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Dominica Dorning

Biography

Dominica is a Clinical Psychologist and board approved supervisor who completed her undergraduate and postgraduate studies at La Trobe University in Melbourne. She has undertaken additional training in Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Dialectical Behavioural Therapy (DBT). Dominica has worked as a counselor/ project officer at STARTTs for six years, providing treatment and rehabilitation for survivors of refugee torture and trauma, predominately with people seeking asylum whose visas are not yet determined. Dominica is passionate about working with people seeking asylum and is particularly focused on helping to reduce the suffering of individuals whilst their protection claims are processed. Dominica also works in private practice in Newtown where she specialises in trauma informed practice, and a majority of her clients attend for DBT. Dominica is also a yoga teacher with experience in adapting yoga practices to varied participants, including people exposed to trauma, chronic health/pain difficulties and individuals with larger bodies.

Abstract – Clinical Master Class – 8 May 2019

Intolerable pain: trauma, invalidating environments and pervasive emotion dysregulation in refugees and asylum seekers

Borderline personality disorder (BPD) is often associated with a history of traumatic experiences and/or exposure to an invalidating environment. In the trauma field many researchers and clinicians acknowledge that Post Traumatic Stress Disorder (PTSD) is limiting diagnostically in capturing the complex symptom presentations for some individuals who have experienced cumulative and prolonged exposure to trauma, as is common for many refugees and asylum seekers. In order to address this gap expert trauma clinicians have developed criteria to fit more appropriately with the presenting problems commonly exhibited by survivors of severe and cumulative trauma and the diagnostic category of Complex Post Traumatic Stress Disorder (CPTSD) has emerged. Refugee and asylum seeker clients with significant and prolonged trauma histories at times present with prominent symptoms of emotion dysregulation, reduced ability to tolerate distress, interpersonal difficulties and unstable identity concepts, which may be consistent with aspects of both BPD and CPTSD criteria. Through an exploration of a case study of a male asylum seeker, this presentation will demonstrate the potential for overlap between CPTSD and BPD presentations, the challenges of working with such a client within an environment of invalidating refugee status determination processes and the importance of a staged therapeutic approach with an emphasis on validation, non-judgement and skill development.

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