What knowledge do ACEsConnection members feel would be helpful for doctors and Nurse Practitioners to possess concerning Dissociation and Attachment particularity in order to relate better to our patients who are experiencing symptoms like depression, anxiety and panic?   

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Greetings, As a retired family physician I think the second question is what specialty are the docs, nurse practitioners and physician's assistants? You could group them, if you wish, as psychiatry, primary care (family medicine, general internal medicine and general pediatrics), pediatric specialties and adult specialties. Initially, I would set aside the specialists as they would not find this beneficial, most likely. Psychiatrists-I cannot comment.  Primary care--would have general knowledge of attachment (pediatrics and family medicine more than internal medicine) and less knowledge about dissociation.  There is wide variability of knowledge and practice across primary care providers. For example--I did a lot of psychiatric care whereas some of my colleagues referred almost all of it. Likely similar in pediatrics and internal medicine, although I don't know for sure. Regarding nurse practitioners and physician assistants--there is also a wide range of knowledge and practice.

For primary care--knowledge of ACEs, Resilience and Trauma-Informed Practices is vast. Pediatrics, as a specialty has been putting a press on this concept so may be further ahead. I think it is important to understand that along with the issues of attachment and dissociation. 

I hope this is helpful. Feel free to let me know if I can help otherwise. I don't check these boards more than once a week though. Best wishes, Ellen

How much knowledge do FP’s and Peds have concerning attachment Ellen? Is this a part of their training and CME and Board Certification? Do you know?  I would be really interested in seeing that curriculum, if it exists.   I’d also like to know if psychiatry gets any education on these topics.  I know my medical school and residency was only DSM lists.  It was as if parents didn’t exist.   I wanted to do developmental peds but my program was on vents and constipation and feeding teams... we looked at mechanics and the medical problems associated with genetic syndromes or prematurity but no content on normative child emotional development was presented. 

We did have Morris Green and Nancy Hopwood both of whom I loved dearly. I wish we could get back to the information we had then. We knew about psychosocial dwarfism, we knew about the impact of maternal emotional unavailability on child development but we seem to have lost or forgotten all that information. 

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Carey S. Sipp (ACEs Connection Staff)