Psychosis and dissociation are both often defined as experiences characterised by a loss of touch with reality, expressed in false beliefs (delusions), false sensations (hallucinations) and a false self-concept (depersonalisation). This case discussion will explore the ways in which multiple traumatic events, compounded losses and ongoing insecurity may interact to produce complex presentations with blurred features of psychosis, dissociation and post-traumatic stress symptoms. Following the destruction of a person’s reality, these symptoms often interfere with foundational psychological processes required to rebuild a life worth living in an alien resettlement environment.
The case demonstrates the importance of formulating post-traumatic psychosis and dissociation as disruptive but normal human reactions to ongoing complex trauma. The treatment approach outlined involves establishing confidence in coping resources before facilitating the integration of personal narratives and meaning through trauma reprocessing. The crucial role of addressing psychosocial and resettlement stressors that both re-traumatise and prolong insecurity will also be highlighted.