PTSD Professional Perspective: Differentiation Principles in the Treatment of Interpersonal Trauma

Hands down, Bill Krill is one of my favorite professionals speaking on the subject of trauma. He’s insightful, compassionate, creative and above all, very in tune with the human side of post-traumatic stress disorder. Bill’s written guest posts for us before about children and posttraumatic stress. Now he’s back with an explanation of:

The Use of Differentiation Principles in the Treatment of Interpersonal Trauma

Differentiation is a term borrowed by psychology from biology. In biology, itDifferentiation, PTSD, Professional Perspectivedescribes how base cells ‘differentiate’ and become various other, specialized cells. The person who coined this term in psychology was a man named Murray Bowen, who is a founder of family therapy.

In the psychological sense, differentiation has had an ever widening meaning and association of concepts. At it’s most basic, it means that and individual is able to think, emote, and behave as a free standing individual. Various other descriptive concepts branch off of this basic idea.

One current prominent treatment pioneer is Dr. David Schnarch, who has further developed the central concept of differentiation and applied it to his approaches with couples who have issues in their relating and sexual lives. Though his work focuses on couples issues, the principals he sets forth are quite readily and effectively useful for all aspects of life and relationships (both positive and negative relationships).

It is no secret that most interpersonal trauma occurs between individuals who have an established relationship with each other. Cases such as sexual abuse of children, spousal rape or physical abuse, or child neglect due to parental substance abuse are examples of these. In the average, ‘normal’ family, there is always a degree of dysfunction due to problems in differentiation. The longer people are in relationship together, the more likely they are to ‘fuse’ their emotions. This means that each individual in the family is deeply effected and reactive to each other’s moods, emotions, and attending behaviors. In families that have low functioning to begin with, this is more marked.

If a victim of some type of interpersonal abuse is already ‘fused’ emotionally to the perpetrator of the abuse (a family member, for example), the abuse itself serves to greatly increase the fusion of emotions between the perpetrator and victim. In most cases, this is due to the fact that the perpetrator has so much control over the victim as to disallow much (or any) individuality.  In essence, the perpetrator ‘owns’ the individual, body and soul. This in turn, invalidates the victim as a separate, valuable and cherished human being who has the right to their own emotions, thoughts, and behavioral controls. This effect is so predominant and powerful so as to continue to control the victim’s emotions and individuality even when the perpetrator is not present. The victim does in fact continue to have their own emotions, but they learn to submissively set them aside for the more dominant emotions that the perpetrator inflicts upon them. Not to do this is dangerous. Imagine years of such experience in relationship. Imagine decades in cases where the abused child grows up and becomes either an adult who never heals the wound, or worse yet, enters into other like abusive relationships with adult partners.

Clearly, in order for the victim to become a healing survivor, they need to differentiate from their perpetrator. The process of this kind of differentiation growth is very hard work for anyone, even in the best of circumstances. It is all the harder for a person recovering from interpersonal trauma.

In the work of Dr. Schnarch, there is an elegant and deceptively simple formulation he uses to help people remember how to do the work of differentiation in their relationships. The first step is for the individual to get reacquainted with and build upon their core self identity. In the case of a trauma victim, this may be difficult because the core self has been buried for so long under the tyranny of the abuser. Consistent invalidation by the perpetrator must be counterbalanced by self validation, and these skills take time to learn and practice.

Secondly, the individual works on being able to calm down and interrupt their negative thinking patterns and thus gains some measure of control over their reactive emotions and associated behaviors. This is a real challenge for a person who’s brain chemistry has been altered as a result of their trauma. In this area, tools that help the individual to get to know their own body reactivity are helpful, such as meditation, yoga, or biofeedback.

If the individual is able to achieve a modicum of progress in these areas, they are then able to avoid their reactivity and learn to respond to situations at hand. Since a person who has had interpersonal trauma has had so many interaction wounds, there is no doubt that they have plenty of cues and triggers in their current (even non-abusive) relationships that negatively affect those same relationships.

Lastly, Schnarch cites that the final anchor point to being able to differentiate is that the individual must be able to tolerate the pain that growth inevitably causes, and find the goal deeply meaningful. This might perhaps be otherwise stated as determination to heal, despite the odds and difficulties of doing so. Again, this is difficult enough for anyone, but especially so for the victim, because they have endured so much pain already in their life, and likely have had their motivation for growth often repressed by the perpetrator.

The concepts and methods of differentiation have great potential to be used to help victims of interpersonal abuse become survivors that can heal and achieve a far better level of functioning and satisfaction in their lives.

W.E.,Krill, Jr. L.P.C.

Bill has several published articles and books in the mental health and ministry fields. His latest book is titled: ‘Gentling: a Practical Guide to Treating PTSD in Abused Children’.  He is an experienced speaker and teacher in his areas of expertise.

The opinions in this post are solely those of the author. To contribute to ‘Professional Perspective’ contact Michele.


The information provided on the is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her health professional. This information is solely for informational and educational purposes. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Neither the owners or employees of nor the author(s) of site content take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading this site. Always speak with your primary health care provider before engaging in any form of self treatment. Please see our Legal Statement for further information.

PsyWeb Poll

Are you currently taking or have you ever been prescribed anti-depressants?
Total votes: 3979