Working with complex trauma with Joanne Stubley
Complex trauma involves chronic, repeated, or sustained trauma, often accompanied by captivity. Initially, this was the description given by Judith Herman in relation to Vietnam veterans, survivors of domestic violence, and adult survivors of child abuse.
Her descriptions now form the basis of the new psychiatric diagnosis of complex post-traumatic stress disorder. The evidence suggests that this extends to other forms of developmental trauma and severe adult trauma such as torture, slavery, and trafficking, as well as many refugee experiences.
In psychotherapeutic practice, we recognise many of these complex trauma patients as being difficult to engage with, high risk and evoking powerful countertransference experiences and inevitable enactments. Working with this group stretches the psychodynamic frame to require a more flexible, adaptive and at times innovative way of making authentic therapeutic contact.
In this workshop, we will start with an overview of trauma-related disorders including psychoanalytic, neurobiological and attachment perspectives on clinical presentation. We will then go on to look at working with clinical features such as hyperarousal, dissociation, somatisation, and failures of symbolisation within a psychoanalytic frame. Finally, we will consider clinical issues in working with trauma and how the therapist can maintain their own resilience and self-care.
Dr Joanne Stubley is a Medical Psychotherapist at the Tavistock Clinic. She leads the Tavistock Trauma Service, is a member of the British Psychoanalytic Society, and is Co-Chair of the Royal College of Psychiatrists Psychotherapy Faculty Task group on historical child sexual abuse. She is a Clinical Trustee at the charity Freedom from Torture.