Complex Trauma, Dissociation, and the Use of Symbolism in Therapy

Abstract

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.

A qualitative study of single-trauma and dual-trauma military couples.

“…The concept of complex trauma is pertinent to the study of trauma in couples. Complex trauma has specifically been defined as the result of exposure to severe stressors that are repetitive and prolonged, involve harm or abandonment by caregivers or other ostensibly responsible adults, and occur at developmentally vulnerable times in the victim’s life, such as early childhood or adolescence (Courtois & Ford, 2009; Spermon, Gibney, & Darlington, 2009). Consequences of complex trauma may result in changes in the mind, emotions, body, and relationships and may include symptoms such as dissociation, somatic distress, relationship alienation, or emotional dysfunction (Courtois & Ford, 2009).…”

“…Complex trauma has specifically been defined as the result of exposure to severe stressors that are repetitive and prolonged, involve harm or abandonment by caregivers or other ostensibly responsible adults, and occur at developmentally vulnerable times in the victim's life, such as early childhood or adolescence (Courtois & Ford, 2009;Spermon, Gibney, & Darlington, 2009). …”

Psychodynamic psychotherapy for complex trauma: targets, focus, applications, and outcomes

“…The idea of engaging a symbolic function in therapy is increasingly found in the literature with authors such as Pestalozzi48 and Keinanen49 using it to understand the etiology and presentation of trauma psychopathology, as well as in therapy. Others have documented specific applications in therapeutic activity 55,56…”