Working with Trauma, Dissociation, and Psychosis
4.4 (340 ratings)
Course Ratings are calculated from individual students’ ratings and a variety of other signals, like age of rating and reliability, to ensure that they reflect course quality fairly and accurately.
1,615 students enrolled

Working with Trauma, Dissociation, and Psychosis

CBT and Other Approaches to Understanding and Recovery
4.4 (340 ratings)
Course Ratings are calculated from individual students’ ratings and a variety of other signals, like age of rating and reliability, to ensure that they reflect course quality fairly and accurately.
1,615 students enrolled
Created by Ron Unger
Last updated 11/2019
English [Auto]
Current price: $111.99 Original price: $159.99 Discount: 30% off
5 hours left at this price!
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This course includes
  • 6 hours on-demand video
  • 9 articles
  • 35 downloadable resources
  • Full lifetime access
  • Access on mobile and TV
  • Certificate of Completion
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What you'll learn
  • • Identify possible interrelationships between trauma, dissociation, and psychosis, including ways that psychosis itself, and reactions to psychosis by others, can be traumatizing
  • • Describe a variety of possible causal routes from trauma to psychotic experiences, and understand the possible role of dissociation within that process
  • • Utilize proven cognitive strategies to address command and persecutory voices, and other common yet distressing experiences found in trauma-associated psychosis
  • Click "see more" for details on Continuing Education Credit
  • • Plan to integrate CBT for psychosis with various trauma therapies to effectively treat clients who have experienced both trauma and psychosis
  • • Demonstrate a collaborate approach to helping clients develop coherent and compassionate stories of trauma and recovery which provide an alternative to both fragmented “psychotic” stories, and to helplessness-inducing “mental illness” stories.
  • 6 hours of Continuing Education Credit is provided by Commonwealth Educational Seminars for the following professions in the US:
  • Psychologists: Commonwealth Educational Seminars is approved by the American Psychological Association to sponsor continuing education for psychologists. Commonwealth Educational Seminars maintains responsibility for these programs and their content.
  • Licensed Marriage & Family Therapists: Commonwealth Educational Seminars (CES) awards CEs for Licensed Marriage & Family Therapists in the following states: AL, AK, AZ, AR, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IN, IA, KS, LA, ME, MD, MA, MI, MS, MO, NE, NH, NJ, NM, NC, ND, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WI, WY. Please note that it is the responsibility of the licensee to check with their individual state board to verify CE requirements for their state. CES maintains responsibility for these programs. In addition, CES is an approved CE provider for Florida Marriage & Family Therapists (CE Provider # 50-9633) and an approved Continuing Education Provider for Texas Marriage & Family Therapists (Provider Number 558).
  • Licensed Professional Counselors/Licensed Mental Health Counselors: Commonwealth Educational Seminars (CES) awards CEs for the above listed professions in the following states: AK, AZ, AR, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IN, IA, KS, LA, ME, MD, MA, MI, MN, MO, NE, NH, NJ, NM, NC, ND, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WI, WY. Please note that it is the responsibility of the licensee to check with their individual state board to verify CE requirements for their state.
  • Nurses: As an APA approved provider, CES programs are accepted by the American Nurses Credentialing Center (ANCC). These courses can be utilized by nurses to renew their certification and will be accepted by the ANCC. Every state Board of Nursing accepts ANCC approved programs except California and Iowa, however CES is also an approved Continuing Education provider by the California Board of Registered Nursing (Provider # CEP15567) which is also accepted by the Iowa Board of Nursing.
  • This course will still make sense to those without prior training in CBT or any trauma therapies, although such prior training will likely be helpful in understanding some of the material.

Develop a humanistic understanding of how adverse life events can lead to reactions such as dissociation and psychosis, and then learn approaches and skills which will allow you to support people in changing those reactions and turning toward recovery!   

After taking this course, you will be able to bring a truly trauma informed perspective into your work with people who are struggling with the most serious disorders.   

Topics covered include:  

·        Optimal style of therapy

·        Shifting from “what’s wrong” to “what happened” & “what next”  

·        Building coherent, self-compassionate recovery narratives  

·        Incorporating mindfulness approaches  

·        Overcoming dissociative splits  

·        Shifting from suppression to boundaries along with some openness  

·        Finding & working with themes in metaphorical expressions  

·        Spiritual considerations  

Work toward the possibility of true healing, not just “managing an illness”!  

