Survivorship Webinar June 16 – From Fragmentation to Integration

forwarded with permission

Saturday, June 16
3 pm Pacific Time – Please note the time change
Presenter: Dr. Cathy Kezelman
“From Fragmentation to Integration”

This webinar will depict my personal psychotherapeutic journey to explore the process of recovery from an extreme dissociative state, which was characterised by a complete amnesia for 10 years of my childhood and fragmentation of my self onto integration and recovery. Despite my therapist providing a safe reliable and contained space it took me a long time to trust her or appreciate that she could keep me in mind. She was empathic, compassionate and skilled and the relationship we developed was core to my survival and my recovery. Over years she bore witness to the dissociated fragments of trauma returning to my consciousness and the intense emotions which were overwhelming me. Through a committed analytical psychotherapeutic process she guided me from terror and confusion through chaos and onto acceptance and understanding.

It will explore the changes in me from having little insight into myself, my inner world, relationships or functioning as a whole being. I now know my own unique feelings and choices, and have the capacity to reflect, form deeper relationships and live a full rich life.

Dr. Cathy Kezelman is President at ASCA (Adults Surviving Child Abuse), an Australian national charity which advocates for a trauma informed approach to care and trauma specific services for survivors of complex trauma secondary to child abuse and neglect. She is a director of MHCC (Mental Health Co-ordinating Council NSW). She is an active advocate for Australian adult survivors of childhood trauma and informed mental health responses to trauma. Early in 2010 she published her memoir, ‘Innocence Revisited’ – a tale in parts, her story of recovery from childhood trauma. Cathy is also a mother of four adult children and a foster child.

REGISTRATION
Registration closes Thursday evening June 14, 2012

To reserve a space in the webinar, e-mail Shamai at shamai@survivorship.org   and give her this information:

1. Your name
2. The webinar you wish to attend: “The aftereffects of extreme child abuse and the resiliency of the human spirit.”
3. Amount and method of payment  (check, PayPal, money order)
4. Your preferred e-mail address (so we can send you instructions)
5. The name you will be using for the webinar. (This does not have to be your real name or your message board screen name.)

You will receive a confirmation email immediately and an invitation link and instructions after the registration closes

COST
Webinars are on a sliding scale from $50.00 to full scholarship (while we offer full scholarships for webinars please consider paying whatever you are able to. Even $5 will help to cover the cost of the webinar provider). Please remember to factor in the cost of the telephone call if you don’t have a computer headset. The PayPal button is near the bottom of the page at http://www.survivorship.org/webinars.html

If you wish to pay by check please send it to: Survivorship, Family Justice Center, 470 27th Street, Oakland, CA 94612.

PAST WEBINARS
Survivorship members may listen to past webinars in the members’ section.
For information on joining Survivorship, go to http://www.survivorship.org/about/membership.html

Complete details on all our webinars are at http://www.survivorship.org/webinars.html

Survivorship Webinar “From Fragmentation to Integration” Sat. June 16

forwarded with permission

Survivorship Webinar “From Fragmentation to Integration”  Sat. June 16

Another great webinar coming up!

Upcoming Webinar:

Saturday, June 16
3 pm Pacific Time – Please note the time change
Presenter: Dr. Cathy Kezelman
“From Fragmentation to Integration”

This webinar will depict my personal psychotherapeutic journey to explore the process of recovery from an extreme dissociative state, which was characterised by a complete amnesia for 10 years of my childhood and fragmentation of my self onto integration and recovery. Despite my therapist providing a safe reliable and contained space it took me a long time to trust her or appreciate that she could keep me in mind. She was empathic, compassionate and skilled and the relationship we developed was core to my survival and my recovery. Over years she bore witness to the dissociated fragments of trauma returning to my consciousness and the intense emotions which were overwhelming me. Through a committed analytical psychotherapeutic process she guided me from terror and confusion through chaos and onto acceptance and understanding.

It will explore the changes in me from having little insight into myself, my inner world, relationships or functioning as a whole being. I now know my own unique feelings and choices, and have the capacity to reflect, form deeper relationships and live a full rich life.

Dr. Cathy Kezelman is President at ASCA (Adults Surviving Child Abuse), an Australian national charity which advocates for a trauma informed approach to care and trauma specific services for survivors of complex trauma secondary to child abuse and neglect. She is a director of MHCC (Mental Health Co-ordinating Council NSW). She is an active advocate for Australian adult survivors of childhood trauma and informed mental health responses to trauma. Early in 2010 she published her memoir, ‘Innocence Revisited’ – a tale in parts, her story of recovery from childhood trauma. Cathy is also a mother of four adult children and a foster child.

