Psychodynamic Functioning in Complex Trauma: a Case Study

Abstract Complex Post-Traumatic Stress Disorder (C-PTSD) leads to problems in different areas of life, suffering and comorbidities. The aim of the research is to evaluate a female patient with C-PTSD using OPD-2, seeking to understand the psychodynamic functioning and possible changes after four months of treatment. The instruments used were Sociodemographic Questionnaire, CAPS-5, DSQ-40, SRQ-20 and OPD-2. The results follow. The patient presented slight psychological change, maintaining intense subjective suffering. In CAPS-5: 45 and 27 points, at Times 0 and 1, respectively, with reduction in symptoms but maintaining diagnosis of C-PTSD; DSQ-40: diversified use of all levels of immature, neurotic and mature defenses; SRQ-20: score decreased from 16 and then 8; OPD-2: reduction in physical symptoms, with predominance of intense subjective suffering, dependence and isolation. Change in intrapsychic conflict was observed. However, the patient continued seeking attention and demanding care. The patient’s psychic structure level shifted from low to medium, with a slight increase in the understanding of mental states. Conclusion: The patient's psychic organization underwent a small change. The complexity of the disorder and the need for treatments focused on the psychic structure are observed. OPD-2 brought relevant information for the psychodynamic assessment of the C-PTSD patient, as well as the understanding of the perpetuation of trauma in her life cycle. Furthermore, the patient presented good communication with other instruments.