When we hear the word trauma, we usually think of Post-Tramatic Stress Disorder (PTSD). But what is developmental trauma. In this article, we will describe the impact of repeated and complex trauma on children’s developing brains and the wide range of symptoms that affect their ability to attune to themselves and others.
Trauma in early childhood disrupts the normal functioning of a child’s physical, emotional and psychological systems. This disruption is often long-lasting and may interfere with healthy relationships, quality of life, and self-identity. It is also linked to many health issues, including serious chronic physical and mental illnesses and a high risk of suicide.
Research on the adverse effects of multiple traumatic experiences in childhood have been compiled and classified into nine categories called Adverse Childhood Experiences or ACEs. These include: Abuse – either physical or emotional, including neglect; Exposure to family and community violence; Impoverished circumstances; Early life loss or abandonment; Sexual abuse; and Emotional neglect – which can mean not being listened to or supported by one’s caregivers. A person’s ACE Score can be a strong indicator of their future risk for poor mental and physical health outcomes.
Most people who have experienced these types of adversities don’t meet criteria for PTSD and instead develop a broad array of overlapping, complex and disabling symptoms that fall under the broader diagnosis of Developmental Trauma Disorder. A growing number of psychologists and psychiatrists have been advocating that this diagnosis be included in the psychiatric classification system, and that it replace the PTSD diagnosis. They argue that the DTD label provides a more accurate conceptualization of a much wider variety of disabling symptoms and offers a more comprehensive and sensitive way to capture the many ways that repeated and complex trauma impacts the lives of vulnerable children and adults.
While a therapist can work to help clients with PTSD to calm down and detach from their reactive and self-defeating stress responses, a therapist working with someone who has DTD is focused on helping them build a more fluid sense of attunement to themselves and others in safe relationship – starting with the therapist. This process is called ‘trauma integration’ and includes activities that facilitate mindfulness and self-compassion practices, experiential modalities such as arts and movement, cognitive reframing and behavior modification, aspects of nutritional psychology related to the gut-brain connection, and neurofeedback.
The goal of these activities is to give kids bottom-up access to the age when they first experienced trauma so that they can begin to understand and recover from it. This approach is especially effective with young kids.
For example, I work with refugee children who have experienced multiple ACEs, often in the form of somatic dysregulation such as GI problems and headaches. These children can’t attune to themselves or others and have difficulty regulating their bodies. So, I use activities that involve playfulness, imagination and spontaneity to provide these kids with the opportunity to engage in bottom-up access to the age of their initial trauma.