The Practitioners of Trauma: An Interview with the President of the ISSTD

Rosita Cortizo

Interview 2 of Kerry McElroy’s Interview Series “A Light in the Mineshaft: An Interview Series With Society’s Traumaworkers”

Rosita Cortizo, originally from Panama City, Panama, currently works as a high risk, multicultural, bilingual prenatal and perinatal clinical psychologist for Behavioral Health and Women Health Services working with female adults and children. Dr. Cortizo has worked in Public Health in Southern California with pregnant women at high risk with multiple diagnosis, complex traumatic stress, dissociative processes, and relational crisis for more than 30 years.

Dr Cortizo has published four prenatal articles for different peer reviewed Journals in the past 3 years. She holds licenses as both clinical psychologist (2001) and marriage family therapist (1998); and earned a Master of Arts in Psychology with specialty in Chemical Dependency (1993) in San Diego, California.  She is EMDRIA Certified, an Approved EMDR Consultant, trained in Hypnosis, Sensory Motor Psychotherapy, Equine Assisted Therapy Certified, and the 2021 ISSTD President.

 Kerry McElroy is a Contributing Editor to Narrative Paths. She is a feminist cultural historian and writer holding a doctorate in Humanities from Concordia University, Montréal. Her thesis entitled Class Acts: A Socio-Cultural History of Women, Labour, and Migration in Hollywood, focused on women in performance systems. She has published articles on cinema, women, history, culture, and politics in Irish AmericaThe Independent, and Montréal Serai, among other magazines. She holds master’s degrees from Columbia and Carnegie Mellon Universities.

KLM: So, can you tell me about the ISSTD- the International Society for the Study of Trauma and Dissociation? Its history, its makeup.

RC: Sure. The International Society for the Study of Trauma and Dissociation is an international non-profit, professional association organized to develop and promote comprehensive, clinically effective, and empirically based resources and responses to trauma and dissociation, and to address its relevance to other theoretical constructs.

The ISSTD was created in 1983, and the founders were a group of professional visionaries. It was an original steering committee of sixteen practitioners. They were committed to creating a new society or association that would train clinicians and researchers, while also supporting publications on trauma and dissociation. They brought together a community of professionals in these fields.

KLM: Who is able to join?

RC: Anyone who is a behavioral health licensed clinician or practitioner and is interested in learning about complex trauma and dissociation. We currently have 1760 members and still growing.

KLM: What is complex trauma, for the layperson?

RC:  In 1992 Judy Herman, M.D. first discussed and introduced the term Complex PTSD or complex trauma, in herbook Trauma and Recovery: The Aftermath of Violence from Domestic Abuse to Political Terror. Dr. Herman wisely recognised then that the definitions of Post Traumatic Stress Disorder or PTSD were too simplistic, narrow, and usually focused on a single incident. Dr. Herman found that while many people experience a single trauma event, most victim-survivors’ narratives describe multiple, complex, overlapping incidents. Dr. Herman is a member and a recent past presenter at ISSTD.

Drs. Christine Courtois and Julian Ford have also written and talked about complex trauma comprehensively. They describe it as repetitive or prolonged actions or inaction, which may involve harm, neglect, or abandonment by caregivers during developmentally vulnerable times, all of which can negatively impact children’s developmental growth and wellness. Both of these doctors are also ISSTD members, as well 2022 Plenaries at this year’s ISSTD Conference in Seattle.

 KLM: The ISSTD has worked with international NGOs, humanitarian organizations, even the UN. How?

 RC: Originally, the ISSTD purpose of getting involved with the UN was to inform on international and intercontinental matters related to trauma and dissociation. There are other organizations that work with trauma, but we are the only society that educate and do research in both areas. We have found that education and trainings about trauma and dissociation are what’s most needed in remote regions around the world. The ISSTD provides international expertise via virtual trainings, webinars, and conferences.   

KLM: So complex trauma can be about war and geopolitical issues, but it can also be personal and “everyday”?

