Children who have histories of disrupted attachment have experienced trauma. Trauma that occurs within the caregiving system is known as developmental trauma, a concept developed by Bessel van der Kolk, MD. Children who have experienced developmental trauma have difficulty with emotional and physical regulation, problems with impulse control and attention, a poor sense of self (sometimes referred to as poor self esteem), difficulty initiating or maintaining goal directed behavior, poor peer relationships, misreading of cues related to safety and danger.
This is a different form of trauma than being in a car accident or being the victim of a crime committed by a stranger. Developmental trauma happens within the caregiving system. The perpetrators are the people that children look to for love and safety. This trauma affects brain development and has lasting effects on how the child perceives himself, relationships and the rest of his environment.
Children living in an environment where the caregivers do not provide reliable safety, comfort and nurturing learn how to adapt to survive. This environment could be an orphanage or a family with drug addicted parents. Survival skills the child learns in these environments become count productive and often interfere with developing healthy relationships when the child is moved to a safe, nurturing home. For example, often children who are experiencing developmental trauma learn to not ask for help. This makes sense where there are usually no reliable adults available to help. When the child moves to a healthy family this self reliance can be interpreted as rejection of the parents. IT is a barrier to developing a reciprocal, attuned relationship.
So what does trauma therapy do?
First it acknowledges that the trauma occurred. Sometimes the trauma was so early in life that the child doesn’t have words for it. This doesn’t make the trauma less painful. When the trauma is acknowledged, we can work together to tell the story. In doing this we can also identify triggers. Children need help to become aware that they are repeating their early experiences; they need help in identifying new ways of being in relationships. Families are full of triggers that remind the traumatized child of feeling unsafe, unloved, and a host of other difficult feelings. Children can learn to manage their triggers so they become less disruptive.
I work with the child and parents to develop a coherent narrative, a story that makes sense. These narratives put events in the correct order, they clarify who was part of the story at each turn. Trauma has a profound effect on memory. Traumatized children often “remember” their adoptive parents being present or aware of the abuse. We work to identify who was aware of the situation, when did the adoptive parents first know of the child, why didn’t the adoptive parents intervene to protect the child. So many children I have worked with secretly blame their adoptive parents for not stoping the abuse or leaving them in the orphanage when the truth is the adoptive parents had no knowledge of the child at that time. We clarify the child’s role in the abusive or neglectful environment. Children are egocentric, they put themselves in the middle of the story. They often think it was something they did that caused them to be abused. Trauma focused therapy uncovers these thinking errors and strives to replace them with accurate thoughts and beliefs.
When the child has developed a coherent narrative, I support the child while they share the entire story with their parents. Children need to know that their parents know the worst, scariest things that happened to them and still love and accept them. During this stage, children also share the skills they developed in order to survive. While this is happening, I provide a lot of support to the parents. It is hard to hear the awful things that our children experienced. It’s often confusing because of what trauma does to memory. I am always mindful of where the parents are in their process of understanding. The child is not expected to share their story until the parents are ready to hear it.
Once the child has developed this story of their life that makes sense, we can refer to it while working through issues that arise day to day. We can have a better understanding of a child’s misbehavior or unhealthy responses when we look at it against the backdrop of their trauma.
Trauma therapy and attachment therapy are intertwined, they happen at the same time and the work in one supports the work in the other. Occasionally I meet a client who has been able to develop healthy attachment with his parents but needs to work through some trauma. In that case, we identify the healthy parental relationship as a protective factor and encourage the child to rely on this relationship as they process the trauma.