Frances S. Waters, DCSW, LMSW, LMFT

Healing the Fractured Child:
Star Theoretical Model for Assessing and Treating Dissociative Children

This presentation will describe STAR Theoretical Model, a comprehensive model of five theories – attachment, neurobiology, dissociation, child development, and family systems that in combination explain the development and treatment of dissociation in children and adolescents. At the top of the STAR shape is attachment, giving it paramount importance as the attachment style of the child to parents/caregivers contribute to dissociation or provide the foundation to assist the child in his/her healing. I draw heavily on Bowlby, (1980), the father of attachment theory, and his research on children separated from their mothers who displayed dissociative symptoms and describe in my model, a comparison between Bowlby’s psychosocial stages of loss and mourning (1960) to children who also endure other traumatic experiences. Contemporary researchers in attachment will be explained in my model.

Regarding neurobiology of trauma and dissociation in my model, I will describe current research on memory impairment, and will highlight Porge’s (2011) research on the Triune Autonomic Nervous System, the impact of trauma on the child’s developing brain (Perry, et.al.,1995), and the influence of mirror neurons (Casile, Caggiano and Ferrari, 2011) to increase our understanding children’s dissociation and development of self-states. Numerous theories on dissociation (e.g. Putnam, 1997) are highlighted and how they have influenced my work.

Regarding child developmental theory, I will describe my comparison model to Eirkson’s (1963) psychosocial stages of development that incorporate theories of trauma and dissociation to further understand the impact of trauma on a child’s development. Finally, I will describe Virginia Satir’s (1983) family system’s theory that recognize harmful interactional patterns and that the identified client, the child, is often reacting to a dysfunctional family.

This integrative theoretical approach will enhance the success of assessment and treatment process of children and adolescents with dissociation. 

  • Bowlby, J. (1960). Grief and mourning in infancy and early childhood. Psychoanalytic Study of the Child, 15, 9-52.
  • Bowlby, J. (1980). Attachment and Loss, Vol. 3: Loss, Sadness and Depression. New York, NY: Basic Books.
  • Casile, A., Caggiano, V., & Ferrari, P. F. (2011). The mirror neuron system: A fresh view. The Neuroscientist, 17(5), 524–538. Retrieved from www.ncbi.nlm.nih.gov/pubmed/21467305
  • Erikson, E. H. (1963). Childhood and society (2nd ed.). New York: W.W. Norton.
  • Perry, B. D., Pollard, R., Blakely, T., Baker, W. L., & Vigilante, D. (1995). Childhood trauma, the neurobiology of adaptation and use-dependent development of the brain: How states become traits. Infant Mental Health Journal, 16(4), 271–291.
  • Porges, S. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication and self-regulation. New York: W.W. Norton.
  • Putnam, F. W. (1997). Dissociation in children and adolescents. New York: Guilford.
  • Satir, V. (1983). Conjoint family therapy (3rd ed.). Palo Alto, CA: Science and Behavior Books.