practical Guide to Self-Therapy) (BoD, 2018) and Les 5 cercles de la résilience (The 5 Circles of Resilience) (Larousse, 2021).
Presentation of the workshop
Patients with complex trauma have dissociative mechanisms that are most often based on a first fault line, disorganized attachment, between the motivations to seek out and cling to the attachment figure / and to push it away or to run away. These motivational systems become more complex during development and their internal conflicts maintain dissociative disorders.
They can be compared to “inner children”, and the reprocessing of their post-traumatic disorders can only be done by restoring internal representations of secure attachment ties.
We will offer participants the opportunity to experiment with different ways to strengthen these specific resources
Learning objectives:
  • To understand the different ego states or parts, and their different motivations related to injuries and traumas of the attachment system
  • To be able to identify the different parts of the “inner family system”
  • To know how to install resource figures to meet the needs of “inner children”
  • To know how to strengthen the different resources of the Self to strengthen the stability of patients and their integrative capacity
Participants and prerequisites:
Therapists working with patients with complex post-traumatic stress disorder
Recommended readings:
Contamin E.,« Prenons soin de nous ! Guide pratique d'auto-thérapie » (BoD, 2018), en particulier le chapitre 3
Contamin E., « Les 5 cercles de la résilience » (Larousse, 2021), en particulier le chapitre 2
Art-Mella, « Emotions : enquête et mode d’emploi », tome 3 (bande dessinée)

Room 2

09:30 - 16:30

Workshop 2

Collaboration, Metacognition, and Security-Promoting Mental Imagery: 3 Pillars of Therapy for Resolving Disorganized Attachment

David Elliott (workshop in English)
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Biography:
David Elliott is a clinical psychologist who received his PhD in Psychology from Harvard University in 1989. He is former President of the Rhode Island Psychological Association (USA). Currently he is Chair of the Advisory Board of the International School for Psychotherapy, Counseling, and Group Leadership in St. Petersburg, Russia, and is on the faculty of the Psykosyntes Akademin in Stockholm, Sweden. He is co-author of Attachment Disturbances in Adults (2016), and of a chapter on controversies in the treatment of traumatic dissociation and complex PTSD in the forthcoming second edition of Dissociation and the Dissociative Disorders (2022).
Presentation of the workshop
Psychotherapy for the conditions of attachment insecurity rightly focus
on the relationship between the patient and the therapist. But when
insecurity is most severe – often called 'disorganized' – there are prominent intrapersonal and interpersonal disruptions – such as dissociation -- that can bring big challenges to the therapy relationship and the treatment process. The 'Three Pillars' model of treatment offers an integrative approach that
helps both the patient and the therapist to navigate and resolve the challenges of disorganized attachment in therapy.
In this workshop we will explore the three pillars of treatment: (1) developing a consciously collaborative therapy relationship; (2) enhancing metacognitve ability; and (3) co-creating immersive mental imagery of security-promoting childhood experience. Examples of each will clarify their interconnected roles in effective therapy for resolving insecurity and its associated disorganization and dissociation. A live demonstration of the 'ideal parent figure' imagery process will highlight the healing power of its meta-relational dynamics.
Learning objectives:

  • Participants will be able to describe the 'Three Pillars' of psychotherapy for attachment disorganization, and understand their interdependence in treatment.
  • Participants will be able to describe why the use of co-created mentalimagery both strengthens and transcends the traditional therapeutic relationship for attachment insecurity.
Participants and prerequisites :

My workshop is open to everyone, though I will expect that people have a basic knowledge about attachment security and insecurity. It is not intended to be an introduction to the field of attachment.
Recommended readings :

Elliott, D.S (2021). Co-creating secure attachment imagery to enhance relational healing. Attachment, 15, 36-55.

Room 3

09:30 - 16:30

Workshop 3

Stuck in therapy? Using a Trauma and Dissociation Lens to Find the Way Forward

Renée Potgieter Marks (workshop in English with translation into French)
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Biography:
Renée Potgieter Marks works in the north of England at Integrate, as a therapist and clinical lead. She specialises in children and adolescents with attachment difficulties, complex trauma and dissociation who display significant emotional, social and behavioural problems and/or are struggling with mental health problems.
Renée is also a national and international trainer as well as the founder of BICTD, providing online training for therapists on Assessment and Treatment of Children with Complex Trauma and Dissociation. She is chair of the Child and Adolescent Committee of the ESTD and was involved in developing the Guidelines for the assessment and treatment of children and adolescents with dissociative symptoms and dissociative disorders
Presentation of the Workshop
Becoming stuck in therapy with children and adolescents with complex emotional, social, and behavioural problems is not unfamiliar to therapists. In many cases ‘being stuck’ initiates the beginning of the end of therapy, similar, to a locomotive running out of steam. This workshop will focus on how to uncover underlying problems of trauma and dissociation in children who become stuck in therapy.

