Developmental Trauma

Janae B. Weinhold & Barry K. Weinhold

Developmental trauma is a breakthrough term with roots in both developmental psychology and traumatology. Developmental trauma is inflicted on infants and children unconsciously and most often without malicious intent by adult caregivers who are unaware of children’s social and emotional needs. Infants and children require energetic attunement, skin-to-skin and eye-to-eye contact, kind and comforting words, protection and safety from their mother during gestation, birth and the first years of life.

Unfortunately, most parents have not been educated about children’s social and emotional needs and lack skills for supporting their child emotionally when they become upset. They also never fully experienced emotional attunement with their parents when they were children. This makes it difficult for them to respond to their needs for nurturing, protection, safety and guidance in timely and appropriate ways. They also do not correlate their deficiencies in their own parenting experiences with their own day-to-day struggles to effectively parent their own children. 

Here is a word picture to help you understand what these terms look like in real time. The inspiration for this word picture comes from a 1986 NOVA film, “Life’s First Feelings,” illustrating the results of a research investigation into the important biological and social functions emotions serve in the early development of a child’s personality (NOVA, 2000).

Early in the film, chief investigator Dr. Edward Tronick describes an interactive dance of communication that he observes between an infant about the age of 5 months and his mother. In this dance, the infant is sitting in a carrying seat and the mother is standing in front of him. She is instructed to interact with her child for several minutes while being videotaped. Sometimes she puts her face too close to her son, and he fusses, looks stressed, withdraws, and looks at his hands.

Then she backs away and again comes in close several times. Sometimes she makes sounds, wipes the drool off his chin, and waves her hands close to his face. When the boy becomes overly stimulated and gets a little upset, he withdraws and soothes himself by breaking eye contact and looking at his hands. Then he looks back at his mother and smiles really big in an effort to reengage with her.

This part of Tronick’s experiment is an excellent illustration of the infant–mother dance of communication. The next part of the experiment, however, contains something that would not be done today because we now understand that it causes experiences of shock, trauma, and stress in infant research subjects.

Tronick does a short “cold mother” experiment in which he asks the mother to keep a blank face and not respond to her child’s attempts to engage with her. It is obvious after the previous playful exchanges with his mother that the infant does not anticipate her withdrawal. At first he looks surprised and then he smiles really big at her in an attempt to draw her in. When she stays stony-faced, he looks off to one side and again peers at his hands. Then he looks back at his disengaged mother’s face and smiles and tries to reengage with her.

When he sees she is still not responding to him, this causes a series of things to happen very fast—so quickly that they are almost invisible. First the pupils in the boy’s eyes dilate, then his eyes bulge, and his face becomes blank. Then he has what looks like a severe hiccup, and finally he vomits a little bit.

Tronick does not comment about the look of terror on the infant’s face, the change in his eyes, or his hiccup. He does remark about the child’s “loss of bodily fluids” and then shifts the focus. An announcer in the background asks the question, “If this response occurs in the laboratory, what happens when infants are emotionally deprived over long periods of time?”

This short video segment illustrates four important points. The first point is the difference between developmental shock, trauma and stress. This process begins in the first part of the experiment when the invasive mother over-stimulates her child. He shows signs of developmental stress and then flees his mother’s overstimulating behavior by looking at his hands and self-soothing, at which point he then attempts to reengage with his mother.

He first shows signs of disorientation during the cold mother experiment when he is unable to reengage her in their dance. Then he quickly drops into a state of developmental shock that is visible in the dilation of his pupils, his bulging eyes, his blank facial expression, his hiccupping, and finally his vomiting. The experiment becomes a shattering experience for this small boy who dissociates and becomes immobile.

The second point the video illustrates is the immense power of the interactive dance between the child and mother, and what happens to the child when the mother disengages from it. The third point it illustrates is how few resources this child has to cope with a mother’s disengagement and how rapidly this causes him to move from stress into trauma. Then he attempts to re-regulate himself by looking at his hands and then into shock when his mother does not respond to his efforts to engage.

The fourth point is that this video segment demonstrates is the sequences of state-shifting from developmental stress, into developmental trauma, and then into developmental shock; from higher-order brain functions to more primitive defensive responses contained in the limbic system and reptilian brain; and from newer parts of the autonomic nervous system to the older. These are the primary components of what we call the trauma continuum, which we describe briefly in the next section.

By definition, developmental shock, trauma, and stress are inflicted on infants and children unconsciously and most often without malicious intent by adult caregivers who are unaware of children’s social and emotional needs. Infants and children require energetic attunement; skin-to-skin, eye-to-eye, and right brain-to-right brain contact; kind and comforting words; and protection and safety during gestation, birth, and the first 3 years of life. Most adults, including many mental health professionals, have not been educated about these needs, and many lacked these personal experiences of emotional attunement when they were children. Adults also do not correlate these developmental deficits with the day-to-day struggles they experience in their lives. Consequently, they are unaware when they are shocking, traumatizing, or stressing their own children and are not able to recognize the symptoms of developmental shock, trauma, or stress in themselves, their children or others.

The authors of the new DSM-V edition, due for release in 2012, are considering the inclusion of Developmental Trauma Disorder as a new diagnostic category (van der Kolk, (2009).[1] Many traumatologists use the term “Complex Trauma” to describe experiences of multiple and/or chronic and prolonged experiences of chronic interpersonal trauma in the context of inadequate caregiving systems that delay development. This new diagnostic category would encapsulate diagnoses such as bipolar disorder, ADHD, PTSD, conduct disorder, phobic anxiety, reactive attachment disorder and separation anxiety.

Researchers in children's mental health have typically focused on more extreme traumatic events of an interpersonal nature that involve sexual or physical abuse, war, community violence that happen early in life. These experiences often occur within the child’s care giving system and include physical, emotional, and educational neglect and child maltreatment beginning in early childhood.

Developmental trauma is caused by seemingly “ordinary,” “normal” or “subtle” daily events that involve relational and energetic disconnects between children their mothers that are either too long or too frequent. Unfortunately, most adults do not recognize or perceive these relational disconnects as traumatic, but see them as “normal” because they “happen to everyone.” 

Early traumatic experiences, anchored in these “ordinary” events, hard-wire children’s brains and nervous systems for a life built around trauma. The primary goal becomes avoiding anything that might trigger the memory of an experience involving developmental trauma and the underlying emotional stress associated with it. When children are unable to avoid these triggers, they react by trying to flee or fight. This is the most common cause of hyperactive behavior in children.

Our definition ofdevelopmental trauma recognizes the chronic effects of subtle emotional events that draw no attention from adult caregivers and provide no relief for children’s symptoms. We believe that many who are using the term “developmental trauma” are actually referring to developmental shock and that they are not discriminating between shock and trauma. Events involving shock are much easier for mental health and medical professionals to recognize because the causative events associated with it are often extreme enough to draw their attention. 

[1] van der Kolk, B. & R. Pynoos (2009). “Proposal to include developmental trauma disorder diagnosis for children and adolescents in DSM-V” http://www.traumacenter.org/announcements/DTD_NCTSN_official_submission_to_DSM_V_Final_Version.pdf

[2] NOVA Video Series (2000). Life’s First Feelings. Boston, MA: WGBH.

 

  

Comments

[Judy Kingston-Smith]

Thank you very much for this insightful post. As I am expecting our first child these are the kind of things you worry about. I just want to give our child the best change in life that I can possibly give him or her.