Childhood Trauma: Psychodynamic Approach

According to modern research, an estimated 46% of children experience trauma at some point in their young lives.

But what is the reason behind it?

Today I thought I would delve into the topic of childhood trauma and its effects on children. I appreciate this is a broad, complex and heavy topic, which some of the readers might not find appealing, but in spite of that, I find myself rather interested in the background of trauma, and how it affects us in later life. Therefore, I shall look at the matter specifically from the psychodynamic point of view, which focuses on past traumas revealing from our unconsciousness in our progressed lives.

As Freud believed, past experiences have to some extent effect on us, even though we might not be aware of it. As people experience trauma in their early lives, something shifts in their unconsciousness which causes the person potentially vulnerable to specific life events in the future.

It is important to distinguish the contextual cause of trauma, that is, where the trauma comes from. We can distinguish two types of trauma, based on this aspect:

1. Intrafamilial trauma = trauma within the family, e.g. abuse or neglect
2. Extrafamilial trauma = trauma outside the family circle, e.g. car accident

Principally, intrafamilial trauma tends to be more harmful and is more likely to lead to long-lasting psychological consequences in children.

In reference to Bowlby's concept of the internal working model (IWM), which suggests that children form IWMs based on their early interactions with primary caregivers (usually parents), which then serve as cognitive frameworks that influence how they perceive themselves and others in later adulthood relationships. Although this is a theory primarily explaining the psychological branch of Attachment, it can be applied to how trauma affects and alters fixed and embedded children's perceptions in adult life.

And now, we are getting to the key point of this article, which is that of HOW and WHY the trauma is acquired and uncovered in later life.

Psychodynamic Theory of Trauma

The Psychodynamic Approach emphasizes the role of the unconscious processes, early childhood experiences, and inner conflixts in shaping personality and behavior.

Trauma-wise, psychoanalytic theory asserts that trauma results from anxiety caused by an event that exceeds the child's ability to process it. These traumatic events, which can range from neglect to physical or emotional abuse, create psychological distress that the child's mind struggles to process.

Trauma acquisition is typically linked to significant disruptions in the attachment bond (i.e. disruptions in the relationship between the child and caregiver). When the caregivers are inconsistent, neglectful, or abusive, the child experiences emotional disorganization which impacts the child's ability to form a coherent and healthy internal representation (via IWM) of themselves and others, which could manifest as trauma later in life.

The psychodynamic theory suggests trauma becomes unconsciously internalized, meaning that it is repressed into the unconscious mind to protect the individual from psychological distress. This might sound kind of paradoxical (it does to me now), but when you think about it… Repression is a defense mechanism which refers to the unconscious blocking of distressing thoughts, memories, or feelings from reaching conscious awareness in order to protect the individual from overwhelming emotional pain. Lest, the idea is that, by pushing traumatic experiences out of conscious awareness, the mind seeks to protect the person from the immediate psychological distress those memories might cause if brought to the surface. Nevertheless, while repression provides a form of protection in the short term, it doesn't make the trauma disappear. The trauma remains unconsciously stored and can continue to impact an individual without them being consciously aware of it. To illustrate, after a near-drowning incident as a child, the memory of the trauma may be repressed, but the child might still feel a sense of fear or unease around water, even if they don't consciously recall why. The repression of the trauma allows the child to go on with their daily life without becoming paralyzed by the overwhelming emotions connected to the memory of the near-drowning, but there are consequent signs of the person having experienced trauma in early life.

Trauma and the Formation of Neurotic Symptoms

In psychodynamic theory, trauma often leads to the formation of neurotic symptoms, such as anxiety, compulsions, or phobias. These symptoms are psychic expressions of unresolved unconscious conflicts and serve as a means of managing the anxiety generated by the trauma.

These neurotic symptoms are seen as an attempt by the psyche to manage the emotional pain that stems from trauma. However, the individual remains unable to process or resolve the traumatic experience fully, leaving them stuck in a cycle of distress.

Somatic process of Trauma

1. Initial Storage: Trauma from childhood or emotional experiences is stored in the subconscious and may cause chronic tension, headaches, or digestive issues. For example, childhood emotional neglect can result in persistent muscle tightness or stomach discomfort in adulthood.
2. Triggering Event: When encountering situations similar to the original trauma, the body's defense mechanisms (fight-or-flight) are activated, leading to physical reactions like rapid heartbeat or shallow breathing. For instance, someone who experienced childhood abuse may feel anxious or panicked when faced with conflict in adulthood.
3. Somatic Responses: These triggers cause physical reactions that mirror the original trauma, even if the individual isn't aware of the connection. A person who was in a car accident may experience chest pains or shortness of breath when driving in heavy traffic, reflecting the body's stored trauma response.

Linking disorders

• Attachment Disorders: Reactive Attachment Disorder (RAD) & Disinhibited Social Engagement Disorder (DSED)
• Post-Traumatic Stress Disorder (PTSD)
• Obsessive Compulsive Disorder (OCD)
• Borderline Personality Disorder (BPD)

Working Through Trauma

The psychodynamic approach to trauma treatment focuses on working through the unconscious material related to the trauma. This involves bringing repressed memories and feelings to consciousness and allowing the individual to confront and process them.

Therapy helps individuals understand how their past trauma influences their present life, behavior, and relationships. Over time, by re-experiencing and reinterpreting these past events, individuals can integrate the traumatic experience into their sense of self, reducing its power and emotional impact.

Transference as a Tool for Therapy

From a psychodynamic perspective, transference is a window to the unconscious mind

Transference occurs when unresolved feelings from significant past relationships (often with primary caregivers, such as parents) are unconsciously transferred to the therapist or another figure in the person's current life. In essence, the person begins to view and relate to the therapist as though they are someone from their past, such as their mother, father, or another important figure. These past emotions are re-enacted in the present, leading to distorted feelings and reactions.

A person might react to their therapist with anger or affection that feels disproportionate to the situation. For instance, if the patient had a distant or critical parent, they might transfer feelings of resentment or inadequacy onto the therapist, even though the therapist hasn't done anything to deserve that reaction.

The Desired Outcomes and Point of Transference:

• Unconscious Material: Revealing repressed emotions from past relationships.
• Repetition of Past Patterns: Re-enacting unresolved emotional conflicts in the present.
• Emotional Expression: Safe expression of intense emotions like anger or love.
• Corrective Emotional Experience: Experiencing healthy attachment through the therapist.
• Breaking Destructive Patterns: Identifying and disrupting unhealthy relationship behaviors.
• Integration of Repressed Feelings: Bringing unconscious emotions into conscious awareness.
• Therapeutic Alliance Strengthening: Building trust and understanding within the therapy relationship.
• Empowerment and Autonomy: Gaining control over emotional responses and relationship dynamics.

In conclusion, trauma can impact how we go through our lives. The psychodynamic explanations offer insight into the matter and bring along the psychoanalytic therapies which help individuals cope with trauma and heal.

As Freud had once said: 'What you resist, persists.'