Sometimes the work that we do and the individuals that seek us out for help are complicated, and it can be hard to know where to start. I often work with individuals who are transgender or nonbinary, have both Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder (OSDD) and who are also autistic or neurodivergent in other ways. Traumatic impacts are higher in both transgender and nonbinary populations. This is also true in populations that are autistic and/or ADHD, or who present with other neurodevelopmental disorders.

As a result, it stands to reason that we may see higher percentages of individuals presenting with OSDD/DID in these populations. Therapists may have an expectation that individuals resolve their complications with OSDD/DID before accessing gender-affirmative care in order to ensure that the individual is making a fully-informed choice. However, this sort of barrier to care can also serve to further increase traumatic impacts and impede mental health recovery.

In this presentation, we will look at the ways all of these things can present in our client populations as well as how they can intersect. We will examine some of the neurobiology that is present with the different neurotypes we are discussing and we will go over some of the neurobiological differences for individuals who are autistic and/or ADHD, as well as some of the changes that chronic PTSD may cause to the brain.

I will also go over some of the modalities that I use in my work such as somatic modalities and how they are adjusted as well as a brief overview of parts work.

By the end of this training you will be able to:

1. Define the difference between neurodivergence and neurodiversity and why the difference matters.
2. Know the overall statistics for exposure to traumatic experiences for  populations who are autistic and/or ADHD as well as populations that are transgender and non-binary.
3. Name at least three factors in a child’s environment that may lead to that child developing OSDD/DID
4. Identify at least two important things that are necessary for a clinician to utilize in order for OSDD/DID clients to improve.

Katie Keech, LMFT, has over twenty years of clinical experience in community mental health (CMH) and private practice in a range of settings. They initially worked as a volunteer coordinator for San Francisco Suicide Prevention, where they helped launch the Trevor Project (a hotline for LGBT youth) and led grief groups for people who’d lost loved ones to suicide.  They have led several Emerging Adult programs that specialized in severe mental illness  as well as a forensic mental health program.

They were previously the International Society for the Study of Trauma and Dissociation (ISSTD) Secretary and they pioneered several individual learning communities within ISSTD ranging from Transgender identities, Emerging adult needs, and Neurodivergence.  

Since 2021, Katie has worked full time in private practice. Katie continues to provide trainings on assessing and diagnosing dissociative disorders and Emerging Adults to CMH programs. They received the City of Berkeley Mental Health Division’s Mental Health Achievement Award in 2021 for this work.

They utilize somatic work which includes their training in Sensorimotor therapy and are continuing to deepen their training in this model. They utilize this in their practice along with a feminist psychodynamic therapy models. Katie primarily works with multiply neurodivergent individuals  have complex dissociative disorders along with autism and/or ADHD. The majority of individuals Katie works with are from diverse cultural background and are LGBTQ+.

Most recently, Katie co-founded the Refractory Think Tank, a clinical community of therapists, researchers, coaches, and clinical students with personal lived experience histories of OSDD/DID/ Plurality, with the aim of improving clinical work and research from a lived experience perspective and mentoring new student clinicians.