Friday 20th & Saturday 21st September 2019

Working With Dissociative Processes In Clinical Practice:Engaging The Fear Of Feeling Real

About the Workshop

Dissociative processes are most evident in the rapid shifts in self-states identified by the close tracking of ‘no-go zones’ - those places in our psyche which are too dangerous or painful to enter. These places frequently result from persistent early trauma, commonly as a consequence of growing up in an environment where the child’s caretaker(s) are either frightened or frightening, or both.

Working therapeutically with individuals with such disorganised attachments presents considerable difficulties since, by definition, the dissociative processes are designed to ‘hide’ both the fear and the longing for connection from both oneself and the Other. This can result in behaviours which fluctuate between angry attacks on the therapeutic relationship and a tenacious attachment to it. An intolerable dilemma arises from a longing to feel ‘real’ yet also desperately wanting to avoid the associated pain that comes with it. This requires the therapist to survive, detoxify, and metabolize the emotional turmoil that results from the internal shame and fear of humiliation, intolerable loss, intense dislike, disgust, and contempt that often underpin such ‘attackments’.

In this workshop, Dr Chefetz marries dissociation and its clinical manifestations with a wealth of extended case histories. Drawing on theories of self-states and their involvement in dissociative experiences, he demonstrates how to identify and work with persistent dissociative processes, and their related neurobiological and psychodynamic underpinnings.

Learning outcomes

  • Recognising dissociative processes in your casework;
  • Understanding memory processes in trauma patients; and
  • Working with shame, repetition compulsions, enactments, addictive behaviours, depersonalisation, self-harm, and suicidality in the lives of adult survivors of childhood trauma.


  • Describe the normal tension between association and dissociation and how the balance between them contributes to mental coherence.
  • Discuss why discerning depersonalisation is critically important in assessing dissociation.
  • Describe how dissociative process influences memory and the questions that are important in discerning dissociative disturbances of memory
  • Compare the basics of infant attachment behaviours and their adult manifestations in trauma treatment.
  • Discuss the differences between emotions in the shame spectrum of experience and their personal and interpersonal correlates
  • Explain the potential value and pitfalls of countertransference disclosure in psychotherapy with trauma survivors.
  • Describe appropriate questions to discern depersonalisation, derealisation, amnesia, identity confusion, and identity alteration toward making a diagnosis of a dissociative disorder.
  • Discuss and be able to apply the four basic patterns of infant attachment, secure, anxious-ambivalent, avoidant, and disorganised/disoriented to their adult cases and apply these to the clinical setting.
  • Predict which patients in your practice are likely carrying hidden shame
  • Describe the process from which shame and rage become welded together.
  • Discuss how hippocampal and amygdala functions interact in trauma treatment.
  • Discuss a strategy for pointed intervention to impact and reduce suicidality as an immediate threat.
  • Explain how "attackment" describes a shift from proximity seeking in the attachment paradigm to guaranteeing distance when domination- submission, power and control, dynamics overwhelm the interpersonal world of a child
  • Describe the difference between the words affect, feeling, and emotion as well as the clinical utility of distinguishing between them.
  • Describe the general underlying cause of addictive behaviour as it relates to dissociative processes.
  • Discuss a technique for specific psychotherapeutic exploration of addictions and their relief.
  • Explain the likely sources of negative therapeutic reaction in the treatment of a person with a complex dissociative disorder.


  Friday 20th September 2019
Time Activity
9:00am - 10:00am Recognising Dissociative Processes in Your Casework
10:00am - 10:50am Morning Tea
10:50am - 12:20pm Process Interventions and Psychodynamics of Self-states
12:20pm - 1:15pm Lunch
1:15pm - 2:45pm Catastrophic Shame, Negativity and Dissociative Self-states
2:45pm - 3:00pm Afternoon Tea
3:00pm - 4:30pm ‘Attackments’: Subjugation, Shame and Dissociative Self-states Case Presentation
  Saturday 21st September 2019
Time Activity
9:00am- 10:00am The Neurobiology of Emotion, Self-states, and the Gateway to Treatment
10:00am - 10:50am Morning Tea
10:50am - 12:20pm Addictive Processes, the Compulsion to Repeat, and Enactment
12:20pm - 1:15pm Lunch
1:15pm - 2:45pm Self-states, Suicidality, and Self-harming Behaviours
2:45pm - 3:00pm Afternoon Tea
3:00pm - 4:30pm Depersonalization: Can We Dance to the Music?

Who is this workshop for?

About the Presenter/s

Presenter Name
  Dr Richard A. Chefetz M.D
Presenter Blurb

Dr Chefetz is a psychiatrist in private practice in Washington, D.C. He was President of the International Society for the Study of Trauma and Dissociation in 2002, and Co-Founder and Chair of their Dissociative Disorders Psychotherapy Training Program for eight years. Dr Chefetz is a Distinguished Visiting Lecturer at the William Alanson White Institute of Psychiatry, Psychoanalysis, and Psychology; and a faculty member at the Washington School of Psychiatry, the Institute of Contemporary Psychotherapy & Psychoanalysis, and the Washington Baltimore Center for Psychoanalysis.

He has published numerous journal articles on psychoanalytic perspectives on trauma and dissociation; and published the internationally acclaimed Intensive Psychotherapy for Persistent Dissociative Processes: The Fear of Feeling Real in 2015 with W.W. Norton, in their Interpersonal Neurobiology series.

Presenter Image


Date/s: Friday 20th & Saturday 21st September 2019

Registration opens on 1 July 2019.

Please register at

Inaugural membership offer ends on the 16th August 2019.

Venue: Trinity on Hampden Conference Centre,
230 Hampden Road,
Crawley WA 6009
Additional Venue Information
Accomodation Suggestions:

Recommended Reading:
Cancelation Policy:

Cancellation prior to September 1st will attract a $50 processing fee.

Cancellation after September 1st will attract full fee – transfer of registration is possible.


Mrs Sonia Smuts

Amount For Who?
$800 Non members
$600 COTWA Members
Notes about Fees


The information in this panel discussion is general in nature and should not be relied on. You should always seek your own professional advice. The views expressed are those of the presenters and may not represent the views of COTWA.

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