The Trauma-Self and Its Resistances in Psychotherapy

Abstract

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.

Parallel-Distinct Structures of Internal World and External Reality: Disavowing and Re-Claiming the Self-Identity in the Aftermath of Trauma-Generated Dissociation

“…In addition to the detached “sociological” and “psychological” selves, the “trauma-self” Şar and Öztürk (2005, 2007) emerges and remains in a perpetual status of help-seeking. In fact, this is the “symptomatic” self (Öztürk and Şar, 2016a) which may be explicit in daily life.…”

“…Constituting resistances of the “trauma-self” (Öztürk and Şar, 2016a), such relatively subtle and chronic phenomena are associated with NWS (i.e., that the individual appears “normal” but not crisis-prone in daily life) rather than TRASC which is related to more explicite dissociation. This condition reflects the secondary phase (“Trauma-Illness” as opposed to “Inflammation” and “Estrangement” phases) of post-traumatic process in the proposed “Tri-Modal (T-MR) Reaction Model of Protection” (Mutluer et al, in press) as inspired by findings of a recent neurobiological study on adolescent girls with PTSD due to severe sexual abuse.…”

“…According to the “Theory of Functional Dissociation of Self” (Şar and Öztürk, 2007), depressive phenomena, loss of interpersonal mutuality and functional somatic experiences are resistances of the “trauma-self” (Öztürk and Şar, 2016a). They require resolution in psychotherapy to repair the detaching of “sociological” and “psychological” selves.…”

“…Hence, if developmental trauma is not processed; i.e., a better level of integration and wholeness is not attained, attachment security may be difficult to achieve by highly dissociative individuals. This requires elimination of the resistances of the trauma-self (Öztürk and Şar, 2016a). The conception of the “sociological self” (Şar and Öztürk, 2007, 2013), however, serves to fit the needs of interpersonal attachment.…”

Culture, trauma and dissociation: A broadening perspective for our field

“…A pioneer in the field of trauma and dissociation, Vedat Sar, made important contributions to understanding societal influences on individual dissociation (Sar, 2017a(Sar, , 2017bŞar, 2016;Sar & Ozturk, 2007. Sar developed a theory of functional dissociation of the self, according to which a person's 'sociological self' gets differentiated from their 'psychological self' in the context of an 'apparently normal family'.…”