Complex psychological trauma affects all structures of the personality—one’s image of the self, images of the others, and one’s values and ideals, and leads to the sense that the personality coherence and continuity is assaulted and systematically broken down. Complex trauma, such as war-related trauma, severe brutal rape, kidnaping, terrorism, etc., overwhelms the ordinary human adaptations to life and involves the threats to life and bodily integrity, and confronts human being with the extremities of helplessness and terror, and evokes response of catastrophe. As the complex trauma is a specific traumatic experience, it requires specifically designed trauma-focused therapeutic approach which should deal with: a) the nature of the predisposing factors in complex trauma, b) the manner in which trauma experience and conditioning produce distortions in trauma victim’s personality, c) the relationship between the personality structure and trauma, d) the constituents of inner conflicts, e) meaning function and manifestations of trauma syndrome, f) the structure of the psychic apparatus, and g) the mechanisms of defences. The Dynamic Therapy model has been developed as a three-phase treatment while providing therapy for over decade to the complex PTSD patients whose condition has been an aftermath of human-designed disasters (wars, brutal rapes, assaults and serious violence). The Dynamic Therapy model emphasises that there is a complex process in interactions between different phenomenological components of the complex trauma and that there is a variety of the ways in which etiological factors can contribute to the onset of the trauma syndrome. With the patient’s complicated clinical presentations, the therapy accentuates the main principles and targets in treating complex trauma syndrome: 1) trauma symptoms reduction and stabilisation, 2) processing of traumatic memories, dissociation, and emotions, and 3) life integration after trauma processing. The model is a goal-directed phased treatment towards the restoration of a disrupted sense of self that affects the inner and the outer world of a traumatised individual.
Allen, J. G. (2005). Coping with Trauma. Washington DC: American Psychiatric Press.
APA, American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd Edition). Washington DC: APA.
APA, American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Arlington: APA.
Banyard, V. L., & Williams, L. M. (1998). Trauma and Memory. London: Sage.
Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety Disorders and Phobias: A Cognitive Perspective. New York: Basic Books.
Bisson, J. I., Ehlers, A., Matthews, R., Pilling, S. et al. (2007). Psychological Treatments for Chronic Post-Traumatic Stress Disorder. British Journal of Psychiatry, 190, 97-104. https://doi.org/10.1192/bjp.bp.106.021402
Boss, P. (2006). Loss, Trauma, and Resilience. New York: WW Norton.
Briere, J., & Spinazola, J. (2009). Assessing the Sequelae of Complex Trauma. In A. C. Courtois, & J. D. Ford (Eds.), Treating Complex Traumatic Stress Disorders. New York: The Guilford Press.
Burgess, A. W. et al. (1985). Rape and Sexual Assault. New York: Garland.
Clark, D. A. (2004). Cognitive Behavioural Therapy for OCD. New York: The Guilford Press.
Cloitre, M., Courtois, C. A., Ford, J. D., Green, B. L. et al. (2012). The ISTSS Expert Consensus Treatment Guidelines for Complex PTSD in Adults. Washington DC: APA.
Courtois, A. C., & Ford, J. D. (2009). Treating Complex Traumatic Stress Disorders. New York: The Guilford Press.
Duckworth, M. P., & Follete, V. M. (Eds.) (2012). Retraumatisation: Assessment, Treatment, and Prevention. New York: Routledge.
Ehlers, A., & Clark, D. M. (2000). A Cognitive Model of Posttraumatic Stress Disorder. Behaviour Research and Therapy, 38, 319-345. https://doi.org/10.1016/S0005-7967(99)00123-0
Erikson, E. H. (1968). Identity, Youth & Crisis. New York: WW Norton.
Foa, E. B., & Rothbaum, O. B. (1998). Treating the Trauma of Rape. New York: The Guilford Press.
Foa, E. B., Keane, T. M., & Friedman, M. J. (2009). Effective Treatments for PTSD. New York: The Guilford Press.
Ford, J. D. (2009). Dissociation in Complex Posttraumatic Stress Disorder or Disorders of Extreme Stress Not Otherwise Specified (DESNOS). In P. F. Dell, & A. J. O’Neil (Eds.), Dissociation and the Dissociative Disorders. New York: Routledge.
Traumatic Memories
Ford, J. D., Courtois, A. C., Steele, K., van der Hurt, O., & Nijenhuis, E. R. S. (2005). Treatment of Complex Dysregulation. Journal of Traumatic Stress, 5, 437-447. https://doi.org/10.1002/jts.20051
Herman, J. L. (1992). Trauma and Recovery. New York: Basic Books.
Horowitz, J. P., & Zilberg, N. (1983). Regressive Alterations in the Self-Concept. American Journal of Psychiatry, 140, 284-289. https://doi.org/10.1176/ajp.140.3.284
Horowitz, M. J. (1978). Stress Response Syndrome. Northvale: Jason Aronson.
