Abstract
Complex psychological trauma affects all structures of the personality—one’s image of the self, images of the others, and one’s values and ideals, and leads to the sense that the personality coherence and continuity is assaulted and systematically broken down. Complex trauma, such as war-related trauma, severe brutal rape, kidnaping, terrorism, etc., overwhelms the ordinary human adaptations to life and involves the threats to life and bodily integrity, and confronts human being with the extremities of helplessness and terror, and evokes response of catastrophe. As the complex trauma is a specific traumatic experience, it requires specifically designed trauma-focused therapeutic approach which should deal with: a) the nature of the predisposing factors in complex trauma, b) the manner in which trauma experience and conditioning produce distortions in trauma victim’s personality, c) the relationship between the personality structure and trauma, d) the constituents of inner conflicts, e) meaning function and manifestations of trauma syndrome, f) the structure of the psychic apparatus, and g) the mechanisms of defences. The Dynamic Therapy model has been developed as a three-phase treatment while providing therapy for over decade to the complex PTSD patients whose condition has been an aftermath of human-designed disasters (wars, brutal rapes, assaults and serious violence). The Dynamic Therapy model emphasises that there is a complex process in interactions between different phenomenological components of the complex trauma and that there is a variety of the ways in which etiological factors can contribute to the onset of the trauma syndrome. With the patient’s complicated clinical presentations, the therapy accentuates the main principles and targets in treating complex trauma syndrome: 1) trauma symptoms reduction and stabilisation, 2) processing of traumatic memories, dissociation, and emotions, and 3) life integration after trauma processing. The model is a goal-directed phased treatment towards the restoration of a disrupted sense of self that affects the inner and the outer world of a traumatised individual.
Highlights
Without any doubt, the impact of complex traumatic experience is quite severe on a victim’s personality with the deepest feelings of powerlessness, hopelessness and helplessness
The Dynamic Therapy model has been developed as a three-phase treatment while providing therapy for over decade to the complex PTSD patients whose condition has been an aftermath of human-designed disasters
The Dynamic Therapy model emphasises that there is a complex process in interactions between different phenomenological components of the complex trauma and that there is a variety of the ways in which etiological factors can contribute to the onset of the trauma syndrome
Summary
The impact of complex traumatic experience is quite severe on a victim’s personality with the deepest feelings of powerlessness, hopelessness and helplessness. Developed trauma-focused CBT, such as a prolonged exposure (Foa & Rothbaum, 1998) was predominantly focused on sexual assault in women This raised the question of whether this method works in other traumatised populations. While identifying core cognitive abnormalities and developing a cognitive model of PTSD, the close attention to the phenomenology to the disorder is identifying treatment targets and clear understanding of the disorder making differentiation between the severity and the complexity of the symptoms (Herman, 1992; Van der Kolk et al, 1986; Zepinic, 2011). Many symptoms of PTSD, such as avoidance and hypervigilance, are anxiety symptoms and, by the DSM diagnostic criteria, anxiety is a result of appraisals relating to impeding threats This puzzles many clinicians in whether PTSD is a disorder in which symptoms of traumatic memories are of something that already happened, and why so many anxiety and fears still exist. Re-experiencing trauma symptoms is an involuntary process (Duckworth & Follete, 2012; Ehlers & Clark, 2000; Zepinic, 2008, 2011) with four aspects: 1) Re-experiencing lacks the one’s awareness of the self in the past (“there-and-” circumstances), and the sensations and perceptions appear as they were happening in the present threat (“here-and-” circumstances); 2) Re-experiencing can take a form of affect without recollection
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