Though mainstream approaches still commonly focus on biological factors, a large body of research now provides strong evidence that psychosis is often an understandable reaction to trauma, abuse, and other adverse experiences, with dissociation commonly at the center of that reaction.   

This course presents a science based yet very humanistic and understandable conceptualization of the complex difficulties which can occur in response to adverse life events, and then teaches how CBT and other approaches can be used to help people change their relationship with these experiences, opening up possibilities for recovery.   

Included in the course are video lectures, slides with some diagrams, lots of case examples, exploratory exercises, and links to additional resources for study.  

The course will take 6 hours to complete.

6 hours of continuing education credit is available for social workers, psychologists, and nurses in the US, and also for licensed professional counselors and marriage and family therapists in many states in the US. (See the “What am I going to get from taking this course" section for more details on CE credits.)

Grievance Policy:  Ron Unger LCSW and Commonwealth Educational Seminars (CES) seek to ensure equitable treatment of every person and to make every attempt to resolve grievances in a fair manner. Please submit a written grievance to: Ron Unger, Grievances will receive, to the best of our ability, corrective action in order to prevent further problems.

Who this course is for:
  • This course will primarily be of interest to mental health workers who work with people who have experienced both trauma and psychosis
  • The ideal student might be a therapist, but case managers, peer support specialists, nurses, medical providers and other support workers will also find much they can use.
  • The course may also be of interest to people with lived experience of psychosis and to family members who would like to better understand these tricky experiences and what might possibly help people do better.
Course content
Expand all 47 lectures 05:58:19
+ Introduction
2 lectures 03:20

This overview will help you appreciate the darkness you are about to explore, as well as the possibilities of people emerging from that darkness to reclaim their lives, maybe with your help!

Preview 02:15

Note that all the slides for the course are available here in one place, for your notes.

Notes on Taking This Course
+ What Are the Possible Connections Between Trauma and Psychosis?
8 lectures 01:00:10

This video will make you familiar with the scope and the diversity of the evidence that indicates trauma and other childhood adversity can make later psychosis more likely, as well as more complex links such as psychosis possibly causing trauma which in turn contributes to more psychosis.

Preview 10:16
Quick Quiz on the Relationship Between Trauma and Psychosis
1 question

In this video you will learn how to conceptualize trauma as just one of what might be a number of interacting factors that can lead to psychosis.  You will also become familiar with a functional definition for trauma, so that trauma can be related to as a process and not something that follows mechanically from certain types of events.

Preview 09:59

Is psychosis just an automatic reaction to adverse life events experienced by some people, or is it more complex, and perhaps related to attempts to solve trauma related problems which in turn backfire?  This video will help you gain insights from research into how everyday people respond to problems that have no apparent solution, so you can conceptualize psychotic reactions as having roots in this "normal" response to certain difficulties.

When Problem Solving Backfires: Vicious Circles and the Origins of Psychosis

This lecture reviews some of the ways the "mainstream" has and also continues to downplay any possibility of trauma causing psychosis, especially more extended psychotic reactions such as those diagnosed as "schizophrenia."

How Common Is the Denial of a Possible Link Between Trauma and Psychosis?
Where You Work, Is a Possible Connection Between Trauma & Psychosis Recognized?

When attempting to address the link between trauma and psychosis, it can be helpful to understand the sources of resistance to recognizing that link.  After watching this video, you will be familiar with a range of factors and social pressures which have led to so much "denial."

What Causes the Role of Trauma to Be So Often Denied?

It's common for professionals to think that trauma leads to PTSD, while some sort of illness leads to psychosis.  As you watch this video, you will see that there is often little difference between reactions to trauma that are obviously diagnosable as PTSD, and those which appear as "psychosis."

Preview 10:13
Quiz regarding PTSD and Psychosis
1 question

What are the effects on people when they enter a mental health system blind to the possibility that trauma may be at the root of a psychotic reaction?  This video will introduce you to a number of real life examples, including the story of Peter Bulimore, who was treated for "schizophrenia" without any attention to the possible role of trauma.

