Trauma and Relationships

I thought this week I would give you a short summary of a chapter I just read by Bruce Perry and Christine R. Ludy—Dobson titled “The Role of Healthy Relational Interactions in Buffering the Impact of childhood trauma”. If you would like to read the entire chapter click on this link.

The Power of Relationships to Heal

Understanding the power of traumatic events to shape the brain helps us to better determine what a child needs to heal. Although negative early life relational experiences have the ability to shape the child’s developing brain, relationships can also be protective and reparative. Many case studies have shown the power or relationships to both injure and to heal. There exists a wide body of research indicating that social connectedness is a protective factor against many forms of child maltreatment—including physical abuse, neglect, and failure to thrive.  For some traumatized children their foster/adoptive parents and their extended family supply them with the emotional connections, healthy interactions, and nurturing that provide a strong basis for surviving the horrors of life with their biological parents.

Others, unfortunately, miss out on the nurturing, touch, and love that is needed in order to grow into a healthy, secure child. Their brain, literally, was a reflection of the severity of their neglect, likely combined with some type of physical maltreatment. Their stress response system is overly active, which causes them to spend most of the time either hyperaroused or dissociating when their system can not take any more. Also, not surprisingly, the strategies that helped them survive in the negative environment make it more difficult to “take advantage of good quality, loving and responsive” caregiving in their new home. Experience in the earliest caregiving relationships have taught them that adults were frightening, hurtful, unpredictable, and confusing. Children with early neglect histories and subsequent attachment-related problems rarely feel safe when placed in new, healthy caregiving situations. Instead, they work to avoid close relationships, often becoming aggressive and controlling as a way to protect themselves from further hurt.  Relational health during development is protective. The Neurosequential Model of Therapeutics diagnostic tools have shown a clear relationship between the relational health scores and overall quality of brain organization and functioning.

Trauma Children’s Agenda

The agenda of traumatized children is to control and not to engage people. This denies them exposure to the very experiences they need. So long as they remain unable to give up control and relate fully and accurately with their caregivers and therapists, these children make little emotional or developmental progress. Healthy caregiving and strong attachments can help protect children from the lasting impact of traumatic events. The chapter does not say all of the scars disappear or that the memories of trauma no longer exist, only that the reestablishment of predictable routines, reconnections with attentive, committed caregivers, and solid therapeutic treatment provide the opportunity for children to heal.

Implications

The current mental health, child welfare, and judicial systems, as well as child-placing agencies deal with traumatized and maltreated children as if they were completely unaware of these essential findings in development, attachment, and trauma. There are few metrics to measure the number, quality, and patterns of healthy (or unhealthy) relational interactions; we move traumatized children from therapist to therapist, school to school, foster home to foster home, community to community. Our systems at times often add to or even replicate the relational impermanence and trauma of the child’s life. We expect “therapy”—healing—to take place in the child via episodic, shallow relational interactions with highly educated but poorly nurturing strangers. We undervalue the powerful therapeutic impact of caring teacher, coach, neighbor, grandparent, and a host of other potential “cotherapists.” Future effective therapeutic interventions—both preventive and healing—must be developmentally informed and trauma sensitive. There is much to learn, yet we know enough now to begin to evaluate and modify our current therapeutic practices, programs, and policies to take full advantage of the biological gift of the healing power of relationships.

To read more about the Center and how it works with traumatized children click on the link.

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