RC:  Complex trauma can result from experienced repetitive and multifaceted trauma in both areas. Fortunately, there are specific international trauma trained clinicians and groups who specialize and devote their time to assist in recent trauma events– natural disasters, and wars. Other trauma can be personal and “everyday”, yes– and there are numerous clinicians trained in such matters.

The ISSTD provides education in all the mentioned areas through conferences, virtual webinars, and our online platform, ISSTDWorld. Members can study from offered courses and journal articles, and adapt these to their own needs.

KLM: One of my non-western interviewees in this series raised the idea that “trauma” as a concept can sometimes feel western in non-western communities, externally imposed or even invasive. How does your organisation deal with this, in its global outreach?

RC: As an international and intercontinental association, we are culturally sensitive and strive to create opportunities to remain inclusive, diverse, and to evolve. We have an International Task Force (ITF) with members from six continents to address such important challenges, and to identify caveats. Also, our Public Health Committee has standards to identify specific trauma and dissociation clinical idiosyncrasies, both locally and abroad.

KLM: What is the difference between trauma-focused work and what most would consider “regular” therapy?

RC: There are specific guidelines and standards of care for trauma-focused work. Comprehensive clinical assessment, screening questionnaires, and the pacing of the clinical work are all important elements of this trauma informed work. The ISSTD offers the clinical public and members two Adult, and Child & Adolescent Treatment Guidelines.

KLM: What kinds of consultants and clinicians make up your group, or are drawn to it in the first place? In other words, who would you say are the healthcare and other professionals who actively choose to work with trauma?

RC: I think of us as a diverse, committed, and curious community of clinical practitioners who are dedicated to research, to the profound understanding of complex trauma and dissociation, and to work alongside extreme abuse survivors. There is a strong sense of clinical community among the society’s members.

The ISSTD seems to be a magnet for pioneers, visionaries, and younger leadership, actually. Our younger andolder leaders work together swiftly and harmoniously.  

KLM: But even with such care and such precautions, secondary trauma for your practitioners— it must happen. It does still happen. So then, how does one deal with it? In treating traumatized patients, really difficult cases.

RC: It’s true, the intense work and the frequent long hours can often be very taxing, and so it’s vital to practice mindful self-care. We have special interest groups (SIGs) to support our members in this vital area. We know that this kinds of care, effort, and conversation can reduce burnout.

At the same time, seeing someone’s progress can be very stimulating. This work is invigorating.  

KLM: From your perspective, both doing this type of trauma work and supporting others who do it: do you have the impression that society doesn’t want to think about these things? The many horrible ways people become traumatized, from family sexual abuse to domestic violence or rape? And just the sheer numbers of people in societies going around traumatized?

RC: There is certainly a degree of social denial, misunderstanding, or disinformation about complex trauma and dissociation. Universal education, updated psychology texts, and apolitical courageous reporting are all critical, and needed.

KLM: Right, but as of now and how societies have typically been organized– do you think there are social tendencies to sweep certain types of trauma under the rug?

RC: Yes, and we’d say it’s time to tenderly lift the rug and provide schools, community centers, and the media with universal trauma and dissociation education.    

KLM: And finally, how did you become president of the ISSTD?

RC: It was an honour to be asked to be part of such a hard-working community of practitioners, researchers, academics, and writers. I have been the ISSTD President for seven months and it has been a privilege, and revitalising, to serve our members and the public.  

KLM: And just lastly– would you tell us a bit about yourself, leading up to how you came to be the person you are and to do the work you do?

RC: I’m originally from Panama, and part of my developmental education included service work and social contributions. Family, faith, friends, spirituality, nature’s appreciation, and public service were important regional social values. I moved to the US to do my undergraduate and graduate work, and I’ve been in the country for more than thirty years. I believe those early years of scholastically organized community service, my multicultural and intercontinental upbringing, a love for nature, and family and social interests—all of these creatively influence the work I do today.

Over the past thirty years, I have become increasingly interested in working with complex trauma in my own practice. I have remained a prenatal care and substance abuse treatment advocate in terms of prenatal bonding and developmental trauma work. Working with survivors of neglect and extreme abuse is inspiring, and a gift.