Synthesizing Psychoanalytic and Biological Approaches to Trauma: Some Theoretical Proposals

This paper offers some theoretical possibilities for synthesizing psychoanalytic and neurobiological approaches to understanding the effects of severe psychic trauma. The paper argues that biological and psychoanalytic perspectives can enrich and enhance each other in our attempt to understand and ameliorate the damaging consequences of trauma. The findings of biological researchers and the observations of psychoanalysts are integrated, as they apply to two functions that are damaged by trauma: the capacity for representation and the capacity for self-regulation. These capacities are interdependent and interactive. Disrupting either will affect the other. The combined result of this disruption can profoundly alter subjective experience. The paper discusses how helping patients to symbolize traumatic experiences, affect, and other mental states and helping patients regulate physiology and affect through nonverbal, affect-regulating interactions, and through the use of medication, lead to an improved capacity to symbolize, to experience meaning, and to relate and can lead to a subjective sense of increased strength.