Preview 06:13
+ Inquiring About Possible Trauma and Abuse
1 lecture 06:54

The first step to insuring that trauma issues will be addressed is to ask about them.  After watching this video, you will have a good overview of why this is important and how to go about it.

Asking About a Possible Trauma History
Quiz, Asking about abuse
1 question
+ General Principles of Therapy When Trauma and Psychosis Are Related
3 lectures 37:16

Learn some key elements of a therapeutic style likely to be successful with people who have experienced both trauma and psychosis.

General Principles of Therapy for Trauma and Psychosis

Some of the trickiest aspects of trauma and distressing states of mind have to do with the way approaches that seem successful in the short term can lead to long term problems.  After watching this video you will be more aware of these kinds of issues and have ideas about the type of approach more likely to succeed with them.

Short Term Versus Long Term Strategies

This video addresses the sometimes perplexing question of "where to start?" when people have a mix of unresolved trauma from the past, various vulnerability factors, and difficulties with psychotic experience in the present.  

Thoughts About Timing: In What Order Should Problems Be Addressed?
+ Facing Disturbances With Equanimity: Using Mindfulness
5 lectures 22:00

What might be the role of mindfulness practices in better handling traumatic memories and psychotic experiences?  And on the other hand, what are the dangers and limitations of this kind of approach?  This video provides some answers to those questions.

Mindfulness: Finding Clarity in the Present Moment

This video provides an example of an exercise that uses mindfulness and compassion to take an accepting and soothing attitude toward distressing experience.

A Mindfulness Exercise

A really key skill to support recovery is being able to accept the presence of intrusions, for example in the form of voices, while directing one's attention back to desired activities.  This video describes one way of practicing this and then gives you a chance to practice it yourself, using prerecorded "voices"!

Another Exercise: "Taking Your Voices for a Walk"
Discussion about "Taking Your Voices For a Walk" Exercise

Psychosis and re-traumatization happens typically when a person is over-stressed, so one key to reducing vulnerability is helping people manage stress better.  There's one important trick to it though that often throws people off; this video will some of the contradictions involved and give you ideas about how to help people manage them.

Two Directions in Good Stress Management
+ Helping People Develop Coherent, Self-Affirming Narratives
3 lectures 21:15

Learn how to help people form coherent narratives of their lives, framing both traumatic and psychotic experiences in ways that preserve and promote a sense of self worth.  Being able to relate one's troubles in the form of a story fosters social connection, compared to simply framing them as "symptoms" which is more likely to promote isolation.

Supporting Coherent, Self-Affirming Narratives

Rai Waddingham provides an extremely coherent account of how she first framed her story in a psychotic way, then in a mental illness/symptom sort of way, then learned to frame and understand her story in a very human way, leading to a sense of "becoming a person."

Becoming a Person: Rai Waddingham's Recovery Narrative

Helping people tell a coherent story is more difficult when some of what they are relating appears to be "delusional."  After watching this video, you will have a few strategies to work with people when this seems to be the case.

How To Respond When Reported Trauma May Be Imaginary
+ Understanding the Role of Dissociation
5 lectures 47:39

This lecture will help you clearly identify how dissociation is a natural response to some of the conflicts arising out of response to traumatic threat and then the need to return to everyday life after the trauma.  You will also be able to identify the most common type of dissociative split, or "structural dissociation."

Understanding the Origins of Dissociation

Problems with dissociation come in two forms, one more having to do with "absence" of something, the other having to do with something that had been absent now "intruding" or creating a disturbance.  This lecture will help you understand this dynamic and track what's happening with your clients as they struggle with these kinds of issues.

Idendifying Two Types of Dissociation: "Positive" and "Negative"
Quiz, Truama and Dissociation
1 question

This video will help you grasp some of the functions of "hallucinations" and "delusions," and how that relates to what may be going on with underlying dissociative process.  This will help you see these sorts of experiences as possibly understandably related to people's experience with difficult events, rather than just "symptoms of an illness."

