Applying contemporary interpersonal theory to the study of trauma

Abstract

Introduction: Symptom-focused theories of trauma and posttraumatic response have yielded many valuable clinical insights, ultimately leading a number of empirically supported approaches to diagnosing and treating trauma survivors. Limitations observed in these approaches have led some trauma-focused researchers and clinicians to examine the role not only of symptoms, but of interpersonal factors on trauma and posttraumatic response. The study of such interpersonal factors is the mainstay of contemporary interpersonal theory, although at present research and clinical intervention concerning trauma has been largely detached from the insights of contemporary interpersonal theory. Objective/Method: In this paper we review and integrate the disparate literatures on trauma and interpersonal theory. Results/Conclusion: We conclude that synthesizing these two literatures is not only feasible, but may also generate useful clinical insights and provide directions for future research relevant to trauma.

Integrating collaborative/therapeutic assessment of interpersonal functioning into group therapy for veterans with posttraumatic stress disorder.

“…One implication of this is that focusing on the interpersonal ramifications of PTSD may be as helpful in alleviating PTSD symptoms as focusing on the traumatic experiences directly. A reason for this may be that PTSD symptoms are intrinsically interpersonal in nature (Janoff-Bulman, 1992; Yalch & Burkman, 2019). This idea is consistent with research suggesting that the problems with which PTSD is frequently comorbid (e.g., disorders of mood, anxiety, and substance use; see Bryant & Keane, 2013; Kramer, Polusny, Arbisi, & Krueger, 2014; Kruse, Steffen, Kimbrel, & Gulliver, 2011) also have interpersonal underpinnings (Flores, 2004; Saliani, Barcaccia, & Mancini, 2011; Segrin, 2011).…”

“…This can be problematic for people whose behavior patterns become maladaptive, such as veterans with PTSD. Among such people, the expectations of themselves and other people may be adversely affected (i.e., pulled to be more cold and detached) by traumatic experiences, thereby leading to patterns of behavior that are antagonistic and otherwise alienating toward other people (which in turn pull for complementary cold behavior, thereby reinforcing veterans’ maladaptive expectations of themselves and others; for extended review, see Yalch & Burkman, 2019). Indeed, there are several EBPs that focus on interpersonal factors that have shown efficacy in treating PTSD.…”

“…Some of these problems are likely due in part to the psychological difficulty veterans often have in completing these EBPs, which entail directly confronting painful memories that veterans often spend much of their waking lives avoiding (Hundt et al, 2018). Additionally, these EBPs are relatively few in number, address a narrowly prescribed set of symptoms as the target of clinical intervention, and have several barriers to access for the modal veteran (Riggs & Mallonee, 2017; Yalch & Burkman, 2019). These concerns have led PTSD researchers and counselors to look for alternative means of treating veterans with PTSD.…”

“…One reason for the relatively modest research support for conventional approaches to treating PTSD in veterans may be that these treatments address only a small aspect of the phenomenon of PTSD as described in predominant theoretical models of PTSD. While PTSD is diagnosed in terms of discrete symptoms, contemporary theories of trauma understand the cause and phenomenology of PTSD to be a violation or shattering of expectations (Janoff-Bulman, 1992; McCann, Sakheim, & Abrahamson, 1988; Resick et al, 2017), specifically the expectations of other people and one’s relationships with them (Freyd, 1996; Shay, 1994; van der Hart, Nijenhuis, & Steele, 2006; Yalch & Burkman, 2019). In other words, from a theoretical (as distinct from a symptom-focused) perspective, at the root of PTSD are maladaptive shifts in thoughts about oneself, of other people, and of the world, resulting from one or more traumatic life experiences.…”

Interpersonal sensitivities associated with sexual assault.

“…Recent work has applied interpersonal theory and the IPC to the experience of trauma (Yalch & Burkman, 2019; see also Boulanger, 2007). Within an interpersonal perspective, we can understand trauma as an experience that violates a person's bonds with other people (coldness) and that is either invasive/aggressive (cold-dominance; e.g., a physical assault) or neglectful (cold-submissiveness; e.g., child neglect).…”