The concept of psychological trauma implies a causal relation between the traumatic event and subsequent psychopathology. Difficulties in defining the characteristics of causal agent and establishing its firm correlation with signs and symptoms of disorder stem from the paradoxes embedded in the concept of posttraumatic stress disorder (PTSD), which ignores unconscious dynamics of posttraumatic states. In this article, we argue that the impact of extreme traumatization on personality can be made observable through analysis of unconscious mechanisms, processes and structures, such as capacity for symbolization/mentalization, representation and meaning making as well as thinking and intersubjective transformation. The article focuses on the theoretical background for creating a multifactorial, complex and biopsychosocial model of psychopathology of posttraumatic states and does not focus on treatment and psychosocial interventions directly.