The term Complex trauma captures the sequelae of early attachment trauma accompanied by cumulative other trauma i.e. emotional, physical and/or sexual abuse and neglect. The central disturbance in complex trauma is dissociation which causes disconnectedness among the elements of neural function i.e. parts of the brain, such as the hippocampus, prefrontal regions, anterior cingulate, corpus callosum and cerebellum, necessary for the brain’s capacity to create stable, flexible and adaptive states of mind. Dissociation must be understood to exist on a continuum, and understood to occur in a relational context.
Altered self-capacities result, and include the collapse of relatedness which when it cannot be endured, internalised aspects of traumatising others relegated to the unconscious, become discrete self-states, assuming the voice, words and behaviour of the other/s which according to Kernberg (1996) Schwartz (1994) and Stolorow (1990) are variants of narcissistic personality, when aggression, fantasy and use of transitional phenomena along developmental lines have been derailed. Shame is an added dimension that is often dissociated, and what is left is a vulnerability to exposure. This seminar attempts to understand the dynamics of dissociation, dissociative experiences and shame in the understanding of the effects of complex trauma.
The Bare Essentials of the Conversational Model By Tony Korner Selves in Conversation Humans live in a language environment as much as they live in a physical one. Throughout life we are faced with decisions (or ‘motivated selections’) about whether to associate through language or to dissociate through non-communication. Each person’s life gets shaped by these decisions, many of which occur unconsciously under the influence of traumatic experience. Each self has the form of a story, an incomplete one. Dissociation, relating to trauma, is an important reason for this incompleteness.
The model I am presenting is an integrated, trauma-informed, contemporary, relational and dynamic way of working with adolescents and adults. Conducted in 10 to 20 weekly sessions, it is phase oriented, structured, flexible, focussed, active and time-limited. Its purpose is to change the patient's way of behaving, thinking and feeling, by beginning to work on a specific focus which is collaboratively decided upon by patient and therapist. It derives theoretically from the Conversational Model, Attachment Theory, Interpersonal Theory and a long history of short term dynamic therapies.