Relating Dissociation to "Hallucinations" and "Delusions"

Terror can be more intense when its source is unknown.  This lecture will help you understand the way traumatic events can leave people with memories that are "decontextualized" and which, when activated, feel like something terrible happening in the moment - and you will better understand how this experience can easily be interpreted in a psychotic way.

Dissociation and "Decontextualized Experience"

One confusing thing about "psychosis" is that it involves not just one state, but a number of contrary states or polarities, and switching between those states.  This video offers a map to put some of these possibilities into perspective and to relate the extremes to the more moderate or "middle way" approach where balance between extremes can be achieved.

A Possible Map of Extreme States and Polarities
+ Discovering and Supporting a Balance Between Extremes
2 lectures 12:23

What are some practical and collaborative ways to help people become more aware of the hazards of various extremes, and to help them reorient toward finding a balance?  This video provides some basic tools for accomplishing this objective.

Helping People Find a Balance Between Extremes

This is a guide to getting experience identifying polarities, and a middle ground, within a discussion.

Getting Practice Mapping Polarities Within Discussions
+ Constructively Working With Voices and Other Intrusions
8 lectures 01:03:02

When intrusions, in the form of trauma memories, voices, etc. are disturbing, it's natural to try to block them out.  This video introduces the notion that healing requires something more complex:  combining being able to set limits with intrusions along with ways to accept and integrate the disturbing content.

Coping With Intrusions, What Works and What Doesn't, Part 1

Become able to identify the problems associated with "threat based" responses to voices that involve "fight," "flight," and "submission," and learn to identify a balanced strategy that is more likely to be effective.

Coping With Intrusions, What Works and What Doesn't, Part 2

Eleanor Longden is a good example of someone who has learned more effective ways of responding to voices.  Learn a bit about her story, and hear her highlight some of the most important parts of her journey in her own words.

Learning from Eleanor Longden's Story

Problems with voices often develop into a vicious circle, and people can be trapped by these dynamics for a very long time.  Learn one way to help them escape, by mapping out exactly how the vicious circle works and how they might transition to a more constructive "virtuous" circle.

Using a Formulation to Aid Recovery from Problems With Voices

People who have experienced trauma and psychosis are often at high risk for self harm, and this risk is often worst when people experience commanding voices which they feel unable to resist.  Learn how to understand this dynamic and help people shift the balance of power with these voices, so that dangerous forms of compliance are reduced or eliminated.

Reducing Harm from Commanding Voices

You might want to practice this role play first with a colleague.....

Role Play: Responding to Voices

How can people learn to be compassionate toward not just themselves but also to dissociated parts of themselves which manifest as oppressive voices?  This lecture links to a video which provides a clear overview of this process.

Brining Compassion Into One's Relationship With Voices

People often feel isolated with their voices, and stuck in an unproductive relationship with them.  This video introduces a novel way to possibly overcome this pattern: having the therapist or other helper attempt a conversation directly with a voice!  When this is successful, important changes can be initiated in how the person relates to the voice, leading to various kinds of breakthroughs.

Voice Dialogue: A Therapist or Helper Speaks Directly To a Voice
+ Making Sense When Meaning May Be Metaphorical
3 lectures 30:51

While people with "psychosis" are often saying things which are literally untrue, there may be considerable truth or at least real meaning in what they are saying if they are understood as speaking metaphorically.  Learn how to respond in a constructive way when it seems your client's communication may be more metaphorical and indirect rather than literal.

Facilitating Dialogue When Meaning Emerges as Unrecognized Metaphor

This lecture provides more detail on how to work when issues are expressed in a metaphorical way, and it presents interesting case examples drawn from the work of Bertram Karon, a psychodynamic therapist.

Examples of Working With Themes That Emerge Metaphorically, From Bertram Karon
Quiz, Working With Communication That May Be Metaphorical
1 question

Trauma often causes people to question things very deeply, and some of the deepest questions are those which are often described as "spiritual."  This questioning then often comes alive within psychotic experience, but people can flounder when there are too many questions, and inadequate support in finding constructive answers.  Learn a way of conceptualizing this process of breakdown and attempts at "rebirth" in a way that doesn't pathologize it, but keeps alive the hope for a more constructive outcome.

Addressing Spiritual Issues Related to Trauma and Psychosis