By Igor Pietkiewicz, PhD and Radosław Tomalski, MD, PhD, ESTD representatives for Poland
Poland is a country in central Europe, with a population of more than 38 million people. According to the Central Statistical Office, in 2013, there were more than 1.6 million people (over 4 per cent of the population) treated in outpatient units for mental disorders (predominantly anxiety and mood disorders) or substance abuse. There is no information about the incidence or prevalence of various types of abuse. The number of licensed psychotherapists is relatively low in comparison to that of healthcare consumers. There are about 1000 psychotherapists holding a certificate of the Polish Psychiatric Association or the Polish Psychological Association (the two oldest and largest professional organisations in the country). It is difficult to estimate the number of therapists in training, because psychotherapy schools do not provide such information. There are currently only 5 ESTD members in Poland and our activities are closely linked to the SWPS University of Social Sciences & Humanities Faculty in Katowice.
HIGHLIGHTING THE SIGNIFICANCE OF TRAUMA
In 2015 and 2016, our work focused on the dissemination of knowledge about the diagnosis and treatment of trauma-related disorders among healthcare practitioners who attended numerous events we organised in Katowice: two conferences dedicated to the psychotherapy of psychosis and a few workshops on trauma. During the conferences, Trevor Eyles from Denmark delivered interesting presentations on the “Maastricht approach” and the “Aarhus model” followed by 3-day workshop for psychiatrists and voice-hearers on “Voices-led therapy”. Andrew Moskowitz also gave a pre-conference, whole-day workshop "Reconceptualizing trauma, dissociation and psychosis: Can ‘madness’ have a meaning?" There were also two intense and inspiring two-day workshops led by Suzette Boon: “Diagnosis and differential diagnosis of dissociative disorders and other trauma-related disorders” in October 2015, and “Long-term consequences of chronic traumatization: Assessment and phase 1 treatment of Complex PTSD and dissociative disorders” in September 2016. Suzette additionally agreed to give an interview about the effects of trauma, which was recorded and made available to students and the general public via the University page and social media: http://swps.pl/dysocjacja. In 2016, Giovanni Tagliavini, Antonio Onofri, and Giovanni Liotti were invited by a small group of therapists from Poznań and Katowice, to talk about dissociation, adverse childhood experiences, grief, and disorganized attachment. A number of valuable books about trauma and dissociation have also been published in Poland recently, but this is beyond the scope of this brief report to enumerate all of them. However, it is worth mentioning that a few these publications have been translated from Italian by Hanna Michalska, a Polish ESTD member.
To develop education in our field and attract new members to ESTD, a Trauma and Dissociation Seminar was also launched at the University, where professionals can meet and discuss practical aspects of diagnosis and treatment. This seminar is supported by ESTD members who agreed to participate online and share their experience. In November 2016, Anabel Gonzalez from Madrid gave an introductory talk about dissociative phenomena and disorders, and in March 2017, Giovanni Tagliavini from Milano will talk about treatment of dissociative disorders (http://badaniepsyche. pl/news/11). A Facebook interest group for trauma and dissociation has also been established, to share news and encourage discussion.
PREPARING TOOLS
To support further research and therapeutic work, we prepared a cultural adaptation of several popular screening instruments: a revised version of the Dissociative Experience Scale (DES-R), Dissociative Symptoms Scale (DSS), Somatoform Dissociation Questionnaire (SDQ20), and Trauma Experiences Checklist (TEC). We are also planning to support Prof. Eli Somer in creating a Polish version of his instrument to measure maladaptive daydreaming. Two structured clinical interviews were also translated into Polish: Trauma and Dissociation Symptoms Interviews (TADS-I) and the Maastricht Interview to explore the experiences of people hearing voices.
TALKING TO THE DEVIL
In Poland, which is predominantly Catholic, many people are highly involved with religious communities, affecting practitioners’ values, social axioms, and illness-behaviour, including how they conceptualise symptoms and seek help. In many groups, individual and collective exorcisms are practised for those who experience changes in behaviour and identity, attributed to possession. At the beginning of 2016, we launched a pilot study to explore phenomena and symptoms associated with possession. We submitted a grant proposal to the National Research Centre, hoping to obtain the budget to continue this study. We submitted another one for research into depersonalisation and derealisation in clinical and non-clinical samples.
We received great support from Prof. Onno van der Hart and Dr. Suzette Boon in creating both projects and running a pilot study. Both grant proposals are undergoing an evaluation process. One of them has already received very good reviews from the Polish experts and qualified for phase two (review of international experts). Success in that would lead to establishing a Centre for the Study of Trauma & Dissociation at our University, employing research assistants and developing international co-operation.
We are extremely grateful for ESTD's warm reception and the continuous support we receive from the board and regular members who support us in these endeavours.
