Exposure Begins at Hello: A Case Study of Complex Relational Healing

Interpersonal trauma can be disruptive at any point in the lifespan; however, it carries a unique consequence profile when repetitive betrayals and abuse are present in early childhood. In the case of Ruby, she developed various parts to manage her distress, some of whom focused on engaging in risky or other destructive behavior without the knowledge of the rest of the system, as well as significant substance use to mediate her pain. This case study focuses on what has worked over the course of her 15-year treatment history with this author. Although she was not in therapy for that entire time, she has discussed the strategies she utilized for holding onto gains made in therapy, even during her darkest times. In addition to presenting her story, this study seeks to expand the conversation on relationship building, highlighting aspects of Stage 1 of the triphasic model as exposure therapy for many of the humans who take the risk to share their stories.