The case study below, illustrates the methods of intervention that references to the complex cognitive and constructivist approach, together with the use of specific techniques and procedures in the treatment of traumatic spectrum disorders (Liotti, Farina, 2011). Through careful psychological assessment, in addition to detecting the comorbidity between major depressive disorder and avoidant personality disorder, it was possible to highlight specific patterns that are common to patients who are victims of abuse: despair, hostility, derealization, loss of coherence in the self-representation, deficit in emotional regulation, irritability and a strong dependence, coexisting with an anxious-avoidant attachment type. The typical dysfunctional patterns, demonstrate that the dissociative mode, which is implemented as a defensive mechanism designed to shield the patient from an intolerable reality, is automated in adulthood, becoming a protective shield against painful and unmanageable emotionalism. The procedures used in the various stages of intervention, pointed out that the outcome depends on the synchronization and integration of theoretical models and protocols. Thanks to the positive dynamics of development exhibited by the patient, the focus is on two topical key: the effectiveness of complex cognitive and constructivist model concerning the intervention with the type of patient victim of abuse; the need to approach complexity by multimodal and multi-level intervention, respect to which the main objective is given by overcoming critical in relationships, through activation of the motivational cooperative system and consolidation of the therapeutic alliance.
Keywords: Complex post traumatic stress disorder (cPTSD), avoidant personality disorder, dissociative experience, cognitive complex therapy (CCT), sexual abuse
Roberta Anna Irene Soldà, Luciana Cracco, Mauro Polacco, Giulia Greselin, Complex post traumatic stress disorder and avoidant personality: A case of sexual abuse in "QUADERNI DI PSICOTERAPIA COGNITIVA" 32/2013, pp. 139-148, DOI:10.3280/QPC2013-032010