REGISTRATION
Registration closes Thursday evening June 14, 2012

To reserve a space in the webinar, e-mail Shamai at shamai@survivorship.org   and give her this information:

1. Your name
2. The webinar you wish to attend: “The aftereffects of extreme child abuse and the resiliency of the human spirit.”
3. Amount and method of payment  (check, PayPal, money order)
4. Your preferred e-mail address (so we can send you instructions)
5. The name you will be using for the webinar. (This does not have to be your real name or your message board screen name.)

You will receive a confirmation email immediately and an invitation link and instructions after the registration closes

COST
Webinars are on a sliding scale from $50.00 to full scholarship (while we offer full scholarships for webinars please consider paying whatever you are able to. Even $5 will help to cover the cost of the webinar provider). Please remember to factor in the cost of the telephone call if you don’t have a computer headset. The PayPal button is near the bottom of the page at http://www.survivorship.org/webinars.html

If you wish to pay by check please send it to: Survivorship, Family Justice Center, 470 27th Street, Oakland, CA 94612.

PAST WEBINARS
Survivorship members may listen to past webinars in the members’ section.
For information on joining Survivorship, go to http://www.survivorship.org/about/membership.html

Complete details on all our webinars are at http://www.survivorship.org/webinars.html

Jewish Communities – Child Sex Scandals, Agencies Failed to Rescue Lilly Manning

Tempest in the Temple – Jewish Communities and Child Sex Scandals
Amy Neustein, ed.

Brandeis Series in American Jewish History, Culture and Life
Brandeis University Press
2009 Sociology / Jewish Studies 978-1-58465-671-5

Tempest in the Temple brings together fifteen practicing rabbis, educators, pastoral counselors, sociologists, mental health professionals, and legal advocates for abuse victims, each of whom offer insights into different facets of the problem.

This book is divided into three sections. The first section, “When the Vow Breaks,” describes rabbis who break their “vows” through active pedophilia. The second section, “Sacrificing Victims,” illuminates the community dynamics surrounding abuse: how a community unwittingly contributes to the cover-up of abuse; why victims of abuse are all too often ignored or cast off by their religious communities; and the mechanisms by which powerful religious institutions protect their own. The third section, “Let Me Know the Way,” addresses how Jewish communities can overcome the ignorance, bias, and corruption associated with clergy sexual abuse. Solutions—some already successful, others yet to be tried—are explored here.
http://www.dartmouth.edu/~upne/1-58465-671-9.html

describes severe abuse

California, Texas agencies all failed to rescue Lilly Manning
By Marjie Lundstrom Jul. 31, 2011

Lilly Manning was 15 when she escaped from a cramped closet in south Sacramento, after being stabbed and beaten and shoved into the darkness.
This time, she said, she knew she would have to save herself.

Government documents confirm she was right. Four different agencies visited the family at least 11 times on reports of suspected abuse or neglect in a five-year period but did not move to protect her or her siblings, according to confidential records obtained by The Bee.

“They came, they looked, they left,” said Lilly, now 19, reflecting on the parade of visitors from law enforcement, Child Protective Services and the schools, some of whom she had secretly called. “We just gave up.” Today, Lilly Manning lives with more than 100 scars etching her 5-foot-3 body, physical reminders of the hammer attacks, beatings, burns and strikes to the head with a 2-by-4 and a padlock swinging from a cord. Earlier this month, her adoptive mother and great-aunt, Lillian Manning-Horvath, was sentenced to up to six years in a mental health facility, followed by consecutive life terms in state prison.

The woman’s husband, Joseph Horvath, was convicted by a jury in 2009 and also sentenced to multiple life terms. Documents and interviews with family members also reveal how a domineering matriarch terrified people who witnessed and endured years of her verbal tirades and physical abuse….

Authorities swept in, and the rest of the children were taken into protective custody in the early morning hours of Nov. 6, 2007. The children would never go home again. Help that didn’t come

Lilly says she does not remember much about those chaotic first days and has “lots of blank spots” about her childhood. She knows that she and her four siblings were removed from their biological mother in the early 1990s and placed with their great-aunt Lillian, who later adopted them. In 2002, their adoptive mom married Horvath, a felon 18 years her junior.
Lilly wants to know more. She recently sought and received nearly 700 pages of documents from the Sacramento Juvenile Dependency Court, which detail the many missteps among government agencies. She shared those records with The Bee. CPS also is preparing to give her her file….

