Complex trauma-related disorders (Giovanni Liotti)

Early attachment disorganization is a likely risk factor for many different types of severe trauma-related DSM disorders, ranging from Complex PTSD and BPD to dissociative disorders. It is also a likely risk factor in the genesis of other DSM disorders. An explanation of the influence of this type of infant attachment on so many different syndromes may be found in the intersubjective dynamics that typically follow it (controlling strategies in the relationship between the child and the caregiver), and in the role of the collapse of these strategies in mediating dissociative responses to traumatic experiences.
In order to understand the nature of both early disorganized attachment and the controlling/disorganized strategies, an overall theory of the systems (variously called action systems, emotional systems, or motivational systems) that organize and govern human behaviour and experience will be discussed in the first part of the workshop. In the second part, the dynamics that lead from attachment disorganization to the controlling strategies, and those that link trauma to dissociation through the collapse of the controlling strategies will be dealt with extensively. The analysis of these dynamics suggests that dissociative processes may play a major role in the genesis of many DSM disorders.
The second part of the workshop also focuses on some consequences for psychotherapy of the theory of dissociation based on attachment disorganization. One theme will be the understanding of the potentialities of parallel integrated treatments in the psychotherapy of severe disorders implying dissociation, traumatic memories and attachment disorganization. The relational configuration created by the simultaneous presence and close cooperation of at least two therapists working in two different settings may constitute an ideal basis to prevent or correct the consequences of disorganized attachment emerging in the therapeutic relationship.