S: How did your interest in dissociative disorders start?
B: I found out in high school that a friend of mine was being sexually abused by her dad, as were her two sisters. He was an official in their church and it was startling to me. It looked like she was all together. So as a high schooler, I started learning a little bit about trauma and over the next few years, her sisters began to have a lot of trouble, and they’ve had a lot of psychiatric troubles for decades now.
This led to my dissertation research. I wanted to understand how some people could experience trauma and be relatively intact and resilient and other people are decimated and struggle for decades with it.
And in my first year of graduate school I did an externship with Johns Hopkins Hospital. I worked on an inpatient unit with kids from the surrounding neighborhood and most of the kids I did psychological testing on had been neglected or traumatized. It became clear that there was no research that could tell me how trauma might impact the children’s psychological evaluations. So now I do two kinds of research: I study the assessment of traumatized people as well as treatment outcome research with severely traumatized people. There’s still not as much research as you would expect there to be on assessing the impact of childhood trauma using psychological testing. There’s quite a lot on veterans, but not as much on child abuse survivors [which is a much larger population].
S: What is the relationship between complex trauma and Dissociative Identity Disorder?
B: Complex trauma is considered a broader conceptualization that refers to the impact of certain types of chronic interpersonal trauma, typically during the developmental years.
Practitioners who assess and diagnose DID recognize that DID is the result of severe complex trauma. And many features of DID—such as difficulties with affect regulation, identity and consciousness, and difficulties with relationships—overlap with features of complex trauma.
S: I’ve noticed that “complex trauma” seems to mean different things to different people.
B: It does. Some people argue that complex trauma doesn’t only apply to people who experienced developmental trauma. Others make a good argument that long-term imprisonment and torture could cause the emotional and interpersonal disruptions that we see in complex trauma. When I first got into the field, I only thought of complex trauma as developmental trauma. Now we’re more aware of the types of prolonged trauma that adults, such as women from war torn countries that are repeatedly raped. We can see that they’re likely to have the same issues of those with complex trauma such as, Who am I going to trust, is life worth living when people are so cruel? They’re going to have the same disruptions that we see in developmental trauma.
S: It’s also interesting how even a one time event of interpersonal trauma can cause such disruptions in trust and safety. I get a lot questions on Tumblr from young adults who report one assault but feel such difficulty connecting and trusting now that they wonder if they have complex trauma.
B: That makes sense, and it’s true, especially in the case of sexual assault, that one event can cause major issues with trust and safety. Especially if they weren’t taught in childhood how to healthfully manage emotions and get support from close friends and loved ones.
Bethany Brand, Ph.D. specializes in the assessment and treatment of trauma related disorders including posttraumatic stress disorder (PTSD) and dissociative disorders. She has over 25 years of clinical experience, including training at Johns Hopkins Hospital, George Washington University Hospital, and at Sheppard Pratt Health System’s Trauma Disorders program. She is a Professor of Psychology at Towson University near Baltimore, Maryland where she directs the Clinical Focus program. Dr. Brand has received international recognition for her work on complex trauma-related disorders. She is a practicing psychologist with experience in outpatient and inpatient treatment. Dr. Brand has served on three national task forces that are developing guidelines for the assessment and treatment of trauma-related disorders. Dr. Brand conducts research on the assessment and treatment of trauma related disorders, including the assessment of dissociative disorders, and has over 50 published articles. Dr. Brand is the primary investigator for the largest and only international treatment outcome study of dissociative disorders (the TOP DD study). Regarded as a seminal study in the trauma field, the TOP DD study has resulted in multiple publications and international presentations. Her forensic research studies have provided critical insights about distinguishing genuine from feigned dissociative disorders. Dr. Brand has been awarded numerous research, clinical, writing, and teaching awards including Maryland Psychology Teacher of the Year, awarded by the Maryland Psychological Association, the Cornelia B. Wilbur Award for outstanding clinical contributions, and the Morton Prince Award for Scientific Achievement. Dr. Brand is highly regarded for being a dynamic speaker who provides a compassionate understanding of trauma, grounded in empirical research. Dr. Brand has delivered clinical and research presentations in Germany, Norway, Turkey, Canada, and the United States. She is sought after for media interviews including by National Public Radio’s show, Science Friday. Dr. Brand maintains a private practice in Towson, Maryland where she provides treatment and consultation.