My Blog (Tag: therapy)

ATTACh Conference: Building Attachment Across States: Healing the Spectrum of Dissociative Symptoms in Children and Adolescents

Joyanna Silberg's  Powerpoint Presentation can be found here.


I have to say ATTACh did a great job of finding speakers who catch your attention and keep it.  With humor and references to previous speakers it makes it seem like they are all a great big family wanting to help you with each of their specialties.


Joyanna Silberg kept me interested even though I was already suffering from jet lag as I am a west coast girl getting up early on the east coast.


I highly urge you to look through the Powerpoint Presentation linked above but here are my notes and important thoughts I took away from her presentation.


Disassociation is defined as disruption in the usual integrated functions of consciousness, memory, identity or perception - but really it is too adult centric.


When your inner life is a place you have to stay out of, having an identity is impossible.  Remembering not to remember such as "I try to forget to remember." or "It hurts to remember." or "I have nightmares".  Funy though how much energy it takes in the present to avoid making sense of the past.


"It's like a brain seizure"

"My face was smiling but my brain was crying"

are how some people feel about being disassociated.


What neurophysioloigcal affects of trauma lead to disassociation?

Excessive activation of amygdala

Suppression of activity in left prefrontal cortex

observing ego

underdevelopment of right orbitofrontal cortex, ability to self-regulate

decreased hippocampal volume: putting experiences into chronology

Underdeveloped corups collosum: disintegration of left and reight

Decreased serotonin: Mood is dysregulated.


At each moment the state is self is constructed from the ground up... so continuously and consistently reconstructed that the owner never knows the it is being remade unless something goes wrong.


States become increasingly flexible through development.

Fear based states are rigid and resistant

loving caregiver helps regulate those states.


Interest  to Excitement

Enjoyment to Joy

Suprise to Startle

Fear to Terror

Distress to Anguish

Anger to Rage

Same to Humilation

Smell to Dissmell

Taste to Disguste


Affect is an amplifier.  It either makes good things better or bad things worse.  Affect is the psychic glue of consciousness and identity.

So complex and pervasive are habits of script formation that we live more within these personal scripts for the modulation and detoxification of affect than in the world of innate behavior.


Key insights from Interpersonal Neurobiology:

The mind is a regulator

Transitions between states are key moments when the self is built

Interpersonal processes shape the mind (Daniel Siegel - the developing mind)


The brilliance of the mind lay in what is discarded not what is retained.


Dissociative shifts in a child create reciprocal states in caregivers and therapists.

Children encode contradictory parental behaviors and messages and realities and represent environmental dissociation within.


Healthy attachment promotes integrated functioning by allowing the child to grow with freedom and trust emotional information.

A healthy mind effectively selects the information that will allow seamlessly managing the transitions between states, between affects, between contents and between developmental challenges in a way that is adaptive to each shifting environmental demand.


In the normal brain affect is a signal for memory retrieval, approach or avoidance, action plans, assessment or reorganization. 


The New Definition of Disassociation: The automatic activation of patterns, action, thought, perceptions, identity or affect which are overlearned and conditioned avoidance responses to traumatic cues and emotions.


Her book The Child Survivor will be out shortly.


By Support