Table Of Contentebook
THE GUILFORD PRESS
TreaTmenT of Complex Trauma
also from ChrisTine a. CourTois and Julian d. ford
For more information, visit the authors’ websites:
www.drchriscourtois.com and www.advancedtrauma.com
Treating Complex Stress Disorders:
An Evidence-Based Guide
Edited by Christine A. Courtois and Julian D. Ford
Treating Complex Traumatic Stress Disorders
in Children and Adolescents:
Scientific Foundations and Therapeutic Models
Edited by Julian D. Ford and Christine A. Courtois
TreaTmenT of
Complex
Trauma
A Sequenced, Relationship-Based Approach
Christine A. Courtois
Julian D. Ford
Foreword by John Briere
The Guilford Press
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ISBN 978-1-4625-0658-3
To Mom and to Tom,
my most stalwart supporters
—CAC
For Judy, my cotherapist,
coparent, and life partner
—JDF
about the authors
Christine A. Courtois, PhD, ABPP, is a counseling psychologist in private
practice in Washington, DC. She is immediate past president of Division 56
(Psychological Trauma) of the American Psychological Association (APA)
and past Clinical and Training Director and cofounder of The CENTER:
Posttraumatic Disorders Program, also in Washington. Dr. Courtois is a
recipient of the Outstanding Contributions to Professional Practice Award
from APA Division 56, the Lifetime Achievement Award from the Interna-
tional Society for the Study of Trauma and Dissociation (ISSTD), and the
Sarah Haley Award for Clinical Excellence from the International Society
for Traumatic Stress Studies (ISTSS), among other honors. She has pub-
lished numerous books, book chapters, and articles on trauma-related top-
ics.
Julian D. Ford, PhD, a clinical psychologist, is Professor of Psychiatry at the
University of Connecticut School of Medicine, where he is also Director of
the Child Trauma Clinic and of the Center for Trauma Response, Recovery,
and Preparedness. He is Associate Editor of the Journal of Trauma and
Dissociation and serves on the board of directors of the ISTSS. With Dr.
Courtois, Dr. Ford is a recipient of the Print Media Award from the ISSTD
for their coedited volume Treating Complex Traumatic Stress Disorders; he
has also published several other books on trauma-related topics. Dr. Ford
developed and conducts research on the Trauma Affect Regulation: Guide
for Education and Therapy (TARGET®) psychosocial intervention for ado-
lescents, adults, and families.
vii
foreword
o
ver the last several decades we have witnessed a huge amount of
progress in our understanding of psychological trauma, its many forms, its
immediate and lasting effects, and how it can be treated. This book is an
excellent representation of this progress and, I will suggest, a further step
forward.
It wasn’t that long ago that those alleging interpersonal trauma were
likely to be disbelieved, or at least viewed with suspicion. Similarly, expres-
sions of posttraumatic distress were frequently seen as fabrications, or the
effects of other, far more ominous things that were the “real” source of
the victim’s complaints, including pre-Oedipal psychopathology, hysteria,
personality disorder, psychosis, or an easily overwhelmed psychology or
neurobiology (Briere & Scott, 2006; Herman, 1992). As a result, therapies
were offered that attempted to (1) uncover and resolve unconscious con-
flicts and hysterical symptoms that were believed to masquerade as post-
traumatic distress; (2) strengthen the psychological mettle of individuals
whose assumed inherent weakness caused them to overreact to events; or
(3) teach the client how to suppress, deny, or otherwise avoid symptoms in
order to adjust to life’s challenges.
Slowly, however, historical events changed these societal and profes-
sional perspectives. One of the most significant of these was the Vietnam
War, which confronted the world with the horror of combat and its obvi-
ous effects on survivors. These impacts were manifestly real, as repeatedly
seen on television sets worldwide, and as witnessed personally in the return
of affected relatives, spouses, and friends. Importantly for the time, those
impacted could not be dismissed as “merely” women complaining of ques-
tionable sexual events, or a small number of individuals inventing psycho-
logical symptoms for secondary gain. They were red-blooded soldiers and
sailors, and there were a lot of them: Almost 20% of American Vietnam vet-
erans returned home with posttraumatic stress disorder (PTSD; American
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