Pub Date : 2019-06-17DOI: 10.33212/ATT.V13N1.2019.130
Caroline Adewole
{"title":"Sibling Abuse Trauma: Assessment and Intervention Strategies for Children, Families, and Adults by John V. Caffaro","authors":"Caroline Adewole","doi":"10.33212/ATT.V13N1.2019.130","DOIUrl":"https://doi.org/10.33212/ATT.V13N1.2019.130","url":null,"abstract":"","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125959757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-17DOI: 10.33212/ATT.V13N1.2019.81
Katherine Roe
What you are about to read has been an unknowable, unspeakable thread of my own life history. To demonstrate the uncovering of a dissociated experience of early childhood incest, I track the developing relationship between analyst and patient as they explore together the nightmares the patient brings to the treatment.
{"title":"From nightmare to memory: a psychoanalytic model of early childhood incest trauma","authors":"Katherine Roe","doi":"10.33212/ATT.V13N1.2019.81","DOIUrl":"https://doi.org/10.33212/ATT.V13N1.2019.81","url":null,"abstract":"What you are about to read has been an unknowable, unspeakable thread of my own life history. To demonstrate the uncovering of a dissociated experience of early childhood incest, I track the developing relationship between analyst and patient as they explore together the nightmares the patient brings to the treatment.","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133736432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-17DOI: 10.33212/ATT.V13N1.2019.31
Sara Lynn Rependa, R. T. Muller
This article discusses the case of a male vowed religious clergy, who was also in residential treatment for sexual misconduct and interpersonal difficulties. Importantly, this client also had a childhood history of sexual trauma. The case, difficult and complex in its own right, posed unique clinical challenges. The first author and therapist, a Catholic, feminist, woman often works with child trauma clients. Thus, the experiences of transference and countertransference were particularly important therapeutic considerations working with this client. Themes of power, sex, shame, guilt, and blame needed to be explored and processed in depth from the client’s and therapist’s perspectives both during session and supervision. Concurrent issues include personality disorders, physical disability, and psychosexual disorders. This client was referred by their religious institution and took part in a mandated fourteen to twenty-week residential programme. Therapeutic modalities include trauma-informed, attachment-oriented, and psychodynamic individual and grouporiented psychotherapy.
{"title":"Dancing with demons: working with vowed religious clergy who are also sex offenders","authors":"Sara Lynn Rependa, R. T. Muller","doi":"10.33212/ATT.V13N1.2019.31","DOIUrl":"https://doi.org/10.33212/ATT.V13N1.2019.31","url":null,"abstract":"This article discusses the case of a male vowed religious clergy, who was also in residential treatment for sexual misconduct and interpersonal difficulties. Importantly, this client also had a childhood history of sexual trauma. The case, difficult and complex in its own right, posed unique clinical challenges. The first author and therapist, a Catholic, feminist, woman often works with child trauma clients. Thus, the experiences of transference and countertransference were particularly important therapeutic considerations working with this client. Themes of power, sex, shame, guilt, and blame needed to be explored and processed in depth from the client’s and therapist’s perspectives both during session and supervision. Concurrent issues include personality disorders, physical disability, and psychosexual disorders. This client was referred by their religious institution and took part in a mandated fourteen to twenty-week residential programme. Therapeutic modalities include trauma-informed, attachment-oriented, and psychodynamic individual and grouporiented psychotherapy.","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125009193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-17DOI: 10.33212/ATT.V13N1.2019.15
M. Salter
This article draws on psychoanalytic theories of malignant trauma to explain the invisibility of ritual abuse. Ritual abuse refers to the misuse of rituals in the organised sexual abuse of children. Despite expanded recognition of the varieties of child maltreatment, ritual abuse remains largely invisible outside the trauma and dissociation field as a specific form of sexual exploitation. Presenting qualitative data from interview research with ritual abuse survivors and mental health specialists, this article argues that the trauma of ritual abuse and its invisibility are co-constitutive. The perpetration and denial of ritual abuse occur within a relational matrix of perpetrators, victims, and bystanders structured by the presymbolic dread of vulnerability and dependency. The simultaneity of perpetration and disavowal creates the conditions for the malignancy of ritual abuse, including the invisibility of victims and the intergenerational transmission of extreme abuse. The article examines how the provision of care to ritual abuse survivors can become contingent on its erasure, and reflects on the role of therapists and others in interrupting the metastases of malignant trauma and crafting cultural and moral frameworks to transform the dread at the core of ritual abuse.