The workshop will also focus on the dissociative and traumatised child’s inability to express themselves, avoidance, distraction, and fear of feelings which can cause a sense of ‘stuckness’ in both therapist and child.

Possible other reasons for becoming stuck in therapy with children will also be explored as well as some ideas on how to manage these, sometimes, complex situations. Practical ‘tools’ and innovative ideas on managing being stuck in therapy with children and adolescents will be discussed and illustrated at the hand of case examples to equip therapists with insight and knowledge on how to enable these children to move forward in their therapy process.
Learning objectives:

The objectives of this workshop will be:
  • To raise the awareness of therapists how the problems of unprocessed trauma and dissociation might lie at the root of many children’s emotional, social and behavioural problems;
  • To explore the problem of becoming ‘stuck’ during therapy with children and adolescents with trauma and dissociation;relationship for attachment insecurity.
  • To enhance the knowledge and understanding of participants on the wide variety of potential problems which might cause dissociative children to become stuck during therapy;
  • To provide the participants with sufficient information, case examples and therapeutic ‘tools’ to be able to become ‘unstuck’ and reactivate the therapeutic process with traumatised and dissociative children and adolescents.
Participants and prerequisites:
This workshop is open to all therapists. The workshop will mainly be of value for therapists involved with children and adolescents who display emotional, social, and behavioural difficulties and therapists treating traumatised and dissociative children and adolescents.
Recommended readings:
Waters, F. (2015) Healing the Fractured Child; Diagnosis and Treatment of Youth with Dissociation.

Half Day Workshops

Thursday 9 March

Room 4
09:30 - 12:30

Workshop 4

Different Diagnostic Dhallenges.
Using the Trauma and Dissociative Symptoms Interviews ( TADS-I )

Suzette Boon (workshop in English)
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Biography:
Suzette Boon is a clinical psychologist, PhD, was a psychotherapist at the Top Reference Trauma Centre Altrecht, Zeist. She was president of the European Society for Trauma and Dissociation (ESTD). She does important research into the diagnosis of dissociative disorders and is first author of the book 'Coping with trauma-related dissociation'
Presentation of the workshop
The workshop is intended for participants who already have some experience in diagnosing dissociative disorders. So if you have three levels ( beginning , intermediate and advanced, I would say the last two levels).
Presentation of the worshop and learning objectives

The following challenging differential diagnostic questions will be addressed on the first day using the TADS-I as a diagnostic interview. In this workshop I will give a short introduction about the TADS-I, in the second part I will discuss symptom profiles of patients with and without a dissociative disorder:
Participants and Prerequisites
  • Is my patient hearing dissociative voices or is she psychotic?
  • Are her rapid mood switches part of a bipolar disorder or does my patient have DID, OSDD or both?
  • My patient is selfharming and says that she doesn’t remember doing this. When I try to discuss this she can become very angry with me. Is she a borderline or does she have a dissociative disorder? Or both?
  • My patient talks about different dissociative parts and is convinced that she has DID. She has read a lot about dissociation. How can I be sure that she has a dissociative disorder? She has such a dramatic presentation!
Recommended readings

Boon, S. Assessment of trauma-related dissociative disorders With an introduction to the Trauma and Dissociation Symptoms Interview (TADS-I) New York: Norton Publishers (in press)

Room 5

09:30 - 12:30

Workshop 5

Challenges and Strengths of the Diagnostic Process of Dissociative Disorders.

Olivier Piedfort-Marin (workshop in French)
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Biography
Dr Olivier Piedfort-Marin completed his doctoral thesis on the diagnosis and treatment of dissociative disorders. He is a psychologist and federally recognised psychotherapist in private practice in Lausanne, Switzerland. He has specialized in the diagnosis and treatment of trauma-related disorders. He is (co-)author of about 25 peer-reviewed articles and book chapters in this field of specialization and regularly presents at international conferences. He is honorary president of the AFTD and president-elect of the EMDR Europe Association.
Presentation of the Workshop
The diagnosis of dissociative disorders is a complex and difficult undertaking that requires rigor and following the patient through the meanders of a wounded psyche, while relying on solid scientific concepts. In this seminar we will use SCID-D to illustrate the different types of dissociative symptoms that should be explored: sensorimotor dissociative symptoms, amnesia, depersonalization, derealization, identity confusion, and identity alteration.

The new version of the SCID-D, validated in its French version (Piedfort-Marin, Tarquinio, Steinberg et al., 2021), makes it possible to make DSM-5 and CIM-11 diagnoses. Interview videos will clarify the different symptoms and how patients describe them. We will see how to differentiate between dissociative identity disorder (DID) and partial dissociative identity disorder according to ICD-11.

