Core Interpersonal Patterns in Complex Trauma and the Process of Change in Psychodynamic Therapy: A Case Comparison Study

Abstract

We performed a case comparison study to investigate the nature of interpersonal patterns in childhood trauma and the process of change therein. We analyzed three matching cases of childhood trauma that followed a psychodynamic treatment via a mixed-methods design. We found that (1) the core tendency to avoid negative reactions from others through passive behaviors emerged in all three cases, both in childhood and adulthood, (2) core interpersonal patterns transpired in the interaction between patient and therapist and thereby affected the therapeutic relationship, and (3) change ensued when a repetition of core interpersonal patterns was avoided and a new relational experience occurred. The accumulated findings across cases further resulted in several clinical implications and recommendations, such as the importance of the assessment of patients' (covert) conditions, responsiveness, supervision and facilitating patients' agency, and provided several avenues for further research.Keywords: case comparison study, systematic case study, childhood trauma, interpersonal patterns, core conflictual relationship theme, treatment process the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Depth of experiencing and therapeutic alliance: What predicts outcome for whom in emotion‐focused therapy for trauma?

“…Here, developers and practitioners assume that the achievement of an accurate appraisal of one’s trauma and the extinguishment of maladaptive cognitive distortions and misattributions are essential for the alleviation of trauma sequelae (Harvey, Bryant, & Tarrier, 2003). Treatment developers informed by a Psychodynamic approach posit that it is the repetition of core maladaptive interpersonal relational patterns that are the worthy target of therapeutic intervention and that successful change comes when the client avoids old and develops new, more adaptive ways of relating to others (Van Nieuwenhove & Meganck, 2020). In the current investigation, we explored mechanisms of change in the treatment of individuals traumatized during their childhood using emotion‐focused therapy for trauma (EFTT) within the context of therapist responsiveness, namely depth of experiencing and the strength of the therapeutic alliance.…”