Complex trauma and (therapeutic) relationships : A single-case study.

Aim: Complex trauma is associated with the development of deeply engrained interpersonal patterns, which cause difficulties in adult relationships (Herman, 1992). Therapy should therefore create a place in which these dysfunctional interpersonal patterns can be revised and reworked (van der Kolk et al., 2005). However, research concerning the nature of these relationship patterns and their influence on the therapy process is scarce. Method: Interpersonal patterns are analysed in a single case by means of the Core Conflictual Relationship (CCRT) Method (Luborsky & Crits-Christoph, 1998), which characterizes people’s habitual ways of interacting with others by defining dominant wishes, responses of others (RO) and responses of self (RS) in concrete relationship episodes. Principles of Consensual Qualitative Research for Case Studies (Jackson, Chui, & Hill, 2011) are used to systematically examine the influence of dominant relationship patterns on the therapeutic relationship and the therapeutic process. Results: Results indicate that 1) the patient’s wishes to regain recognition, to be respected, and to be understood are frustrated by significant others, which leaves her helpless and unable to open up; 2) related issues appear in the therapeutic context, especially concerning reciprocity in the therapeutic relationship and the perceived obligation to talk about the traumatic past; 3) supportive interventions enable to patient to open up about interpersonal difficulties and traumatic experiences. Discussion: This case illustrates the importance of understanding and addressing the CCRT in the broader narrative of the subject and the dynamic nature of a therapy process