Kathy Steele Knihy

Life is a continuous struggle for patients who have experienced chronic trauma, often presenting a complex array of symptoms and comorbidities that complicate assessment and treatment. These individuals frequently face significant challenges in daily living and relationships, grappling with deep intrapsychic conflicts and maladaptive coping strategies rooted in a painful past. Despite attempts to mask their distress, therapists often encounter overwhelming symptoms and profound suffering. Many survivors have cycled through multiple therapists without substantial progress, leading to labels of being untreatable or resistant. In this work, three leading experts draw on over 65 years of combined experience in treating chronically traumatized individuals. They present a model of phase-oriented treatment grounded in the theory of structural dissociation of personality and Janetian psychology of action. This approach emphasizes identifying and addressing structural dissociation and maladaptive behaviors. The primary goal is to help patients learn more effective mental and behavioral strategies, enhancing their ability to manage daily life and confront unresolved traumatic memories. Clinicians, psychology and psychiatry students, and researchers interested in adult survivors of chronic child abuse and neglect will find valuable insights and practical tools to improve treatment efficacy and patient experience.