The (Personal) Complexity of Trauma

Map of the public transport system in the northeast metropolitan area of Rome, by Civiter. Licensed under CC BY 4.0.

In my view, we have (and should) abandon the idea that we can treat psychological distress guided by experimental determination of the deficit involved in particular disorders. Psychological problems are too complex to think that there is an identifiable psychological deficit that can be addressed by a particular therapeutic ingredient. We should think that we are working with people rather than with deficits.

Reading between the lines, I think those who have developed treatments for Post-traumatic Stress Disorder believe this, but it is not a perspective that can be used to promote a particular approach.

Wampold, B. E. (2019). A smorgasbord of PTSD treatments: What does this say about integration? Journal of Psychotherapy Integration, 29(1), 65–71.

The Dialectic of Trauma

Trauma impels people both to withdraw from close relationships and to seek them desperately.

The profound disruption in basic trust, the common feelings of shame, guilt, and inferiority, and the need to avoid reminders of the trauma that might be found in social life, all foster withdrawal from close relationships. But the terror of the traumatic event intensifies the need for protective attachments.

The traumatized person therefore frequently alternates between isolation and anxious clinging to others. The dialectic of trauma operates not only in the survivor’s inner life but also in [their] close relationships. It results in the formation of intense, unstable relationships that fluctuate between extremes.

from Trauma and Recovery, by Judith Herman