Exploring the role of relationships in complex trauma: A systematic review of the therapeutic relationship and an IPA study on personal relationships

Mangham, Caroline (2025) Exploring the role of relationships in complex trauma: A systematic review of the therapeutic relationship and an IPA study on personal relationships. Doctoral thesis, University of East Anglia.

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Abstract

Background: Complex trauma, often rooted in early childhood adversity, disrupts attachment and relational functioning. Individuals who experience complex trauma frequently struggle with emotion regulation, identity, and interpersonal relationships. Relationships have been considered both challenging and fundamental for recovery.

Aims: The first aim of the thesis was to synthesise research exploring the qualities of the therapeutic relationship from the perspective of individuals with complex childhood trauma histories and therapists. The second aim was to qualitatively explore the experiences of the impact of complex trauma on personal relationships in individuals with complex trauma.

Methods: A systematic review of 12 qualitative studies was conducted to explore the qualities in therapeutic relationships with individuals with histories of complex childhood trauma and therapists, using a narrative synthesis approach. An empirical study explored the lived experiences of the impact of complex trauma on personal relationships. Semi-structured interviews were conducted with ten research participants. Interpretive Phenomenological Analysis was used to analyse the data.

Results: Six themes narratively synthesised findings in the systematic review: The core foundations are fundamental, From chaos to coherence, Therapists with courage, We are in this together, Boundaries, and A new attachment relationship. The empirical paper identified four Group Experiential Themes and related subthemes: The void of attachment needs, Inner narratives that shape our relationships, Challenges in relating with others, and Change and growth.

Conclusions: Both studies showed that complex trauma profoundly disrupted relational functioning and attachment. Adaptive relational experiences, whether therapeutic or personal, supported healing and growth for individuals with complex trauma.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	11 Feb 2026 14:18
Last Modified:	11 Feb 2026 14:18
URI:	https://ueaeprints.uea.ac.uk/id/eprint/101915
DOI:

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