Complex Trauma

5

People may have been traumatised repeatedly over a period of time or within specific settings and scenarios. Emotional neglect also has the same impact on children, if not greater. Emotional Neglect is a parent’s or primary caregiver's lack of adequate response to a child’s emotional needs. Those who have been chronically traumatised may suffer through their lives; they may have a wide range of symptoms, most of the time with combinations of co-morbidity. Traumatised people may struggle with relationship, daily living, interpersonal conflict including rigid and maladaptive coping strategies. The traumatising events create a division of personality in terms of dissociative parts of the personality with a lack of coherence and collaboration within traumatised individuals' personalities as a whole. Personality is defined as the dynamic organisation within the individual of those bio-psycho-social action systems (behaviours) that determine our characteristic mental and behavioural actions. The basic splitting is between the two major action systems, resulting in what is called the Emotional Part of the Personality (EP), which holds (using AIP language) the dysfunctionally stored information and the Apparently Normal Part of the Personality (ANP), focused on carrying on daily life (Van der Hart et al., 2006).

Complex trauma requires complex and sequenced treatment, which involves multiple components that target the different symptoms that arise on the road to recovery. The good news is that treatment is available, and research is helping to inform the development and implementation of treatments. Successful treatment of traumatic memories involves relinquishing related dissociations (EPs and ANP). This conciliation is called "realisation" of the event and its consequences. Realisation is the formulation of a belief about what happened (the trauma), when it happened (in the past), and to whom it happened (to self). Realisation evolves over time as more of the events and their meanings are digested and resonate throughout the mind and as the various dissociated layers are uncovered and integrated. The trauma thus becomes gradually assimilated or integrated into an individual’s personality.

We offer a Phase Oriented treatment approach for treating complex trauma. A phase oriented approach consists of:

  • Stabilisation, symptom-reduction, and skills training

  • Treatment of traumatic memories

  • (re)integration of the personality

​(The Treatment of Traumatic Memories: Synthesis, Realization, & Integration. Onno van der Hart, Ph.D., Kathy Steele, R.N., M.N., C.S. Suzette Boon, Ph.D. & Paul Brown, M.D.)