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

Conference Programme

We have the pleasure of presenting to you the 2023 programme of the ESTD - AFTD Conference. The programme is scheduled for two days starting on March 10th and will consist of 10 Keynote Lectures and we will finish with a Round Table / Panel Discussion on Saturday afternoon. For more detailed information on the Keynote Speakers, please consult the Faculty page.

Conference Programme


Programme in detail

Friday 10 March

Registration and Welcome Coffee

Keynote 1

From Attachment Trauma to Disintegration Dimension.

Benedetto Farina
Abstract: Traumatic attachment refers to the presence of specific interpersonal dynamics with caregivers described in studies on attachment disorganization and the pathogenic processes these dynamics activate, which, if repeated over time during an individual's development, can be likened to forms of child maltreatment, abuse, and neglect. Traumatic attachment activates several pathogenetic processes: one of them is traumatic disintegration, which causes disruption of high level integrative and regulatory functions, generating psychopathological vulnerability that characterizes some mental disorders (such as borderline personality or complex PTSD) but also spreads to all mental disorders as a psychopathological dimension, worsening their clinical picture and response to treatments.

Keynote 2 (on-line)

Child Sexual Exploitation, Attachment, and the Intersection with New Technologies.

Michael Alan Salter
Abstract: This presentation will describe the evolving impacts of technology on patterns of disorganised and abusive attachment evident in child sexual exploitation. Children may be subject to exploitation online as well as offline by abusive attachment figures such as parents. Children with disorganised attachment are more vulnerable to exploitation by online offenders who manipulate their emotional and relational vulnerabilities. In both cases, the attachment patterns and needs of children are central to the dynamics of technology-facilitated exploitation. Drawing on original research with survivors, therapists, police and other professionals, this presentation identifies common scenarios for child sexual exploitation, the shifting role of technology, and the implications for the treatment of complex trauma and dissociation.
Coffee Break, posters on display

Keynote 3

Early Childhood Crying and Dissociative Tuning:
Towards an Alternative Approach to our Understanding of the Emergence of Dissociative Process.

Eric Binet
Abstract: There is strong evidence that traumatic attachments combined with painful emotions and extreme physiological responses can lead to the emergence of traumatic dissociation. The resulting fragmentation has been described in the ‘structural dissociation of the personality’ theory by Van der Hart, Nijenhuis and Steele. This explanatory paradigm sees dissociation as an adaptive reaction by the child to an environment fraught with adversity. The example of crying in early childhood – and, in particular, its control or even repression – offers alternative view of this use of dissociation, defined as the response of an innate defence system. We will explore another paradigm, which considers that the appearance of the earliest forms of dissociation is linked to toddlers' confrontation with the dissociative states of their attachment figures, to varying extents, to the point of creating dissociative tuning.
12:30- 14:00
Lunch Break (lunch provided) , posters on display

Keynote 4

Dissociation, Relationship and Attachment.

Renée Potgieter Marks
Abstract: This Plenary will focus on attachment as one of the factors which might be instrumental in developing dissociation during infancy and childhood. Early attachment experiences provide a template for future relationships. The given information will highlight research in this field and will be illustrated by practical cases where symptoms such as anxiety and depression masked a significant dissociative disorder originated early attachment trauma experiences. The long-term implications and tendency to be permanently caught within drama triangle relationships will also be discussed and illustrated. The dynamic between attachment, dissociation and relationship is often key to uncover the core of longer term mental health problems in children, adolescents and adults.

Keynote 5

The Impact of Trauma on DNA. Epigenetic Dynamics.

Nathalie Zammatteo and Marie Botman
Abstract: Trauma can leave an imprint on our DNA and alter the expression of genes involved in stress response and regulation. This imprint is driven by chemical modifications to the DNA or its surrounding proteins without changing the DNA sequence. These modifications are known as epigenetic and are more prevalent the earlier the trauma occurs in life or if the trauma is particularly dramatic. Epigenetic changes have been reported in anxiety disorders and post-traumatic stress disorder. These stress fingerprints are transmissible under certain conditions to offspring. The imprints left by stress on the DNA can be reversed through medication and psychotherapy as well as practices such as mindfulness meditation. The aim of this plenary session is to highlight the benefits of psychotherapy and meditation in trauma by targeting the expression of genes involved in chronic stress.
Coffee Break, posters on display

Keynote 6

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

David Elliott
Abstract: Dissociation is a common feature of the more severe forms of insecure attachment. The conditions that result in disorganized attachment also disrupt the organization of mind, and some forms of dissociation may reflect psychological defense in the context of reduced mental structure. This talk will present the 'Three Pillars' model of treatment for attachment insecurity. It will describe the integrative importance of collaborative relationship, of enhancing metacognitve ability, and of immersive mental imagery as a way of resolving insecurity and its associated disorganization and dissociation.
Presentation of the AFTD-EJTD prize for the best article in french 2022.
AFTD General Assembly .
Presentation of the AFTD 2023 research grant .
Dinner at the Comic Strip Museum (Centre Belge de la Bande Dessinée)

An accomplished attraction located in the heart of Brussels, the Belgian Comic Strip Center has been honouring the creators and heroes of the 9th Art for more than 25 years.