{"title":"Malignant trauma and the invisibility of ritual abuse","authors":"M. Salter","doi":"10.33212/ATT.V13N1.2019.15","DOIUrl":"https://doi.org/10.33212/ATT.V13N1.2019.15","url":null,"abstract":"This article draws on psychoanalytic theories of malignant trauma to explain the invisibility of ritual abuse. Ritual abuse refers to the misuse of rituals in the organised sexual abuse of children. Despite expanded recognition of the varieties of child maltreatment, ritual abuse remains largely invisible outside the trauma and dissociation field as a specific form of sexual exploitation. Presenting qualitative data from interview research with ritual abuse survivors and mental health specialists, this article argues that the trauma of ritual abuse and its invisibility are co-constitutive. The perpetration and denial of ritual abuse occur within a relational matrix of perpetrators, victims, and bystanders structured by the presymbolic dread of vulnerability and dependency. The simultaneity of perpetration and disavowal creates the conditions for the malignancy of ritual abuse, including the invisibility of victims and the intergenerational transmission of extreme abuse. The article examines how the provision of care to ritual abuse survivors can become contingent on its erasure, and reflects on the role of therapists and others in interrupting the metastases of malignant trauma and crafting cultural and moral frameworks to transform the dread at the core of ritual abuse.","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114896178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-17DOI: 10.33212/ATT.V13N1.2019.43
O. Epstein
Sexual assault and other forms of abuse on a young child and its psychological aftermath cascades down through the decades of a person’s life. Apart from shattering the mind and sense of selfhood, it later manifests in what we would consider as the client’s repetitive, reckless, and self-harming behaviour. When working with clients with complex trauma, we soon learn that paradoxically these harmful ways carry meaning and make sense within the context of the child having spent the majority of their time with an abusive, frightening, and unpredictable attachment figure I named “scaregiver” (Badouk Epstein, 2015). Fran, a survivor of familial organised abuse, was diagnosed with Dissociative Identity Disorder (DID). She had many parts, some suicidal, some had an eating disorder, some parts were disabled and others very capable. This paper focuses on Fran’s sexual part and consequently her sex addiction. While still in recovery, the secure base and the relational journey which we embarked upon demonstrate how a non-pathologising and non-objectifying approach to the client’s many attachment cries eventually paved the way towards the growth of a sense of safety, intersubjectivity, and the abandonment of her sex addiction.
