This book develops a relational-neurodevelopmental framework for understanding how early experience becomes procedurally encoded, organised, and transmitted across generations.

Drawing on three decades of clinical practice, it brings psychoanalysis, attachment theory, infant observation, and neuroscience into close dialogue with the lived moment of therapeutic work. At its centre is the concept of cumulative relational trauma, offering a way to understand developmental harm as emerging through ongoing relational processes rather than discrete events. Structured in four parts, the volume addresses key clinical domains, including enactment, sexuality, power, forensic settings, and psychosis, while remaining grounded in practice. It shows how change unfolds through sustained relational engagement, affect regulation, and reparative processes over time.

Written for psychotherapists, clinicians, and scholars, this book offers an integrative, ethically attuned account of development that honours complexity.

About the Author

Paul Renn is a UKCP-accredited psychoanalytic psychotherapist, supervisor, and couples therapist in London. He has a background in the National Probation Service and is on the editorial board of Psychoanalytic Inquiry. He has published widely and is the author of The Silent Past and the Invisible Present (Routledge, 2012).

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