We will also present the elements allowing to differentiate the TDI from the simulated or pretended TDI, a phenomenon unfortunately in full swing in the French-speaking world.
Learning objectives:
  • To be able to identify the different types of dissociative symptoms
  • To know the structure of the SCID-D
  • To learn to follow the patient in his subjective description of the symptoms
  • To differentiate between TDI and partial TDI
  • To differentiate between TDI and imitated/claimed TDI.
Participants and prerequisites:
  • Psychotherapists working with severely traumatized and dissociative patients.
  • Knowledge of structural dissociation theory is welcome but not necessary.
Recommended readings:
Binet, E. (Ed.) (2022). Évaluer et prendre en charge le trouble dissociatif de l’identité. (Paris : Dunod. En particulier les chapitres 3 (par J. Gysi) et 5 (par O. Piedfort-Marin).
Van der Hart, Nijenhuis & Steele (2010). Le soi hanté. Bruxelles : De Boeck.

Room 6
13:30 - 16:30

Workshop 6

A mentalizing approach to the understanding and treatment of trauma

Patrick Luyten (workshop in English)
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Biography
Patrick Luyten, PhD, is Associate Professor at the Faculty of Psychology and Educational Sciences, KU Leuven (University of Leuven), Belgium, and Professor of Psychodynamic Psychology at the Research Department of Clinical, Educational and Health Psychology, UCL (University College London), UK. He is also an Assistant Professor, Adjunct at the Yale Child Study Center in New Haven, Connecticut, USA.
His main research interests are disorders in the affective spectrum and personality disorders. He is involved in both basic and interventional research in both of these areas. His basic research focuses on the roles of personality, attachment and social cognition or mentalizing - that is, the capacity to understand oneself and others in terms of mental states - in these disorders from a developmental psychopathology perspective.
The strong interdisciplinary focus of his research has led to extensive collaborations with researchers from different fields, ranging from psychology to neurobiology and health economics. Some of his most longstanding collaborations involve colleagues at the Yale Child Study Center in the USA, the Free University of Amsterdam and Erasmus University Rotterdam in The Netherlands, and the University of Geneva in Switzerland.
He serves on the editorial board of several scientific journals, has published over 150 scientific papers and 60 chapters, has co-authored or edited several books, and has been the recipient of in excess of 30 grants
Presentation of the workshop
This workshop will focus on the management and treatment of patient with (complex) trauma from a mentalizing perspective. Basic treatment principles are discussed, with a focus on adaptations of the basic mentalization-based treatment (MBT) model to make it more suitable for addressing the problems of people with a history of trauma. We will also discuss MBT-Trauma Focused (MBT-TF), a specific, modular program of group sessions with some individual sessions for patients with a trauma history. Clinical examples will be used throughout, and participants will be invited to join in role-play.
Learning objectives:
  • Learn about the importance of mentalization in working with complex trauma
  • Gaining insight in MBT trauma focused therapy
Participants and prerequisites:
  • Intermediate and advanced level of working with complex trauma

Room 7

13:30 - 16:30

Workshop 7

Attachment From a Cross-Cultural Perspective.

Félicia Dutray (workshop in French)
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Biography
Felicia Dutray is a psychiatrist and psychotherapist in Switzerland (FMH). She is the lead clinician in charge of the psychotherapeutic consultation for migrants at the Association Appartenances and associate lead clinician in charge of the Psy&Migrants Unit at the Department of Psychiatry of the Lausanne University Hospital, Switzerland. After studying medicine in Vienna and Paris, she carried out medical anthropological research among the Seereer healers in Senegal. She then trained in transcultural psychiatry with Marie Rose Moro in Paris and with Cécile Rousseau in Montreal. She is also trained in hypnosis and mindfulness. She worked in a mobile team specialized in psychiatry and precarity (EMPP) in Alsace for ten years before moving to Lausanne, where she currently works. Felicia Dutray has been working with migrant and refugee patients for over 20 years. She teaches and carries out research in the field of transcultural psychiatry. She contributed to the translation of the transcultural sections of the DSM-5 into French and was part of the expert review team for the transcultural aspects of the DSM-5TR. She has published numerous papers and book chapters in the field of transcultural psychiatry.
Presentation of the workshop
Attachment theory was developed in the postwar North American cultural context. Transcultural psychiatry leads us to take a critical look at this theory which claims to be universal because it is based on a universal developmental need. This workshop proposes to rethink attachment from an “emic” point of view, from within the cultural group. This means becoming familiar with some basics of cross-cultural clinical work and then applying these skills to clinical work around the history of the first links of patients from other cultures.
Participants are invited to share clinical situations with the group.
Learning objectives:
  • To discover the objectives of transcultural psychiatry both clinically and in research, taking the example of attachment theory.
  • To learn to decenter from our ethnocentric vision of attachment
  • To learn to work on the themes of attachment with patients from cultures different from ours.
  • To know the usefulness of cross-cultural attachment assessment in clinical work with traumatized refugees.
Participants and prerequisites:
  • Anyone interested in working with patients from other cultures.
Recommended readings:
Crittenden P. Raising parents. Attachment, Representation, and Treatment. Taylor & Francis, 2015.