{"title":"\"The most tender place in my heart is for strangers”: sexual addiction, the fear system, and dissociation through an attachment lens","authors":"O. Epstein","doi":"10.33212/ATT.V13N1.2019.43","DOIUrl":"https://doi.org/10.33212/ATT.V13N1.2019.43","url":null,"abstract":"Sexual assault and other forms of abuse on a young child and its psychological aftermath cascades down through the decades of a person’s life. Apart from shattering the mind and sense of selfhood, it later manifests in what we would consider as the client’s repetitive, reckless, and self-harming behaviour. When working with clients with complex trauma, we soon learn that paradoxically these harmful ways carry meaning and make sense within the context of the child having spent the majority of their time with an abusive, frightening, and unpredictable attachment figure I named “scaregiver” (Badouk Epstein, 2015). Fran, a survivor of familial organised abuse, was diagnosed with Dissociative Identity Disorder (DID). She had many parts, some suicidal, some had an eating disorder, some parts were disabled and others very capable. This paper focuses on Fran’s sexual part and consequently her sex addiction. While still in recovery, the secure base and the relational journey which we embarked upon demonstrate how a non-pathologising and non-objectifying approach to the client’s many attachment cries eventually paved the way towards the growth of a sense of safety, intersubjectivity, and the abandonment of her sex addiction.","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130655507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.33212/att.v12n2.2018.181
Michael Chamberlain
The meaning of the secure base is explored in both clinical and theoretical terms. Bowlby's explanation of infant development is contrasted with Winnicott's conceptualisation of the merged newborn infant and mother. Winnicott gives an account of the infant's sense of fragmentation prior to developing a sense of cohesion and the mother's vital role in this development. The author suggests that in Bowlby's description of infant development there is an absence of this stage of development. The author argues for greater understanding and clarification of the term secure base and draws parallels between the creation of the secure base between m/other and infant, and that created between psychotherapist and analysand. It is further proposed that if one adheres to Winnicott's theory that as greater cohesion is experienced by the patient there can also be greater recognition and felt experience of fragmentation, it therefore follows that the creation of a secure base also means increased risk.
{"title":"The need for something more than a secure base: is a secure base always enough?","authors":"Michael Chamberlain","doi":"10.33212/att.v12n2.2018.181","DOIUrl":"https://doi.org/10.33212/att.v12n2.2018.181","url":null,"abstract":"The meaning of the secure base is explored in both clinical and theoretical terms. Bowlby's explanation of infant development is contrasted with Winnicott's conceptualisation of the merged newborn infant and mother. Winnicott gives an account of the infant's sense of fragmentation prior to developing a sense of cohesion and the mother's vital role in this development. The author suggests that in Bowlby's description of infant development there is an absence of this stage of development. The author argues for greater understanding and clarification of the term secure base and draws parallels between the creation of the secure base between m/other and infant, and that created between psychotherapist and analysand. It is further proposed that if one adheres to Winnicott's theory that as greater cohesion is experienced by the patient there can also be greater recognition and felt experience of fragmentation, it therefore follows that the creation of a secure base also means increased risk.","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121766936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.33212/att.v12n2.2018.164
I. Owen
This article provides an overview of some fundamental aspects of practice within an attachment-oriented view of therapy. The article presents a scholarly approach to understanding the mainstream contribution of the Bowlby–Ainsworth model of attachment as exemplified in the empirical literature (Ainsworth et al., 1978; Owen, 2017). The article starts with a brief conclusion on what John Bowlby argued should be the core aspects of therapy. It connects these ideas to the work of Robert Langs, arguably the one person most responsible for the idea of boundaries and guidelines in contemporary practice since the 1990s. For attachment-oriented practice, the psychodynamics of supplying and receiving care is a central dynamic in therapy. In the case of individual work, there are the countertransference and counter-resistance problems that therapists bring. On the client side of the relationship, there are the problems of what Freud called resistance, a shamefaced inhibition of speech and self-disclosure, plus transference, understood in a broad sense of making assumptions, plus misunderstanding and mis-empathising the intentions of therapists because of clients' personal histories. Bowlby identified the inner working model as explicit or implicit procedural and affective memories that are the link between the onset of an attachment process and its contemporary effects. Attachment is a developmental hypothesis about learned motivation and meaningfulness between the alleged distal causes of proximal events (Bowlby, 1973, p. 44). These topics are discussed in a wider understanding of what it means to provide good enough care.