Ann Edwards, director of Sacramento County’s Department of Health and Human Services, which oversees CPS, said she could not legally comment on Lilly’s case for confidentiality reasons. However, she agreed to talk in general terms about issues raised by the case.
“It’s not uncommon for siblings to want to remain together,” said Edwards. “And it’s not uncommon for children to be afraid of the unknown.

“It’s quite remarkable that even children who are horribly abused typically still love their parents, or the people who are abusing them.”
Lilly says today that their adoptive mom often manipulated the kids into keeping quiet or lying, promising she would stop the abuse.
http://www.sacbee.com/2011/07/31/3806037/california-texas-agencies-all.html

Questions and Answers Regarding Dissociative Amnesia

” Scientific evidence shows that it is not rare for traumatized people to experience amnesia or delayed recall for the trauma.

Amnesia has been reported in combat, for crimes, and for concentration camp experiences and torture. The more severe the trauma, the more likely it is to be forgotten.

Overall, a recovered memory is just as likely to be accurate as a continuously remembered one.”

The sociocognitive model of dissociative identity disorder: a reexamination of the evidence.
” No reason exists to doubt the connection between DID and childhood trauma.”

Questions and Answers Regarding Dissociative Amnesia
by Stephanie Dallam RN, MS, FNP

….there is near-universal scientific acceptance of the fact that the mind is capable of avoiding conscious recall of traumatic experiences.

….Is dissociation a rare phenomenon?
No. Scientific evidence shows that it is not rare for traumatized people to experience amnesia or delayed recall for the trauma. Amnesia has been reported in combat, for crimes, and for concentration camp experiences and torture. Evidence of this process can be found in the early literature on World War I and World War II.

….Carlson, E., & Rosser-Hogan, R. (April, 1993). Mental health status of Cambodian refugees ten years after leaving their homes. American Journal of Orthopsychiatry, 63 (2), 223-231.

Dissociation is also a frequent finding in survivors extreme terror. Between 1975 and 1979, an estimated one to three million of a population of seven million Cambodians were killed or died of starvation. Carlson, E., & Rosser-Hogan selected 50 subjects at random from a list of all refugees (~500) resettled by nonprofit organization between 1983 and 1985. None had any formal education and had lived in the US for a mean of 5 years. 86% met the criteria for PTSD. The mean number of traumatic experiences the refugees endorsed was 14 and “90% reported amnesia for upsetting events.”

….Krell, R. (1993). Child survivors of the Holocaust: Strategies of adaptation. Canadian Journal of Psychiatry, 38 , 384-389.

Krell reported on 22 Holocaust survivors who, as children, hid from the Nazis.
“As children they were encouraged not to tell, but to lead normal lives and forget the past . . .”
“The most pervasive preoccupation of child survivors is the continuing struggle with memory, whether there is too much or too little . . .”
“For a child survivor today, an even more vexing problem is the intrusion of fragments of memory – most are emotionally powerful and painful but make no sense. They seem to become more frequent with time and are triggered by thousands of subtle or not so subtle events . . .”

Marks, J. (1995). The hidden children: The secret survivors of the Holocaust. Toronto : Bantam Books.

One holocaust survivor, Ava Landy, describes her amnesia:
“So much of my childhood between the ages of four and nine is blank….It’s almost as if my life was smashed into little pieces . . .
The trouble is, when I try to remember, I come up with so little. This ability to forget was probably my way of surviving emotionally as a child. Even now, whenever anything unpleasant happens to me, I have a mental garbage can in which I can put all the bad stuff and forget it . . . .
I’m still afraid of being hungry. . . . I never leave my house without some food….Again, I don’t remember being hungry. I asked my sister and she said that we were hungry. So I must have been! I just don’t remember.” (p. 188).

What types of traumas result in dissociative amnesia?
A review of 50 studies revealed that amnesia rates tend to increase with severity of trauma and is particularly high in victims of sex crimes….

What is the relation of memory recovery to psychotherapy?
Albach et al. studied 97 adult victims of extreme sexual abuse and a control group of 65 women, matched for age and education who reported on their memories of “ordinary unpleasant childhood experiences.”  The abuse survivors were broken into two groups.  One group had participated in psychotherapy while the other group had not. There was no significant differences in amnesia, memory recovery, or other memory phenomena between the survivors who participated in psychotherapy and those who did not.

