The Trauma-Self and Its Resistances in Psychotherapy

This paper seeks to highlight phenomena related to resistance in the psychotherapy of dissociative disorders and other trauma- and stress-related psychiatric disorders. The authors consider a particular psychological construct to be at the origin of resistance: the trauma-self. The resistances of the trauma-self consist of three main groups: Depressive manifestations, traumatic obsessions, and loss of psychosocial mutuality. Detemporalization, treating oneself as an object, suicidality, obsessions of abnormality, rupturing the mutuality of the patient-therapist relationship, and dissociative somatic crises are clues of these resistances. Succesful treatment is expected to minimize the resistances of the trauma-self. This is expected to be achieved through the careful contextualization of the trauma-self while conducting psychotherapy. Approaching the patient’s experiences from multiple angles not only from the angle of the therapist but also from the patient’s distinct perspectives are crucial in working through the resistances of the trauma-self.