A case-study of PTSD in infancy: Diagnostic, neurophysiological, developmental and therapeutic aspects

Post-traumatic Stress Disorder of Infancy has become accepted as a nosologi cal entity. Assessment guidelines and diagnostic criteria have been defined , taking into account the impact of development on the expression of post-t raumatic symptoms. Therapeutic reenactment has been considered the cornerst one of the therapeutic process. The issue of deciding what is the optimal t ime for therapist-induced reenactment of the trauma remains ill-defined. Th e less verbal and the more avoidant the traumatized infant is, the more dir ective the therapist needs to be, meaning he will not necessarily get clues from the infant of his readiness for reenactment. The therapist will need to introduce the trauma, at the risk of provoking a massive "flight or figh t" reaction, as is illustrated by the case study of a two-and-a-half-year-o ld post-traumatic preverbal boy and his mother. Issues relating to conditio ns under which reenactment stops causing reactivation of the trauma and sta rts being a process of therapeutic desensitization are raised. We suggest t hat integration of psychodynamic and neurodevelopmental concepts might be u seful in deepening the understanding of the impact of therapeutic reenactme nt in PTSD of Infancy.