What question did this study set out to answer?

The framework aims to differentiate Complex Multilayered Abuse (CMA) from existing clinical concepts and reinforce its survivor-led nature.

May 29, 2026Open Access

Complex Multilayered Abuse (CMA): Boundary Clarification and Structural Integration — v1.5

Key Points

The framework aims to differentiate Complex Multilayered Abuse (CMA) from existing clinical concepts and reinforce its survivor-led nature.
Defines six core boundaries regarding CMA's framework and clinical context.
Integrates first-person and third-person perspectives for comprehensive understanding.
Establishes CMA as a distinct entity separate from psychiatric diagnoses and treatment models.
Establishes clear definitions that prevent confusion with C-PTSD and dissociative disorders.
Reinforces the unique survivor-led perspective of the CMA framework.
Maintains the ongoing status of the framework for further development.

Abstract

This document presents version 1.5 of the Boundary Clarification and Structural Integration framework for Complex Multilayered Abuse (CMA). The primary purpose of this version is to establish explicit boundary definitions that prevent conflation with existing clinical concepts such as C-PTSD, DTD, and dissociative disorders, while reinforcing CMA’s unique descriptive domain as a survivor-led structural framework.The document defines six core boundaries: (1) single lived-experience-based framework, (2) not a psychiatric diagnosis, (3) not a clinical treatment model, (4) cross-sectional integration of first-person and third-person records, (5) complementary positioning with existing theories, and (6) ongoing preliminary framework status.Author: Tatsuki Nakamura(中村達希) | ORCID: 0009-0004-9696-7896© 2026 Tatsuki Nakamura | #ComplexMultilayered

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