Developmental Couple Therapy for Complex Trauma Survivors: A detailed case study of a manualized, time-limited, psychoanalytically informed treatment

ABSTRACT

Many couples in distress encounter significant barriers to accessing psychoanalytic treatments, which leaves psychoanalysis far out of the reach of many of those who would benefit from its rich and deep clinical processes. This paper will briefly outline Developmental Couple Therapy for Complex Trauma (DCTCT). DCTCT is a manualized, evidence-based, time-limited therapy built upon the psychoanalytic foundations of attachment, emotion regulation, mentalizing, and repetition-enactment. This four-stage model integrates psychoeducation about psychoanalytic concepts such as attachment, emotion regulation, and mentalizing, to help couples learn about these developmental self-capacities prior to a second stage of explicit skills building, a third stage of deeper analytic working through of traumatic memories, challenges with sexuality, and developing attachment security prior to a fourth stage of consolidation. The case of Cheryl and Cat will illustrate the process of DCTCT and show some of the advantages specific to couple therapy.

KEYWORDS:

• Access to treatment
• couple therapy
• DCTCT
• Developmental Couple Therapy for Complex Trauma
• psychoanalysis
• PTSD and couple
• self psychology
• trauma

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

¹ H. B. MacIntosh (2019). Developmental Couple Therapy for Complex Trauma: A Manual for Therapists. Routledge, New York.

² The handouts that facilitate these discussions can be found at https://www.routledge.com/Developmental-Couple-Therapy-for-Complex-Trauma-A-Manual-for-Therapists/MacIntosh.

Additional information

Notes on contributors

Heather B. MacIntosh

Heather B. MacIntosh is a clinical psychologist, associate professor and Director of the MScA in Couple and Family Therapy Programme at McGill University, where she is the recipient of the H. Noel Fieldhouse Award for Distinguished Teaching. She is a graduate of the Institute for the Advancement of Self Psychology in Toronto, Ontario and was an Early Career Scholar of the American Psychological Association Division 39. She is currently guest faculty and Adjunct Clinical Consultant of the Certificate program in Integrative Psychoanalytic Couple Therapy co-sponsored by the Chicago Psychoanalytic Institute and the Institute for Clinical Social Work and a Senior Research Fellow of the American Psychoanalytic Association Research Fellowship. Dr. MacIntosh is the author of the recently published book, Developmental Couple Therapy for Complex Trauma: A Manual for Therapists, which brings psychoanalytic developmental concepts into an evidence-based model for working with couples dealing with the multiple impacts of complex trauma with an intersectional and anti-oppressive lens. Dr. Macintosh leads an active research programme funded by federal and provincial research funds where she examines the impact of early life trauma on the process and outcome of couple therapy and the development and maintenance of healthy adult relationships. She is the author of numerous peer reviewed journal articles and book chapters in the field. She is currently principal investigator for a Government of Quebec funded programme providing Developmental Couple Therapy for Complex Trauma in a virtual group couple format for trauma survivors in the context of the Covid–19 pandemic.