Abstract
Dr. Itzkowitz will discuss the interpersonal/relational psychoanalytic treatment of “Christopher,” a middle-aged man referred for the treatment of war-related PTSD. His symptom picture left many physicians puzzled and confused. Eventually, being hospitalized on a psychiatric unit, Christopher was diagnosed with war-related PTSD. During the first few months of working together, Dr. Itzkowitz realized that, in addition to Christopher’s war-related trauma, he was also suffering from an extreme dissociative disorder.
In this presentation, Dr. Itzkowitz will discuss the difference between dissociative processes that are a normal aspect of mind/brain functioning and the dissociative structuring of the mind. He will address the importance of creating and ensuring safety and teaching grounding techniques for helping with episodes of emotional hyperarousal. Sullivan’s method of detailed inquiry will be applied to the processing of traumatic experiences and the uncovering of strengths that
patients can use during recovery. Process notes and dreams will illustrate how working with dissociated self-states is an essential aspect of the recovery process for patients suffering with DID.
Finally, Dr. Itzkowitz has been given permission to show some of Christopher’s artwork. It portrays Christopher’s depiction of some of his traumatic experiences. These were events that could not previously be processed verbally without the exacerbation of his dissociative symptoms.
Learning Objectives
At the end of this presentation, participants will be able to:
1. Identify and list three dissociative processes.
2. Identify and explain one key aspect of the dissociative structuring of the mind.
3. Describe how to work with dreams in the treatment of dissociative identity disorder.
Biography
Dr. Shelly Itzkowitz is an adjunct associate professor of psychology and clinical consultant at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis as well as Guest Faculty at the
William Alanson White Institute’s Eating Disorders, Compulsions, and Addictions Program. He is on the teaching and supervisory faculty of the National Institute for the Psychotherapies and the Trauma Studies Program of the Manhattan Institute for Psychoanalysis. He is an honorary member of the William Alanson White Society as well as a Fellow and Member of the Board of
Directors of the International Society for the Study of Trauma & Dissociation (ISSTD).
Dr. Itzkowitz has published several articles on the topics of trauma, dissociation, and dissociative identity disorder (DID) and has presented his work on dissociation and DID both nationally and internationally. He and Elizabeth Howell have a chapter, “The Unconscionable in the Unconscious: The Evolution of Relationality in the Treatment of Trauma,” appearing in the recently published volume, Dissociation and the Dissociative Disorders: Past, Present, Future
(2nd edition). They are co-editors of their recently published book, Psychoanalysts, Psychologists and Psychiatrists Discuss Psychopathy & Human Evil, which received the 2021 Media Award and the Sandor Ferenczi Award by ISSTD. They have also co-edited The Dissociative Mind in Psychoanalysis: Understanding and Working with Trauma, which received the 2016 Media Award by ISSTD and was nominated for the 2017 Gradiva Award. Dr. Itzkowitz
received the Lifetime Achievement Award from ISSTD. He is in full-time private practice in Manhattan, working with both individuals and couples, and provides clinical consultation individually and in groups.
References
Dorahy, M. J., Gold, S. N., & O’Neil, J. A. (Eds.). (2022). Dissociation and the dissociative disorders: Past, present, future (2nd ed.).
Howell, E. F. & Itzkowitz, S. (2022). The unconscionable in the unconscious: The evolution of relationality in the treatment of trauma. In M. J. Dorahy, S. N. Gold, & J. A. O’Neil (Eds.), Dissociation and the dissociative disorders: Past, present, future (2nd ed, pp. 728-745). Routledge.
Itzkowitz, S. (2022). Through the lens of a DID specialist. Psychoanalytic Perspectives, 19(1), 108-119.
Keating, L. & Muller, R. T. (2020). LGBTQ+ based discrimination is associated with PTSD symptoms, dissociation, emotion dysregulation, and attachment insecurity among adults who have experienced trauma. Journal of Trauma & Dissociation, 21(1), 124-141.
Lahav, Y., Talmon, A., Ginzburg, K., & Spiegel, D. (2019). Reenacting past abuse – Identification with the aggressor and sexual revictimization. Journal of Trauma & Dissociation, 20(4), 378-391.
Stern, D. B. (2022). Dissociation and unformulated experience: A psychoanalytic model. In M. J. Dorahy, S. N.
Gold, & J. A. O’Neil (Eds.), Dissociation and the dissociative disorders: Past, present, future (2nd ed., pp. 341-352). Routledge.
