Traumatic events, posttraumatic states, and the debate on aetiology

ABSTRACT

The concept of psychological trauma implies a causal relation between the traumatic event and subsequent psychopathology. Difficulties in defining the characteristics of causal agent and establishing its firm correlation with signs and symptoms of disorder stem from the paradoxes embedded in the concept of posttraumatic stress disorder (PTSD), which ignores unconscious dynamics of posttraumatic states. In this article, we argue that the impact of extreme traumatization on personality can be made observable through analysis of unconscious mechanisms, processes and structures, such as capacity for symbolization/mentalization, representation and meaning making as well as thinking and intersubjective transformation. The article focuses on the theoretical background for creating a multifactorial, complex and biopsychosocial model of psychopathology of posttraumatic states and does not focus on treatment and psychosocial interventions directly.

KEYWORDS:

• Psychological trauma
• PTSD
• psychoanalysis
• symbolization

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplemental material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/01062301.2024.2384757

Additional information

Notes on contributors

Vladimir Jović

Vladimir Jović, MD, DMSci (Doctor of Medical Science) is a psychiatrist, psychoanalyst and a training analyst of the Belgrade Psychoanalytic Society (BPS), former President of the BPS (2014-2018). He works in psychiatric and psychoanalytical private practice in Belgrade. He is one of founders and currently a consultant in the Center for Rehabilitation of Torture Victims, IAN, Belgrade, which is providing comprehensive rehabilitation for victims and implements activities on prevention of torture in Serbia and in the region. Since September 2020 he is a Member of the Board of Trustees of the UN Voluntary Fund for Victims of Torture. His primary research area is psychological trauma, psychosocial mechanisms of violence and torture.

Sverre Varvin

Sverre Varvin, MD. DPhil, is a training and supervising analyst of the Norwegian Psychoanalytic Society. He is professor emeritus at the Oslo Metropolitan University. He has done clinical research on traumatization and the treatment of traumatized patients, especially in the refugee field. He has done process and outcome research on psychoanalytic therapy, research on traumatic dreams, and on psychoanalytic training. He has twice been president of the Norwegian psychoanalytic Society and he has held several positions in International Psychoanalytical Association (IPA), such as vice-president, board member and chair of the IPA working group on terror and terrorism. He was recently chair of IPA China Committee. He received the Sigourney award in 2004. He has published articles and books on traumatization, refugees, terrorism, and research on treatment process and outcome.