Agnieszka Widera-Wysoczanska:
poland@estd.org
Igor Pietkiewicz
poland@estd.org
Radoslaw Tomalski
poland@estd.org
DATE: 23-24.08.2019
PLACE: Research Centre for Trauma & Dissociation, SWPS University, Katowice (PL)
During a two-day workshop, held in English at the Research Centre for Trauma & Dissociation (Katowice, Poland), we will present basic theory behind trauma-related disorders and develop skills in the differential diagnosis of dissociative disorders, using a structured clinical interview Trauma & Dissociative Symptoms Interview (TADS-I). The interview allows for making a positive diagnosis of dissociative disorders (i.e. not by exclusion) and also of false positive diagnosis. However it requires some training and explanation of symptoms, which will be provided in the course.
We will present the possible answers that may be obtained in the interview and comment on intricate differences between dissociative and non-dissociative symptoms. These objectives will be obtained by presentation of clinical cases as well as video recordings of the interviews. The participants will perform a section of the interview using recorded material and will discuss the difficulties encountered in that task.
The theoretical part of this workshop will help participants understand why the concept of dissociation, used by various clinicians and researchers to denote different phenomena, has become unclear and misleading. Then, participants will become familiar with the theory of the structural dissociation of personality and how it can be applied to understand different mechanisms and symptoms in trauma survivors. This theory has been developed by Dutch clinicians (Onno van der Hart and Ellert Nijenhuis) in cooperation with Kathy Steele from US, who draw extensively on early ideas of the French clinician, Pierre Janet. During the workshop we will discuss in detail both psychoform and somatoform dissociation symptoms, illustrating them with video material. Popular screening tools for dissociation will also be presented.
The main part of the workshop will be based on TADS-I developed in recent years by Suzette Boon and Helga Matthes. Suzette Boon has worked together with Onno van der Hart within the framework of the theory of structural dissociation and the interview is the result of her 30-year experience in diagnosing and treating dissociative disorders. Helga Matthes is a German psychoanalyst and EMDR therapist and trainer.
PRESENTERS
Igor Pietkiewicz, PhD, is an academic teacher, researcher, certified psychotherapist and supervisor at the Polish Psychiatric Association. He is chair of the Research Centre for Trauma and Dissociation at the SWPS University of Social Sciences and Humanities, and a board member of the European Society for Trauma and Dissociation. He has been conducting multiple studies in community health psychology and clinical psychology. He also conducts individual and group therapy in a day treatment centre and in his private practice. Read more
Radoslaw Tomalski MD, PhD, is a psychiatrist, certified psychotherapist and supervisor at the Polish Psychiatric Association and the Polish Society for Psychodynamic Psychotherapy. He is the director of a day treatment center for psychosis in Sosnowiec and also has a private practice in Katowice. He has experience in both group and individual psychotherapy of adult patients with personality, dissociative, and psychotic disorders. He conducts research focused on dissociative disorders and related clinical issues and is a lecturer at SWPS University in Katowice. He is a country representative of the European Society for Trauma and Dissociation (ESTD) for Poland. Read more
FEES
* Participation fee for ESTD non-members is 800 PLN (200 Euro)
* Participation fee for ESTD members is 600 PLN (150 Euro)
* The fee covers participation in this two-day workshop, educational materials used during training, tea & coffee breaks (excluding lunch).
SIGN UP AND RESIGNATION POLICY
Sign up requires filling in a registration form and paying the participation fee, by making a bank transfer to: E-PSYCHE.EU S.C., Dąbrowskiego 17/2, 40-032 Katowice, Poland. Account number: PL 59 1140 2004 0000 3102 7802 4338
Bank name: mBank S.A. FORMERLY BRE BANK S.A. (RETAIL BANKING) LODZ
BIC/SWIFT: BREXPLPWMBK
Please, provide a description in your bank transfer as follows: TADS WORKSHOP,
Ostateczna rezerwacja udziału w seminarium gwarantowana jest po dokonaniu rejestracji i wpłaty na konto. Ze względu na ograniczoną liczbę miejsc, o przyjęciu na warsztat decyduje kolejność zapisów potwierdzonych wpłatą. Ostateczny termin zapisów i wpłaty upływa 11 listopada 2019 r.
W przypadku chęci rezygnacji z udziału, prosimy o wysłanie informacji o tym na adres firma@e-psyche.eu w terminie do 11 listopada 2019 r. Zostanie wtedy dokonany całkowity zwrot wpłaty. Rezygnacja z udziału po tym terminie wiąże się z utratą opłaty za uczestnictwo w warsztacie.
