Core conflictual relationship patterns in complex trauma: A single-case study

Abstract

Dysfunctional interpersonal patterns constitute one of the core features of complex trauma. Supportive-expressive psychodynamic theory operationalises these interpersonal patterns via the core conflictual relationship theme (CCRT), by defining the main wish, response of other and response of self in patients’ habitual ways of interacting with others. Unfortunately, research regarding the specific contents of these CCRT components in complex trauma is scarce and adopts a static approach in studying interpersonal patterns. By means of a longitudinal single-case study of a supportive-expressive psychodynamic therapy with a man with a complex traumatic background, this study provides an in-depth description of the nature and change in the CCRT. In this particular case, the wish to be respected by others and to be close to others was at the forefront throughout the entire therapy. At the beginning of therapy, others were perceived as distant and rejecting, rendering the patient feeling disappointed and dependent. As the therapy progressed, the patient perceived his interactions as more satisfying, being able to self-confidently express himself and to see others as more accepting and understanding towards him, satisfying his main wishes. This case illustrates the importance of understanding and addressing the CCRT in the broader narrative of the patient and the dynamic nature of change throughout a therapy process.