Integrating and Working with PTSD, Complex PTSD and Adverse Childhood Experiences from an Attachment Perspective A 2-day training workshop at London with Dr Felicity de Zulueta London, 11 & 12 May 2018 (Friday & Saturday) 10:00am - 4:00pm on both days

This practical workshop, led by Dr Felicity de Zulueta – one of UK’s leading experts on PTSD and complex PTSD – begins by discussing the latest diagnostic criteria for PTSD, and its dissociative manifestations, as they are presented in the new DSM V and in the current version of ICD-11. The workshop highlights how these diagnostic criteria ignore the existence of a wide range of presentations that arise in survivors of childhood abuse and emotional neglect as well as those who have suffered from chronic and severe exposure to traumatic events, a condition unofficially referred to as ‘developmental or complex PTSD’ and increasingly included within the domain of research on Adverse Childhood Experiences.


Such a state of affairs can leave therapists treating these clients / patients with little or no guidance in relation to the aetiology, diagnosis, assessment and treatment of their symptoms and makes research in the field very difficult. Dr Zulueta demonstrates how an understanding of these disorders from an attachment perspective, enables one to make sense of both the psychological and somatic  symptoms clients / patients  present with and the recent epigenetic findings relating to transmission of PTSD down the generations.


By integrating her clinical experience with Attachment research, Dr Zulueta outlines the process by which psychotherapeutically trained practitioners can assess and prepare traumatised clients for the ‘journey of therapy’ whilst bearing in mind their need for emotional regulation and a sense of security. The workshop discusses different therapeutic approaches to stabilisation & treatment of PTSD and the way severe traumatic attachments can lead to resistance to change. Viewing the assessment and treatment of PTSD through the lens of Attachment Theory, the workshop helps practitioners understand how a rupture in the neurobiological capacity to attune and the capacity to mentalise is fundamental to our understanding of traumatised individuals, while also providing practical new approaches to therapy for both complex and developmental PTSD. Utilising a series of video vignettes and clinical case examples, Dr Zulueta helps us comprehend the linkages between complex PTSD, so-called Borderline Personality Disorder, dissociative disorders and violent behaviour.



Course Aims The course aims to provide an integrative training approach that enables practitioners using different therapeutic modalities to integrate the relevant elements of Attachment Theory and Research with their existing skills, which they can then apply to their work with people suffering from Complex PTSD in particular. A CPD certificate for 10 CPD hours is provided at the end of the course. About the speaker Dr Felicity de Zulueta is Emeritus Consultant Psychiatrist in Psychotherapy at the South London and Maudsley NHS Trust and Honorary Senior Lecturer in Traumatic Studies at Kings College London. She is a Group Analyst and Systemic Family Therapist. She developed and headed the Department of Psychotherapy at Charing Cross Hospital in 1984 and the Traumatic Stress Service in the Maudsley Hospital in 1996 which specialises in the treatment of people suffering from Complex Post Traumatic Stress Disorder including borderline personality and dissociative disorders as well as refugee survivors of torture and war. She participated in a film made by Geographic Magazine (Channel 5) on trauma in elephants, has published papers and chapters on Bilingualism, Family Therapy and Psychosis, PTSD, Borderline personality disorder and dissociation and is author of the book "From Pain to Violence; the traumatic roots of destructiveness" (2nd updated edition published by John Wiley and Sons, March 2006). She is a founder member of WAVE, the International Attachment Network and the Mindful Policy Group. She works as a free-lance consultant psychotherapist with training in psychoanalytic psychotherapy, systemic family therapy, group analysis, EMDR and Lifespan Integration and speaks 4 languages. Her current research interests include studying the effects of a protocol she has developed which elicits traumatic attachment called the Traumatic Attachment Induction Protocol or TAIP in clients and its implications in relation to assessment and treatment.
Workshop Schedule Day 1, Friday, 11 May 2018 10:00AM: Module 1: Making sense of simple PTSD & Complex PTSD from an attachment perspective: an overview In the first module, we consider the manifestations of PTSD and look at: The origin of the concept of PTSD and its current diagnosis according to DSM 5 (and ICD 11) Co-morbid disorders such as depression and substance abuse How attachment theory helps us comprehend PTSD & its complex manifestations The origin of developmental and complex PTSD and its underlying neurobiology focusing particularly on complex PTSD as an attunement and mentalisation disorder. This involves a review of the neurobiology of infant development in relation to attunement, mentalisation and affect regulation with a specific focus on Porges’ view of the autonomic system; with all that this implies for clients suffering from developmental PTSD 1:00PM: Lunch Break (a light lunch is provided as part of the workshop) 2:00PM: Module 2: Clinical implications relating to complex PTSD and ACE findings as an attachment disorder involving mind and body This module builds on the theoretical discussions of the previous session and we consider: Disorganised attachment, structural dissociation and the development of the Traumatic Attachment Induction Protocol during assessment &/or during treatment The relationship between complex PTSD and the study of Adverse Childhood Events looking at the research findings and what we can learn from this extensive work in aid of our understanding of complex or developmental PTSD A cross cultural perspective in relation to the development of the individual sense of self and the social sense of self, leading to the importance of shame and resulting violence The transmission of vulnerability to PTSD down the generations and the importance of trauma and epigenetics in the cycle of violence 4:00PM: Close  Day 2, Saturday, 12 May 2018 10:00AM: Module 3: The assessment of PTSD and stabilisation in complex PTSD This module moves our previous discussions to the therapeutic domain. We consider the integration of findings resulting from Adverse Childhood Events studies, and we look at: Different approaches to the assessment of traumatised clients/patients: In the case of Complex PTSD, the importance of an in depth assessment in relation to the social context and inner world, bearing in mind the importance of traumatic attachment; in terms of levels of dissociation, resistance to change and potential for violence However, some very disturbed people or adolescents may be unwilling to go through such an assessment so what can be done instead? Focusing directly on the traumatic symptoms as expressed by the body is one way of making a person feel understood and contained The provision of an alternative resilience building approach to tackle the widespread effects of Adverse Childhood Events and how these can be integrated with the treatment of complex PTSD The crucial importance of the early stabilisation phase of therapy focusing principally on the body that “keeps the score” and how to keep within the “window of tolerance” to avoid re-traumatisation 1:00PM: Lunch Break (a light lunch is provided as part of the workshop) 2:00PM: Module 4: Attachment informed therapeutic approaches for PTSD, Complex PTSD and Adverse Childhood Experiences In the last module of the course, we look at specific therapeutic implications including: Contemporary therapeutic approaches such as trauma-focused CBT and EMDR used to treat simple PTSD The different modalities now used in the treatment of complex PTSD The importance of secondary traumatisation and how to deal with this The development of new ‘Attunement and mentalisation based therapies’ including equine therapy and Video Interaction Guidance Is trauma focused therapy necessary? The implications of mass traumatization 4:00PM: Close

Continuing professional development through seminars, workshops and conferences for psychotherapists, counsellors and psychologists.