Core conflictual relationship patterns in complex trauma: A single-case study

Abstract

Dysfunctional interpersonal patterns constitute one of the core features of complex trauma. Supportive-expressive psychodynamic theory operationalises these interpersonal patterns via the core conflictual relationship theme (CCRT), by defining the main wish, response of other and response of self in patients’ habitual ways of interacting with others. Unfortunately, research regarding the specific contents of these CCRT components in complex trauma is scarce and adopts a static approach in studying interpersonal patterns. By means of a longitudinal single-case study of a supportive-expressive psychodynamic therapy with a man with a complex traumatic background, this study provides an in-depth description of the nature and change in the CCRT. In this particular case, the wish to be respected by others and to be close to others was at the forefront throughout the entire therapy. At the beginning of therapy, others were perceived as distant and rejecting, rendering the patient feeling disappointed and dependent. As the therapy progressed, the patient perceived his interactions as more satisfying, being able to self-confidently express himself and to see others as more accepting and understanding towards him, satisfying his main wishes. This case illustrates the importance of understanding and addressing the CCRT in the broader narrative of the patient and the dynamic nature of change throughout a therapy process.

Keywords:

• single-case study
• psychodynamic therapy
• core conflictual relationship theme
• interpersonal dynamics
• complex trauma
• interpersonal trauma

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. In order to guarantee the anonymity of the participant and his associates, we made use of pseudonyms. Moreover, all information that would lead to the identification of the patient has been removed or anonymised.

Additional information

Notes on contributors

K. Van Nieuwenhove

Kimberly Van Nieuwenhove is a PhD-candidate in clinical psychology at the Department of Psychoanalysis and Clinical Consulting at Ghent University. She holds a master’s degree in clinical psychology and is in her third year of a four-year course of specialization in psychoanalytic therapy. Besides her academic work, she works as a psychotherapist in a private practice.

R. Meganck

Reitske Meganck is an associate professor and researcher at the department of Psychoanalysis and Clinical Consulting at Ghent University. She has a PhD in clinical psychology and was formally trained in Freudian-Lacanian psychoanalysis. Besides her academic work, she works as a psychotherapist in a private practice.

S. Cornelis

Shana Cornelis is co-ordinator psychosocial support at the Belgian Fondation against Cancer and a freelance researcher at the department of Psychoanalysis and Clinical Consulting at Ghent University. She has a PhD in clinical psychology and was formally trained in psychoanalytic therapy.

M. Desmet

Mattias Desmet is an associate professor and researcher at the department of Psychoanalysis and Clinical Consulting at Ghent University. He has a PhD in clinical psychology and was trained as a Lacanian psychoanalyst. Besides his academic job, he works as a psychotherapist in a private practice.