The treatment of traumatic memories in patients with complex dissociative disorders

To overcome their traumatic memories, survivors need to integrate them into their personality. In patients with complex dissociative disorders who generally have experienced severe and chronic relational traumatization, this integration requires a paced and regulated approach within a relational context. Management and resolution of traumatic memories require, above all, an understanding and treatment of dissociation. The dissociative organization of these individuals’ personality includes at least one part of the personality primarily engaged in daily living, while trying to avoid traumatic memories, and at least one other part primarily fixated in traumatic memories, i.e., sensorimotor and in many cases highly affectively charged re-enactments of traumatic experiences, including innate defensive action tendencies in the face of perceived or actual threat. The treatment of traumatic memories should generally be embedded in a phase-oriented treatment – the current standard of care – in order to ensure that it will not exceed the patient's capacity as a whole person to integrate these re-enactments.