Complex trauma describes that category of severe, chronic interpersonal trauma usually originating in the formative years of a child. In the adult, this can result in global dissociative difficulties across areas of cognitive, affective, somatic, and behavioral functions. Targeting this field of traumatic pathology, this article reviews the contributions and developments within one broad approach: psychodynamic theory and practice. Brief descriptions of aspects of analytical, Jungian, relational, object relations, and attachment therapeutic approaches are given, along with understandings of pathology and the formulation of therapeutic goals. Major practices within client sessions are canvassed and the issues of researching treatment outcomes are discussed.

In this article, we report on a phenomenological study of experiences of recovery of 7 women with histories of childhood maltreatment. We propose a model that recalls the Anglo-Franc etymological origins of rekeverer: to regain consciousness, health, or strength. Dimensions include development of a selfhood; tasks of connection and separation; regulation of overwhelming emotions; management of choices; and internalization of therapeutic relational dynamics. Based on the findings, we suggest that theory and research need to extend concepts of healing, add methodologies privileging victim/survivor voices, and revisit concepts such as neutrality and resistance as they apply to dissociative disorders. Practitioners should have specific training in trauma models, although they need to hold these theories lightly because therapeutic goals and pathways of change might well differ for each client. Integrated whole-of-government initiatives need to identify those at risk of abuse as early as possible, and provide response funding beyond assessment services.

As therapists are confronted with clients who have childhood histories of severe interpersonal trauma, the challenge is to understand how this trauma affects individuals developmentally and how healing might be facilitated. This article explores how integration might be understood in the context of complex posttraumatic stress disorder. It is proposed that the symbolic function is central both to the fracturing of selfhood due to early trauma and to its resolution. The article provides a detailed discussion of symbolism and therapeutic possibilities for the use of symbolism as an adjunct to therapy with sufferers of complex posttraumatic stress disorder. It is argued that symbols provide a potentially powerful means of assisting reintegration and that this can be used within a range of therapeutic traditions, including cognitive-behavioral, psychodynamic, psychopharmacological, and neurophysiological approaches. The work of the first author in this regard is illustrated by means of a case study.