The assessment and psychotherapy of a dissociative adult man with complex PTSD

This paper presents the assessment and four year psychotherapy of a Hispanic man with Complex PTSD and Dissociative Disorder NOS. The patient’s history of childhood sexual abuse caused significant disruptions in normative developmental processes causing what van der Kolk (2005) posits as a Developmental Trauma Disorder. Based on Shapiro’s (2001) adaptive information processing paradigm, the patient’s memories of extensive childhood sexual victimization became blocked from resolution from adaptive memory networks, becoming embedded in the emotional brain and activated by the 9/11 tragedy. This stimulated an array of PTSD and Dissociative symptomatology. In treatment he verbalized and chronicled his experiences of 9/11 and memories of severe childhood sexual abuse, establishing a narrative of victimization, helplessness, and confusion about his sexual orientation (Gardner, 1999). Furthermore, there were episodes of dissociation revealing the possibility of alters. Attempts to access adaptive networks using EMDR protocols were thwarted by intractable defenses. The patient’s desire to return to work was offset by his entitlement to Social Security Disability that was initially denied. Working through my concordant countertransference (Racker, 1968), I ultimately accepted his wish for SSD, which he obtained on appeal based upon my symptom-specific evaluation. The patient transferred to a clinic that accepted SSD.

Participants will be able to : ♦♦ identify the developmental derailing effects of childhood sexual abuse on normative developmental processes. ♦♦ assess how childhood trauma(s) that are repressed or dissociated are invoked by trauma(s) in adulthood through associative memory networks causing Complex PTSD. ♦♦ apply methods of working with patients dissociative defenses in psychotherapy.

Conference

English

Robert Greenfield

Greenfield, R. (2010, October). The assessment and psychotherapy of a dissociative adult man with complex PTSD. Presentation at the International Society for the Study of Trauma and Dissociation 27th Annual International Conference, Atlanta, GA