Korean Journal of Psychology : General
[ Regular issue ]
The Korean Journal of Psychology: General - Vol. 39, No. 2, pp.307-333
ISSN: 1229-067X (Print)
Print publication date 25 Jun 2020
Received 25 May 2020 Accepted 20 Jun 2020
DOI: https://doi.org/10.22257/kjp.2020.

복합 PTSD의 상담 및 심리 치료: 단계 기반 접근을 중심으로

Psychotherapy of Complex PTSD: Focus on a Phase-Based Approach
Jungmin Lee
Center for Campus Life & Culture, Seoul National University

Correspondence to: 서울대학교 교육연구소, 객원연구원 E-mail: sylphmin@naver.com


본 연구는 최근 국제질병분류(ICD-11)에서 독립된 진단 범주로 분리된 복합 PTSD의 증상과 치료에 대하여 기존의 이론과 경험적 연구를 탐색하고 개관하고자 하였다. 복합 PTSD의 증상은 정서조절 장애, 자기 완결성의 상실, 대인 관계 능력의 장애 등 크게 세 가지로 나누어 설명할 수 있으며, 이에는 우울, 불안, 극단적 정서, 수면 장애, 악몽, 해리, 자해 및 자살 충동, 신체화 장애, 대인 관계 문제 등 다양한 증상이 포함된다. 복합 PTSD 내담자는 복합 외상 경험을 다루는 것이 고통스럽고, 자기와 타인에 대한 표상이 부정적이기 때문에 상담 과정에서 라포 형성과 치료의 지속이 어려울 수 있다. 그러므로 내담자에게 안전감을 제공할 수 있도록 단계에 기반한 치료를 제공하는 것이 필요하며, 복합 PTSD 치료를 위한 단계는 (1) 안정화, (2) 외상 기억의 처리, (3) 치료 이득의 통합으로 구성된다. 각 단계별 치료의 내용과 경험적 연구의 내용을 개관하여 제시하였으며, 향후 복합 PTSD 치료의 적용 및 개발을 위한 논의를 제시하였다.


The purpose of this study is to explore and review the existing theories and empirical studies on the symptoms and treatment of complex PTSD separated into independent diagnostic categories in the recent International Classification of Diseases(ICD-11). Symptoms of complex PTSD can be explained in three categories: emotional control disorders, loss of self-integrity, and impairment of interpersonal skills. And it includes various symptoms such as depression, anxiety, extreme emotions, sleep disorders, nightmares, dissociation, self-harm and suicidal thoughts, somatization disorders, and interpersonal problems. Complex PTSD clients may find it difficult to form rapport and continue psychotherapy because processing traumatic experience is painful and representations of themselves and others are negative. Therefore, it is necessary to provide phase-based treatment to provide the client with a sense of safety. The phases for complex PTSD treatment consists of (1) stabilization, (2) process of traumatic memory, and (3) integration of treatment benefits. The contents of each phase of treatment and empirical researches were outlined and discussed for the future application and development of complex PTSD treatment.


Complex trauma, Complex PTSD, phase-based treatment, trauma treatment


복합 외상, 복합 PTSD, 단계기반치료, 외상 치료


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