Beyond Internalization of the Perpetrator: Theory, Assessment, & Treatment Consideration Across Development for Adults

 Description

This webinar series examines in detail the complex victim-perpetrator dynamics within traumatized clients and in the therapeutic relationship. Clinicians often need to identify and work with internalized perpetrator parts, ranging from ego states to dissociative parts, which have multiple layers of meaning and intricate defenses. These parts are interconnected with victimized parts of the self through trauma, creating a cycle of internal (and sometimes external) aggression. In this series, we explore how internalization of the perpetrator occurs and what its many manifestations look like. We discuss the intersection between shame and sadism, how to understand it, and how to effectively address these challenging dynamics within the client and the enactments that occur in the therapeutic relationship. We will emphasize the therapeutic relationship and the clinician’s countertransference, focusing on managing our own fear, disgust, shame, avoidance, and appeasement. Next we cover detailed and practical aspects of assessment, case conceptualization, and decision-making. In the final webinar, we explore treatment issues in depth and with ample case examples. By the end of this series, attendees will have a comprehensive toolkit for approaching internalized perpetrator dynamics with greater confidence, understanding, and clarity.

 ADULT TRACK

July 25, 2025
Module 1 (3 hours)
Theory and Etiological Models

In this module we will explore various models that explain how attachment patterns to abusive figures develop and become crystallized into harsh internal representations that haunt and harass the client. We will discuss trauma bonding and other survival strategies in the face of betrayal trauma, and how it becomes internalized. We will also explore innate motivational systems that underlie introjected perpetrator parts, and explain how this informs treatment, helping us to more clearly understand different types of aggression. Through these frameworks, clinicians will gain a deeper understanding of the victim-perpetrator dynamics, how shame and sadism manifest in these relationships, and their role in maintaining attachment.

Educational Objectives

Participants will be able to:

1. Understand the theoretical and etiological models of internal perpetrator dynamics and their development within traumatized individuals.
2. Identify and address the manifestations of shame and sadism within internal perpetrator parts and develop strategies to manage these dynamics within the therapeutic relationship.
3. Assess and conceptualize cases involving internal aggression and make informed decisions regarding treatment approaches while ensuring clinician readiness and support.

July 26, 2025
Module 2 (3 hours)
Shame, Sadism and Countertransference with Internal Perpetrators

This webinar takes a deep dive into internal and relational perpetrator and victim dynamics. We will examine strategies used by both perpetrator and victim internally that perpetuate a lack of safety for the client. Treatment approaches to address these rigid dynamics will be discussed. We will also explore the role of sadism in internal perpetrator parts and how to address it, but within the client and within the therapeutic relationship. Finally, we address the bond of shame shared by both internal perpetrator and victim, how to identify its many faces, and how to work effectively with it. We will also explore common countertransference reactions to internal perpetrators and aggression and how to manage our own feelings and reactions, which may be intense. Ample case examples will be offered.

Educational Objectives

Participants will be able to:

1. Describe several theoretical and etiological models of internal perpetrator dynamics and their development within traumatized individuals and how these dynamics affect clients.
2. Identify the manifestations of shame and sadism within internal perpetrator parts, and develop strategies to manage these dynamics within the therapeutic relationship.
3. Assess and conceptualize cases involving internal aggression, making informed decisions regarding treatment approaches while ensuring clinician readiness and support.

 August 1, 2025
Module 3 (4 hours)
Assessment, Case Conceptualization and Decision Making

This webinar outlines critical factors for assessing internal perpetrators in traumatized clients, ranging from ego states to dissociative parts. It includes how to evaluate the risk of violence towards self or others, how to examine the client's support system that either exacerbates or contains aggression and monitor escalating arousal levels. The intensity, severity, and accessibility of these factors are assessed alongside the client's capacities. We will explore how to organize a case that involves intense internal aggression, and well as those that involve aggression toward others. Additionally, we emphasize clinician readiness and support while addressing various dilemmas such as over-caution, the need for awareness of potential danger, containment, support for the therapist, and need for consultation.

Educational Objectives

Participants will be able to:

1. Assess the level of severity and chronicity of internal perpetrators, ranging from simple ego states to dissociative parts.
2. Assess risk of violence to self and others in clients with internal perpetrator parts, including the risk of violence toward the therapist.
3. Assess the readiness of the therapist and the reality of the clinical setting in making decisions about taking on clients who have the potential for more aggression.
4. Identify and manage complex countertransference reactions to internal perpetrators and aggression, effectively controlling their own emotions and reactions to maintain a safe therapeutic environment.

August 2, 2025
Module 4  (4 hours)
Therapeutic Interventions  

This webinar outlines key strategies for therapeutic work with internal perpetrator-victim dynamics and therapeutic engagement of perpetrator introjects. We focus on various aspects of managing and preparing clients for engagement with perpetrator-imitating parts and emphasize establishing boundaries within the therapeutic relationship. Adequate psychoeducation and support for the client to understand these parts of self is paramount. We will discuss how to gain different levels of access to perpetrator-imitating parts in a paced manner, with specific interventions. We also explore how to manage aggression in session, how to help perpetrator-imitating parts to become more oriented to the present; how to relay the therapist’s understanding of their functions to these parts, and how to help these parts of the client differentiate from the actual perpetrator.  These approaches help in maintaining a safe, structured and effective therapeutic process.

Educational Objectives

Participants will be able to:

1. Employ skills to establish and maintain therapeutic boundaries while engaging with perpetrator-imitating parts, ensuring a safe and structured therapeutic environment.
2. List specific interventions for accessing and working with perpetrator-imitating parts, including strategies to help these parts differentiate from the actual perpetrator and orient to the present moment.
3. Discuss issues of pacing and working with other parts of self in relation to internal perpetrator parts.
4. Acquire techniques to manage aggression in therapy sessions and provide psychoeducation to clients, fostering an understanding of the functions of perpetrator-imitating parts and supporting clients' overall therapeutic progress.