Developmental trauma and a call for further integration

20130506_175610_Sophia_PergaI just spent four days at the International Trauma Conference hosted by the Trauma Center in Boston.  It was a fascinating experience with many layers of learning!

The focus of the conference was on early childhood attachment and developmental trauma – elite researchers from around the world presented their scientific findings that explored the complexity of trauma.  For example, Bessel van der Kolk, from the Boston area Trauma Center, discussed his attempt to include a new diagnosis called ‘Developmental Trauma Disorder’ in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).  The “new” disorder was not accepted partly due the proven complexity of the condition.  The disorder places emphasis on early childhood attachment – trauma possible through subtle and covert day to day neglect and abuse.  Another example includes findings presented by Alan Stroufe, demonstrating it was possible to confidently predict dissociation and other possible mental health issues in an adult by seeing how a child was raised between infancy and 18 months of age – focusing on their ability to safely and comfortably attach to their caregivers.  All the evidence pointed to developmental trauma contributing to significant long-term impacts on a person that may lead to a lifetime of recovery.  Not only would this person suffer from the effects of accumulated developmental trauma, but if exposed to a traumatic experience as an adult, the adverse affects may leave a larger imprint due to the already saturated trauma related symptoms they are experiencing.

The reoccurring theme and statement

throughout many of the presentations I attended was –

“to support change we must transform one’s relational experience

This got me thinking!

The conference was a gathering of researchers and therapists who work one on one with clients.  The discussion was based on ongoing early childhood trauma, experiences often people cannot explicitly remember…and the solution is to transform the relational experience.

Dare I return to the age old saying – it takes a community to raise a child?!

I find myself wondering where the community developers and policy makers were, those that have an eye on the systemic and structural issues significantly impacting a family’s stress levels?  The scope of this conversation needs to broaden into a diversified audience.  As an example, consider the possible impacts of maternity leave.  In the USA, mat-leave is 3 months (potentially unpaid), Canada 1 year, Slovakia 3 years, and the numbers (time off and percentage of mat-leave pay) are varied between states around the world.  It would be interesting (and challenging!) to explore research on maternity leave duration and the impacts on attachment (mother’s ability to be present for child due to being physically absent and with accumulated financial stress etc).  Policy makers could have a stake in outcomes such as these for individuals and families – but are they aware of the research identifying the complex nature of developmental trauma?

Imagine the possibilities that reside within an interdisciplinary therapeutic team made up of a clinician (supports process and integration), a community developer (brings a structural lens in addition to integrating supports and resources), a family systems therapist (able to view the dynamics at play within the family setting), and a trauma sensitive yoga instructor (elicits somatic experiences supporting implicit memories to safely emerge therefore solidifying relations with self and others).  I realize that a model such as this loosely exists for individuals recovering from trauma, however are the stakeholders involved communicating to provide an integrated process?

Where is the community raising, or supporting the process of raising the child?

Why are those who have professional responsibilities to communities not a part of this conversation…or attending a trauma conference?

When I reflect upon the observations and questions mentioned, it is evident there are two areas to focus on: a) the treatment of developmental trauma, and b) the prevention of developmental trauma.  When considering these two areas, it is valuable to keep the statement – to support change we must transform one’s relational experience – in the foreground.

When considering treatment, I believe the recovery process could be enhanced through professional therapeutic teams that view the situation through different macro and micro lens’ to support the enhancement of relational experiences and interactions with a client’s internal and external world…(and I must speak to the role trauma sensitive yoga could play because – hey, that’s the focus of my internship)…There is a great therapeutic opportunity available for a person who has experienced complex trauma that naturally magnifies a person’s internal relations with self and relations with others – trauma sensitive yoga (TSY).  This occurs through gently activating stored somatic memories that may not explicitly be part of someone’s memory.  TSY provides an opportunity for a client to interact with simple sensations that may historically trigger them, and learn how to feel safe in their body.  This is one example of how TSY can support a trauma survivor develop new relations with themselves, often rippling outward to positively impact surrounding relationships.

When considering prevention – sharing this research at a conference for policy makers, politicians, community developers, even with the corporate world who often provide financial support to local and national projects and initiatives, could benefit outcomes aimed at prevention.

This discussion is just some of the layers of learning I experienced – I am sure there is more to come!  Until then, consider the integration and intersections between micro and macro practice and development, between clinical, community, and policy…and consider the opportunity for healing and recovery available when one feels safe in their own body!