The intersection of unresolved loss, trauma, and psychotic symptoms: a dyadic case illustration

Traumatic experiences affect the brain in a variety of ways, causing issues with memory and cognition, attention, affect regulation, self-esteem, and dissociation. Symptoms of PTSD are often experienced as breaks from reality (e.g., intrusive thoughts about the traumatic event; re-experiencing of the frightening moment). In the most general terms, a psychotic experience can be described as a “loss of contact with reality” (Kleiger & Khadivi, 2015). This paper presents a dyadic therapy case with a mother and her three-year-old son that illustrates the intersection of psychotic symptoms, unresolved loss, trauma, and disrupted attachment. The challenges of diagnosis and treatment for the parent and child are explored, and the flexible approach to intervention is described in detail.