…How accurate are recovered memories?
Dalenberg, C. J. (1996). Accuracy, timing and circumstances of disclosure in therapy of recovered and continuous memories of abuse. Journal of Psychiatry & Law,24 (2), 229-75.

Accuracy for Continuous Versus Recovered Memories
Percent with evidence supporting memory
Continuous  75%
Recovered   75%

Conclusion
Scientific evidence shows that it is not rare for traumatized people to experience amnesia or delayed recall for the trauma. Amnesia has been reported in combat, for crimes, and for concentration camp experiences and torture.
The more severe the trauma, the more likely it is to be forgotten.
Overall, a recovered memory is just as likely to be accurate as a continuously remembered one. However, recovered memories have a prominence of emotional and sensory-perceptual elements vs. declarative (verbal) elements. They are often fragmentary and incomplete and thus hard to make into coherent story.
http://www.leadershipcouncil.org/1/tm/amnesia.html

The sociocognitive model of dissociative identity disorder: a reexamination of the evidence.
Gleaves DH.

According to the sociocognitive model of dissociative identity disorder (DID; formerly, multiple personality disorder), DID is not a valid psychiatric disorder of posttraumatic origin; rather, it is a creation of psychotherapy and the media. Support for the model was recently presented by N.P. Spanos (1994).

In this article, the author reexamines the evidence for the model and concludes that it is based on numerous false assumptions about the psychopathology, assessment, and treatment of DID. Most recent research on the dissociative disorders does not support (and in fact disconfirms) the sociocognitive model, and many inferences drawn from previous research appear unwarranted.

No reason exists to doubt the connection between DID and childhood trauma. Treatment recommendations that follow from the sociocognitive model may be harmful because they involve ignoring the posttraumatic symptomatology of persons with DID.

Psychol Bull. 1994 Jul;116(1):143-65.
http://www.ncbi.nlm.nih.gov/pubmed/8711016

Documentation of Child Abuse and Dissociation in DID/MPD

Documentation of Child Abuse and Dissociation in DID/MPD
Alter Personality Physiological Differences in MPD

Objective Documentation of Child Abuse and Dissociation in 12 Murderers With Dissociative Identity Disorder
Am J Psychiatry 154:1703-1710, December 1997

RESULTS: Signs and symptoms of dissociative identity disorder in childhood and adulthood were corroborated independently and from several sources in all 12 cases; objective evidence of severe abuse was obtained in 11 cases. The subjects had amnesia for most of the abuse and underreported it. Marked changes in writing style and/or signatures were documented in 10 cases.

CONCLUSIONS: This study establishes, once and for all, the linkage between early severe abuse and dissociative identity disorder. Further, the data demonstrate that the disorder can be distinguished from malingering and from other disorders. The study shows that it is possible, with great effort, to obtain objective evidence of both the symptoms of dissociative identity disorder and the abuse that engenders it. (Am J Psychiatry 1997; 154:1703–1710)
http://ajp.psychiatryonline.org/cgi/content/full/154/12/1703

Visual function in multiple personality disorder
J Am Optom Assoc. 1996 Jun;67(6):327-34.

RESULTS:
Physiologic differences across alter personality states in MPD include differences in dominant handedness, response to the same medication, allergic sensitivities, autonomic and endocrine function, EEG, VEP, and regional cerebral blood flow. Differences in visual function include variability in visual acuity, refraction, oculomotor status, visual field, color vision, corneal curvature, pupil size, and intraocular pressure in the various personality states of MPD subjects as compared to single personality controls.
http://www.ncbi.nlm.nih.gov/pubmed/8888853

Optical differences in cases of multiple personality disorder.
J Nerv Ment Dis. 1989 Aug;177(8):480-6.

The results of these analyses showed that MPD subjects had significantly more variability across alter personalities than did their control counterparts on measures of visual acuity with correction, visual acuity without correction, visual fields, manifest refraction, and eye muscle balance. The data were also analyzed for clinical significance. Blind ratings of the data were performed by comparing the results of the individual dependent measures across the alter personalities of individual MPD and control subjects according to established ophthalmological criteria.

