Complex PTSD in relatives of people with ID: an illustrative clinical case study from South Africa

The debilitating impact of trauma on people with learning disabilities is increasingly recognised in research. Sinason's influential psychoanalytic writing has drawn direct links between the presence of an opportunistic secondary handicap and pervasive exposure to trauma. Traumatic events often occur within families, implying that more than one family member may be exposed to the same traumatic stressor(s). Because adults with learning disabilities require additional support from caregivers to live socially valorised lives with optimal degrees of self-direction, in the context of home living, a parent's experience of severe trauma could have a deleterious impact on her caregiving capacity to meet her child with learning disabilities' support needs in an equitable manner. This paper contains a case study that describes how a mother's experience of earlier trauma, which resulted in complex post-traumatic stress, had a profound influence on her object-relations and object-relatedness with both of her children, including her daughter who had mild learning disabilities and severe behavioural difficulties. While the mother's own experience of trauma deserves attention in its own right, her defences against traumatic recollection also affected her responsiveness to her daughter's high behavioural support needs.