这篇文章提供了一些基本方面的概述，在一个以依恋为导向的治疗观点的实践。本文提出了一种学术方法来理解Bowlby-Ainsworth依恋模型在实证文献中的主流贡献(Ainsworth et al.， 1978;欧文,2017)。这篇文章首先简要总结了John Bowlby认为应该是治疗的核心方面。它将这些想法与罗伯特·朗斯(Robert Langs)的作品联系起来，朗斯可以说是自20世纪90年代以来对当代实践中的边界和指导思想负有最大责任的人。对于依恋导向的实践，提供和接受护理的心理动力学是治疗的核心动态。在个体工作的情况下，有治疗师带来的反移情和反抵抗问题。在这段关系的客户端，存在着弗洛伊德所说的抵抗问题，一种羞于表达和自我表露的抑制，加上移情，在广义上被理解为做出假设，加上由于客户的个人历史而误解和错误地理解治疗师的意图。Bowlby将内部工作模型定义为外显或内隐程序记忆和情感记忆，它们是依恋过程的开始与其当代影响之间的联系。依恋是一种关于习得动机和所谓远端原因与近端事件之间意义的发展性假设(Bowlby, 1973, p. 44)。这些话题是在对提供足够好的护理意味着什么的更广泛的理解中讨论的。
{"title":"A return to Bowlby: assessment, boundaries, and inner working models","authors":"I. Owen","doi":"10.33212/att.v12n2.2018.164","DOIUrl":"https://doi.org/10.33212/att.v12n2.2018.164","url":null,"abstract":"This article provides an overview of some fundamental aspects of practice within an attachment-oriented view of therapy. The article presents a scholarly approach to understanding the mainstream contribution of the Bowlby–Ainsworth model of attachment as exemplified in the empirical literature (Ainsworth et al., 1978; Owen, 2017). The article starts with a brief conclusion on what John Bowlby argued should be the core aspects of therapy. It connects these ideas to the work of Robert Langs, arguably the one person most responsible for the idea of boundaries and guidelines in contemporary practice since the 1990s. For attachment-oriented practice, the psychodynamics of supplying and receiving care is a central dynamic in therapy. In the case of individual work, there are the countertransference and counter-resistance problems that therapists bring. On the client side of the relationship, there are the problems of what Freud called resistance, a shamefaced inhibition of speech and self-disclosure, plus transference, understood in a broad sense of making assumptions, plus misunderstanding and mis-empathising the intentions of therapists because of clients' personal histories. Bowlby identified the inner working model as explicit or implicit procedural and affective memories that are the link between the onset of an attachment process and its contemporary effects. Attachment is a developmental hypothesis about learned motivation and meaningfulness between the alleged distal causes of proximal events (Bowlby, 1973, p. 44). These topics are discussed in a wider understanding of what it means to provide good enough care.","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"153 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131786650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.33212/ATT.V12N2.2018.110
F. Benedetto, A. Schimmenti
{"title":"Obituary for Giovanni Liotti (27 March 1945–9 April 2018)","authors":"F. Benedetto, A. Schimmenti","doi":"10.33212/ATT.V12N2.2018.110","DOIUrl":"https://doi.org/10.33212/ATT.V12N2.2018.110","url":null,"abstract":"","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134504069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.33212/att.v12n2.2018.147
Joy Gravestock
This article summarises the author's clinical experiences over recent years of evolving a modality for music therapy with adoptive families. It frames the multi-agency context that adoption happens within as it is helpful for therapists to be aware of context, process and procedure when working within the adoption community. The author's model developed as process and procedure changed and were incorporated into legislation initially during 2015, and as the author witnessed ensuing practice developments during 2016 to 2018. The article explores significant relational and musical moments as they occurred in music therapy with children and young people who had experienced significant trauma prior to being adopted. It forms part of the author's current research which highlights the importance of both client and therapist in the intersubjective relationship, where attunement and attachment are central. It emphasises the long-term nature of such work and why this is deemed essential for relational music therapy with complex attachment issues. The author did not set out with the intent of researching her work formally, but it was apparent that experiences in the therapy room were "speaking" stories that needed sharing. Families were valuing music therapy as a modality for relational change and wanted to share their experiences so that others may benefit. The article is envisaged as providing a guide to the world of contemporary adoption for all psychotherapists unfamiliar with this territory and incorporates current theory alongside case examples from practice to highlight the relevance of music therapy within contemporary adoption. It offers an introduction to how music therapy as a sensorial and affect-laden medium might be a helpful choice of intervention with families who may struggle to describe the impact of traumatic early life experiences on children. All clients have been made into composites and there has been consent to this process.
