Post-traumatic stress disorder can develop following experiences of violence, accidents, disasters, or prolonged stress during childhood. The S3 guideline recommends trauma-focused approaches as the first-line treatment, particularly trauma-focused cognitive behavioral therapy and EMDR.
A traumatic experience overwhelms the mind's ability to process it to such an extent that the usual defense mechanisms break down. The experience cannot be made sense of and remains disconnected.
Dissociation is typical in severe cases: separate subpersonalities alternate without being aware of one another. Those affected describe this as living in different worlds.
This is where trauma pathology differs from repressed conflict. An exploratory approach is not helpful here. Therefore, the focus of treatment is less on the event itself and more on what, what the trauma has left behind.
Traumatic relationship experiences resurface during therapy. The therapist may unconsciously be perceived as taking on the role of the perpetrator, and sometimes even that of the victim. Identifying and limiting such repetitions early on is the central task of TP, and it is now also clear that this approach is effective carefully examined.
It also addresses shame and guilt, which commonly arise after traumatic experiences, and the shift from a passive victim role to a proactive stance.
