Posttraumatic Stress Disorder after Traumatic Brain Injury and Interpersonal Relationships: Contributions from Object-Relations Perspectives

Abstract

Posttraumatic stress disorder (PTSD) has been identified in survivors of traumatic brain injury (TBI), sustained from road traffic accidents, assaults, or industrial accidents. This article reviews the small literature on this population, which is predominantly characterized by integrations of cognitive neuropsychology and cognitive behavior therapy. While these perspectives have been applied to identify etiological processes and treatment options, one insufficiently specified domain in this literature is the role of interpersonal relationships. This includes interpersonal etiological mechanisms and social outcomes, but also therapeutic process for PTSD after TBI. In response, object-relations psychoanalytic concepts of symbolizing (Segal, 1957) and containing–contained (Bion, 1962) mechanisms are applied. These concepts are used to consider the aforementioned factors while permitting close conceptual links to neurological and cognitive vulnerabilities for this clinical group. This article finishes with a therapeutic application of these concepts, from the perspective of a neurorehabilitation team.

Keywords:

• PTSD
• TBI
• object relations
• interpersonal
• containing–sustained