{"title":"Attachment-based, relational, psychoanalytic music therapy: the significance of musical moments of attunement with adoptees after trauma, and how this may influence broader reparation with attachments","authors":"Joy Gravestock","doi":"10.33212/att.v12n2.2018.147","DOIUrl":"https://doi.org/10.33212/att.v12n2.2018.147","url":null,"abstract":"This article summarises the author's clinical experiences over recent years of evolving a modality for music therapy with adoptive families. It frames the multi-agency context that adoption happens within as it is helpful for therapists to be aware of context, process and procedure when working within the adoption community. The author's model developed as process and procedure changed and were incorporated into legislation initially during 2015, and as the author witnessed ensuing practice developments during 2016 to 2018. The article explores significant relational and musical moments as they occurred in music therapy with children and young people who had experienced significant trauma prior to being adopted. It forms part of the author's current research which highlights the importance of both client and therapist in the intersubjective relationship, where attunement and attachment are central. It emphasises the long-term nature of such work and why this is deemed essential for relational music therapy with complex attachment issues. The author did not set out with the intent of researching her work formally, but it was apparent that experiences in the therapy room were \"speaking\" stories that needed sharing. Families were valuing music therapy as a modality for relational change and wanted to share their experiences so that others may benefit. The article is envisaged as providing a guide to the world of contemporary adoption for all psychotherapists unfamiliar with this territory and incorporates current theory alongside case examples from practice to highlight the relevance of music therapy within contemporary adoption. It offers an introduction to how music therapy as a sensorial and affect-laden medium might be a helpful choice of intervention with families who may struggle to describe the impact of traumatic early life experiences on children. All clients have been made into composites and there has been consent to this process.","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129509602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.33212/att.v12n2.2018.113
Hannah Knafo
Traumatic experiences affect the brain in a variety of ways, causing issues with memory and cognition, attention, affect regulation, self-esteem, and dissociation. Symptoms of PTSD are often experienced as breaks from reality (e.g., intrusive thoughts about the traumatic event; re-experiencing of the frightening moment). In the most general terms, a psychotic experience can be described as a “loss of contact with reality” (Kleiger & Khadivi, 2015). This paper presents a dyadic therapy case with a mother and her three-year-old son that illustrates the intersection of psychotic symptoms, unresolved loss, trauma, and disrupted attachment. The challenges of diagnosis and treatment for the parent and child are explored, and the flexible approach to intervention is described in detail.
{"title":"The intersection of unresolved loss, trauma, and psychotic symptoms: a dyadic case illustration","authors":"Hannah Knafo","doi":"10.33212/att.v12n2.2018.113","DOIUrl":"https://doi.org/10.33212/att.v12n2.2018.113","url":null,"abstract":"Traumatic experiences affect the brain in a variety of ways, causing issues with memory and cognition, attention, affect regulation, self-esteem, and dissociation. Symptoms of PTSD are often experienced as breaks from reality (e.g., intrusive thoughts about the traumatic event; re-experiencing of the frightening moment). In the most general terms, a psychotic experience can be described as a “loss of contact with reality” (Kleiger & Khadivi, 2015). This paper presents a dyadic therapy case with a mother and her three-year-old son that illustrates the intersection of psychotic symptoms, unresolved loss, trauma, and disrupted attachment. The challenges of diagnosis and treatment for the parent and child are explored, and the flexible approach to intervention is described in detail.","PeriodicalId":296880,"journal":{"name":"Attachment: New Directions in Psychotherapy and Relational Psychoanalysis","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124525377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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