Theoretical Paper Psychodynamic considerations on clinical work with combat-related post-traumatic stress disorder

Abstract

Content & Focus:This paper will look at the diagnosis of post-traumatic stress disorder from a psychodynamic perspective. Generally, it is espoused that a traumatic event alone is not sufficient to cause significant psychological disturbance. Instead, the complex interplay between developmental and adult experiences contributes to this. To locate this paper within the counselling psychology ethos of drawing links between theory and practice, a fictional client – John Gubbins – will be used to illustrate this model. Specifically, I will consider Fairbairn’s tripartite structural model of ego and internal transitional techniques to understand the neurotic conflicts of combat PTSD. This will then be applied along with other psychodynamic concepts such as transference and counter transference to explore the therapeutic work and relationship.Conclusions:Fairbairns’s tripartite structural model of the ego offers a relational view on the neurotic manifestations of combat-related PTSD. John’s case illustrates the frequency of oscillation between the schizoid and depressive positions. The reintegration of split off bad objects and the use of counter transference have been the main feature of my work with John.