The regularly renewed permanent exhibitions and a diversified programme of temporary exhibitions enable visitors to discover the countless aspects of comics art. Tintin and the Smurfs lead the way towards further adventures, an encounter with a world where creativity has no limits.

Enhanced by an exceptional Art Nouveau home designed by Victor Horta, the Belgian Comic Strip Center is just as much a tribute to the pioneers as a glimpse of contemporary comics art.

Saturday 11 March

Registration and Welcome Coffee

Keynote 7

Trauma and Altered States of Consciousness: Toward the Restoration of the Self.

Ruth A. Lanius
Abstract: This lecture will examine the effects of psychological trauma on five dimensions of consciousness: time, thought, body, emotion, and intersubjectivity. The emergence of the self through the integrated experience of these five dimensions of consciousness through a secure attachment relationship will also be described. Here, the effects of an insecure attachment style on the development of the sense of self will also be highlighted. Furthermore, the clinical presentation and the neuroscience underlying alterations in each of these five dimensions of consciousness frequently observed in various forms of trauma-related psychopathology, including complex dissociative disorders, will be discussed to demonstrate the importance of these dimensions in the healing practice. Clinical case examples will be utilized to illustrate relevant concepts throughout the lecture.
Coffee Break and discovery of the posters

Keynote 8

The Traumatic Impact of Betrayal: How Forgetting and Dissociation Project Attachment to an Abusive Parent.

François Louboff
Abstract: How can we understand that many cases of sexual abuse, committed without violence and sometimes without fear, nevertheless give rise to real psychological trauma? Why do some people forget the trauma they have suffered?
To protect their attachment to and relationship with their abusive parent, child victims are forced to turn a blind eye to the betrayal they suffer at the hands of the person who should be protecting them and on whom they are dependent. They are able to do this by keeping information that poses a threat to their attachment system at bay. We will look at how betrayal trauma is particularly toxic not only for psychological and somatic health, but also for relationships with others.

Keynote 9

The Role of Disorganizing Parental Behavior on multicomplex Trauma Development.

Susana Tereno
Abstract: Quality of attachment relationships is believed to be an important early indicator of infant of social and emotional development in the early years. As a result, there has been a growing call for research in this domain, with a particular attention being given to attachment disorganization since it is considered a significant high-risk factor for infant mental health. Studies have confirmed the link between the disorganized attachment pattern and a range of frightening or confusing parenting behaviors, parental experiences of loss, psychosocial vulnerability factors, and parental addiction. In this presentation we’ll present how to identify these disorganizing parental behaviors. Their subsequent potential effects on the children’s psychopathology, namely on multicomplex trauma risk, will also be discussed.
13:00 - 13:10
Best Poster Award Ceremony
13:10 - 14:00
Lunch Break (lunch provided) and discovery of the posters

Keynote 10

A Mentalizing Approach to the Understanding and Treatment of Trauma: State of the Art.

Patrick Luyten
Abstract: In this talk I will provide an update of the mentalizing approach to the conceptualization and treatment of trauma. Trauma can be best considered as a transdiagnostic factor that is implicated in a wide variety of emotional and (functional) somatic disorders. But what is it that makes trauma potentially such a disruptive experience and so difficult to treat? I will discuss the impact of trauma on three interrelated basic biobehavioral systems, i.e. stress regulation, attachment and epistemic trust. An understanding of these three factors leads to treatment principles that are useful for clinicians using a mentalizing approach to treatment of (complex) treatment. In this context I will also discuss the growing evidence for mentalization based treatments for (complex) trauma and associated conditions, including self-harm and substance abuse.
15:00 - 16:15

Panel Discussion

The Role of Dissociation Across Diagnoses.

Moderator: Remy Aquarone
Patrick Luyten
Renée Potgieter Marks
Ruth Lanius
Susana Tereno
Suzette Boon
Olivier Piedfort-Marin