The ratings for clinical significance showed that the MPD subjects had 4.5 times the average number of changes in optical functioning between alter personalities of the control subjects, with a mean of 2.56 clinically significant changes for the MPD subjects and .55 clinically significant changes for the control subjects. This difference was also statistically significant (p less than .01).
http://www.ncbi.nlm.nih.gov/pubmed/2760599

Optical differences in multiple personality disorder. A second look.
J Nerv Ment Dis. 1991 Mar;179(3):132-5.
In the present study, data from 20 patients diagnosed with MPD and 20 control subjects role playing MPD were analyzed for statistical and clinical significance. The findings from the present study appear to confirm results from the earlier study that individuals with MPD experience differences in some aspects of visual functioning between alter personalities. The results further confirm that MPD subjects experience more differences across visual measures than control subjects simulating the disorder.
http://www.ncbi.nlm.nih.gov/pubmed/1997659

Differential autonomic nervous system activity in multiple personality disorder.
Psychiatry Res. 1990 Mar;31(3):251-60.
The cardinal feature of multiple personality disorder (MPD) is the existence of two or more alter personality states that exchange control over the behaviour of an individual. Numerous clinical reports suggest that these alter personality states exhibit distinct physiological differences. We investigated differential autonomic nervous system (ANS) activity across nine subjects with MPD and five controls, who produced “alter” personality states by simulation and by hypnosis or deep relaxation.

Eight of the nine MPD subjects consistently manifested physiologically distinct alter personality states. Three of the five controls were also produced physiologically distinct states, but these differed from those of the MPD subjects. A habituation paradigm demonstrated carryover effects at the ANS levels from one state to the next for both groups.
http://www.ncbi.nlm.nih.gov/pubmed/2333357

The psychophysiological investigation of multiple personality disorder: review and update.
Am J Clin Hypn. 1992 Jul;35(1):47-61.
…psychophysiologic differences reported in the literature include changes in cerebral electrical activity, cerebral blood flow, galvanic skin response, skin temperature, event-related potentials, neuroendocrine profiles, thyroid function, response to medication, perception, visual functioning, visual evoked potentials, and in voice, posture, and motor behavior. http://www.ncbi.nlm.nih.gov/pubmed/1442640

Brain mapping in a case of multiple personality.
Clin Electroencephalogr. 1990 Oct;21(4):200-9.
Brain maps were recorded on a patient with a multiple personality disorder (10 alternate personalities). Maps were recorded with eyes open and eyes closed during 2 different sessions, 2 months apart. Maps from each alternate personality were compared to those of the basic personality “S”, some maps were similar and some were different, especially with eyes open.

Findings that were replicated in the second session showed differences from 4 personalities, especially in theta and beta 2 frequencies on the left temporal and right posterior regions. A rank ordering of the differences in the brain maps of the alternate personalities from S were similar to the rank ordering of the differences in personality characteristics, as judged by the psychiatrist dealing with this patient. Maps from S acting like some of her personalities or from a professional actress portraying the different personalities did not reveal significant differences.
http://www.ncbi.nlm.nih.gov/pubmed/2225470

Multiple personality disorder. A clinical investigation of 50 cases.
J Nerv Ment Dis. 1988 Sep;176(9):519-27.

To study the clinical phenomenology of multiple personality, 50 consecutive patients with DSM-III multiple personality disorder were assessed using clinical history, psychiatric interview, neurological examination, electroencephalogram, MMPI, intelligence testing, and a variety of psychiatric rating scales. Results revealed that patients with multiple personality are usually women who present with depression, suicide attempts, repeated amnesic episodes, and a history of childhood trauma, particularly sexual abuse. Also common were headaches, hysterical conversion, and sexual dysfunction. Intellectual level varied from borderline to superior.

The MMPI reflected underlying character pathology in addition to depression and dissociation. Significant neurological or electroencephalographical abnormalities were infrequent. These data suggest that the etiology of multiple personality is strongly related to childhood trauma rather than to an underlying electrophysiological dysfunction.
http://www.ncbi.nlm.nih.gov/pubmed/3418321

An examination of the diagnostic validity of dissociative identity disorder. Clinical Psychology Review 21(4) 577-608
(2001)

We review the empirical evidence for the validity of the Dissociative Identity Disorder (DID) diagnosis, the vast majority of which has come from research conducted within the last 10 years. After reviewing three different guidelines to establish diagnostic validity, we conclude that considerable converging evidence supports the inclusion of DID in the current Diagnostic and Statistical Manual for Mental Disorders.

For instance, DID appears to meet all of the guidelines for inclusion and none of the exclusion guidelines; proposed by Blashfield et al. [Comprehensive Psychiatry 31 (1990) 15-19], and it is one of the few disorders currently supported by taxometric research.
http://www.ncbi.nlm.nih.gov/pubmed/11413868
full text
http://leadershipcouncil.org/docs/gleaves2001.pdf