Types of psychological trauma by Ego disintegration mechanism and their neurobiological profiles: a causal model

Abstract

This article presents a typology of psychological trauma developed within the framework of Integrative Causal Psychotherapy* and based on the primary mechanism of Ego disintegration. Four etiopathogenetic trauma types are distinguished: vital, invasive, egotomic, and constitutive trauma**. For each type, the following are consistently described: (a) definition and essence of the trauma, (b) mechanism of Ego damage, (c) clinical phenotype and its neurobiological correlates, (d) clinical implications, and (e) illustrative clinical case. The proposed typology forms a causal algorithm for choosing a therapeutic strategy according to the leading mechanism of traumatization. The compatibility and integrability of the presented typology with ICD-11 and DSM-5 are shown, allowing the translation of a nosological diagnosis into an etiotropic and personalized treatment plan. The article presents a theoretical and clinical model proposing a causally oriented framework for a causally oriented conceptualization of trauma. The presented material is intended for mental health professionals and aims to initiate discussion and empirical validation of the proposed typology.

* Integrative Causal Psychotherapy (ICP; Serbian: Integralna kauzalna psihoterapija, IKP; Russian: Integral’naya kauzal’naya psikhoterapiya, IKP) is a psychodynamically oriented psychotherapeutic approach developed by Yu. N. Tor within a Serbian-Russian psychotherapy school. ICP’s therapeutic protocols focus on identifying and eliminating the causes of mental disorders and integrate neuromodeling methods, elements of Katathymic-Imaginative Psychotherapy, and psychoanalytic techniques.

** Hereinafter, the word “trauma” is used to mean “psychological trauma”.