Hyer, L., McCranie, F. M., Boundewyns, P. A., & Sperr, E. (1996). Models of Long-Term Coping Trauma Memories: Relative Use and Associations with Personality among Vietnam Veterans Chronic PTSD. Journal of Traumatic Stress, 9, 299-316. https://doi.org/10.1002/jts.2490090211
Lazarus, A. A. (1972). Behaviour Therapy and Beyond. New York: McGraw-Hill.
Meares, R. (1987). The Secret and the Self: One New Direction in Psychotherapy. Australian and New Zealand Journal of Psychiatry, 21, 545-559. https://doi.org/10.3109/00048678709158923
Ogden, P., Minoth, K., & Pain, C. (2006). Trauma and the Body. New York: WW Norton.
Putnam, F. W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: The Guilford Press.
Resick, P. A., & Schnicke, M. K. (1992). Cognitive Processing Therapy for Sexual Assault Victims. Journal of Consulting and Clinical Psychology, 60, 748-756. https://doi.org/10.1037/0022-006X.60.5.748
Rosen, G. M. (2004). Posttraumatic Stress Disorder, Issues and Controversies. Chichester: Wiley & Sons. https://doi.org/10.1002/9780470713570
Silova, D. (2002). The Asylum Debacle in Australia: A Challenge for Psychiatry. Australian and New Zealand Journal of Psychiatry, 2, 90-96. https://doi.org/10.1046/j.1440-1614.2002.01036.x
Steele, K., van der Hart, O., & Nijenhuis, E. R. S. (2005). Phase Oriented Treatment of Structural Dissociation in Complex Traumatisation: Overcoming Trauma-Related Phobias. Journal of Trauma and Dissociation, 6, 11-53. https://doi.org/10.1300/J229v06n03_02
Stern, D. N. (2004). The Present Moment. New York: WW Norton.
Summerfield, D. (2001). Asylum-Seekers, Refugees and Mental Health Services in the UK. Psychiatric Bulletin, 1, 61-63. https://doi.org/10.1192/pb.25.5.161
Ulman, R. B., & Brothers, D. (1988). The Shattered Self: A Psychoanalytic Study of Trauma. Hillsdale: The Analytic Press.
Van der Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006). The Haunted Self. New York: WW Norton.
Van der Hart, O., Steel, K., Boon, S., & Brown, P. (1993). The Treatment of Traumatic Memories: Synthesis, Realisation, and Integration. Dissociation, 1, 62-80.
Van der Kolk, B. A., & Courtois, C. A. (2005). Editorial Comments: Complex Developmental Trauma. Journal of Traumatic Stress, 3, 83-85.
Van der Kolk, B. A., MacFairlane, A., & Weiseath, L. (1986). Traumatic Stress. New York: The Guilford Press.
Wilson, J. P. (Ed.) (2006). The Posttraumatic Self. New York: Routledge.
Wilson, J. P., & Drozdek, B. (Eds.) (2004). Broken Spirit. New York: Brunner-Routledge.
Wolpe, J. (1969). The Practice of Behaviour Therapy. New York: Penguin Books.
Zepinic, V. (1997). Psychosocial Characteristics of War-Related Posttraumatic Stress Disorder (Chapter 10). In B. Ferguson, & D. Barnes (Eds.), Perspectives on Transcultural Mental Health (pp. 85-93). Sydney: TCMHC.
Zepinic, V. (2001). Suicidal Risk with War-Related Posttraumatic Stress Disorder (Chapter 14). In B. Raphael, & A. E. Malak (Eds.), Diversity and Mental Health in Challenging Times (pp. 212-221). Sydney: TCMHC.
Zepinic, V. (2004). Treatment Resistant Symptoms of War-Related PTSD. Paper Presented at 18th World Congress of World Association for Social Psychiatry, Kobe.
Zepinic, V. (2008). Healing Traumatic Memories: A Case Study. Dynamische Psychiatrie, 2, 79-87.
Zepinic, V. (2010). Treating the War-Related Complex Trauma Using Dynamic Therapy. The International Journal of Medicine, 3, 84-90.
Zepinic, V. (2011). Hidden Scars: Understanding and Treating Complex Trauma. London: Xlibris.
Zepinic, V. (2012). The Self and Complex Trauma. London: Xlibris.
Zepinic, V. (2015). Treatment Resistant Symptoms of Complex PTSD Caused by Torture during War. Canadian Social Science, 9, 26-32.
Zepinic, V. (2016a). Disintegration of the Self-Structure Caused by Severe Trauma. Psychology and Behavioural Sciences, 4, 83-92. https://doi.org/10.11648/j.pbs.20160504.12
Zepinic, V. (2016b). The Dynamic Therapy Model in Treating Complex Trauma Syndrome. Studies in Sociology of Sciences, 4, 1-18.
Zepinic, V., & Kuzmanovski, B. (2015). Support Person (Co-Therapist) in the Therapy of Panic Disorder. Canadian Social Science, 12, 1-7.
Zlotnick, C., Warshaw, M., Shea, M. et al. (1999). Chronicity in Posttraumatic Stress Disorder (PTSD) and Predictors of Course of Comorbid PTSD in Patients with Anxiety Disorders. Journal of Traumatic Stress, 12, 89-100. https://doi.org/10.1023/A:1024746316245