ORGANISERS
E-psyche.eu s.c. in collaboration with Long Island University (New York, USA), Research Centre for Trauma & Dissociation, University of Social Sciences and Humanities (Katowice, Poland), and the European Society for Trauma & Dissociation (www.estd.org)
CONTACT
Igor Pietkiewicz, tel. 602 648 713, ipietkiewicz@e-psyche.eu
Alterations in consciousness are common experiences in healthy individuals and patients with a variety of mental disorders. Such states may also be natural reactions to traumatic experiences, and accompanied by dissociative symptoms, when the mind detaches itself from overwhelming feelings and one’s surroundings to survive. Depersonalization (a sense of detachment from one’s mind or body) and derealization (experiencing the external world as dreamlike or unreal) can be experienced with different intensity and in various contexts, for example, during meditation, religious practices or intense sports exhaustion.
Some forms of depersonalization and derealization are chronic, significantly dysfunctional, cause distress, and are regarded as pathological. Yet there are no empirical studies that compare normal and pathological depersonalization / derealization, how they relate to trauma, and how individuals subjectively experience them.
In this project, structured clinical interviews with trauma survivors are conducted, video-recorded and analysed by the research team to explore personal experiences of depersonalisation, derealisation, and dissociation. Such studies are necessary to help clinicians recognise and diagnose dissociation and alterations in consciousness characteristic of trauma-related disorders, subsequently leading to better diagnostics, referral, and treatment.
This project offers you: free-of-charge assessment of dissociative symptoms and diagnostics towards a dissociative disorder, a comprehensive report about your symptoms which you can share with your doctor or therapist, and an opportunity to discuss your problems and recommendations for treatment.
The project is financed by the National Science Centre in Poland, grant number: 2016/22/E/HS6/00306.
Research team:
Igor Pietkiewicz, Ph.D.; Radosław Tomalski, M.D., Ph.D.; Suzette Boon, Ph.D.; Onno van der Hart, Ph.D.; Anna Bańbura, M.Sc.; Szymon Nęcki, M.Sc.; Anna Hełka, Ph.D.
28–30 June 2019 EMDR Europe conference. Krakow, Poland.
Transitioning from phase 1 to phase 2 in treatment of dissociative disorders
Katowice, 12th and 13th January 2018
Suzette Boon, PhD
This workshop aims at building up the skills discussed in the phase 1 treatment and takes up the issues connected with moving on to phase 2.
Days 1: Treatment of “Difficult” Patients with a dissociative disorder; continuation of phase 1 treatment
Every therapist has encountered a “difficult patient” who engenders feelings of guilt, rage, shame, humiliation, helplessness, and incompetency, and who seems to resist virtually any efforts toward progress. In the face of massive resistance, the therapist may retreat into destructive enmeshment or distancing with the patient. The “difficult” patient can typically be understood as having extreme problems with several related issues: (1) chronic defenses against perceived relational threat (e.g., criticism, rejection, abandonment, or engulfment and control); (2) chronic defenses against inner experience (e.g., affects, cognitions, physical sensations, wishes, needs); and (3) difficulties in self regulation. On top of these problems there maybe ongoing abuse which makes the therapy more complicated. Interventions are first directed to the therapist, who must learn to empathically understand the patient’s behavior, and act with reflection rather than with reaction. This reflective stance is a treatment strategy in itself for the patient, and paves the way for further interventions. Strategies for the therapist and patient will be discussed extensively. On day one I will focus on chronic defenses and “therapy undermining behaviors”, role play will be the most important way of teaching and participants are encouraged to discuss their cases.
Day 2: The Phase II: the treatment of traumatic memories of patients with a complex dissociative disorder
In phase II the focus turns to working with memories of traumatic experiences. Effective work in this phase involves remembering, tolerating, processing, and integrating overwhelming past events. In this workshop I will discuss several techniques to integrate traumatic memories. The workshop will start with the presentation of a checklist to evaluate if a patient is ready to go from phase I to phase II. And if a patient is ready, where do you start? How do you plan and schedule the sessions? Which dissociative parts participate? What is needed to maintain safety during the work. How can patients contain intense feelings if the work becomes too intense? How do we know that a memory is sufficiently integrated? Special focus will be on the “guided synthesis technique” (Boon & van der Hart, 1995; van der Hart, Nijenhuis& Steele, 2006).
Registration
The fee for the workshop is 150€, for members of ESTD 100€. In order to participate make the payment using the following account:
SWPS Uniwersytet Humanistycznospoleczny
Raiffeisen Bank Polska S.A., Piekna 20, 00-549 Warszawa, Poland
IBAN: PL20 1750 1019 0000 0000 2125 4223
SWIFT: BIC: RCBWPLPW
Please, indicate in the title of your payment “workshop Suzette Boon” together with your name. Also, please send an email to ipietkiewicz@swps.edu.pl with your name, address, telephone number and if you need an invoice – invoicing information (buyer’s name, address and VAT number).
Programme
The workshop will take place on Friday 12th of January and Saturday 13th of January 2018. The exact hours will be announced beforehand.
Venue
Uniwersytet SWPS in Katowice, ulica Techników 9.
Certificates
The certificates of attendance will be available on the second day of the workshop.
