The Trouble with Trauma History: Chapters 9 & 10

van der Kolk's explanation for the hidden epidemic in developmental trauma was spot on. His description of a child who experienced something unexpectedly devastating was helpful, especially the section on diagnosing. He writes, "In the case of the troubled children with histories of abuse and neglect who show up in clinics, schools, hospitals, and police stations, the traumatic roots of their behavior are less obvious, particularly because they rarely talk about having been hit, abandoned, or molested, even when asked" (p. 159). Furthermore, even if they are asked, there is a great chance they will not have the memory of the event, especially if it happened in their early development, or may not have the words to properly describe what had happened. 

For research on a paper I wrote last semester, I read an article focused on an 11-year-old girl named Rachel who had been referred to an outpatient trauma clinic. She appeared to have clinically significant symptoms of PTSD in response to a rock breaking through her window in the middle of the night that seemed to have triggered flashbacks to a traumatic event that had occurred to Rachel ten years prior, yet Rachel had absolutely no memory of the first event. In the first event, Rachel witnesses the murder of her mother by her father when she was 19 months old. Rachel's father was found dead two weeks later, having had fled the scene of the crime and killed himself. Rachel was adopted by her maternal grandmother two months later. 

Although Rachel first exhibited symptoms that appeared as a result of the events, eventually, according to Rachel's grandmother, Rachel had completely forgotten about the murder incident. However, the authors noted that Rachel's grandmother never spoke of Rachel's mother and father or what had happened to her parents. When Rachel had asked what had happened to her parents, her grandmother told her she had died but then lied saying the death was caused by her mother falling off of a roof. After Rachel pressed her again, her grandmother was unable to answer her. It was not until Rachel entered therapy after the rock incident that she received help in processing the early childhood trauma that manifested itself ten years later.

This leads me back to a statement I wrote in my first blog post: "I do not know what I do not know." We will likely never know the traumatic past of the clients we encounter unless we truly understand the process of development and all of the factors at play for anyone with whom trauma has played a role in their history.

Our oldest son joined our family when he was 9 months old. For the first three months of his life, he was cared for and nurtured by his birth mom and her family. He was placed in the care of a care center in rural Ethiopia when he was three months old. At six months he moved from this care center to another center in the capital city, six hours away from his first home. He encountered new nannies, beds, food, and two different languages before we met him nearly thirteen years ago. When we were first introduced, the nannies told us our son was very quiet and he hardly cried or "made a fuss." We know now that because he was very quiet, he did not get the attention he needed. He was less than a year old. Even with years of nurture, care, and love, we continue to live with the ramifications of this early childhood neglect. Our son is amazingly resilient, brave, and kind, but the "trauma-demons" still like to surface when we least expect it. 

van der Kolk quotes Stoufe: "To fully understand how we become the persons we are--the complex, step-by-step evolution of our orientation, capacities, and behaviors over time--requires more than a list of ingredients, however important any one of them might be. It requires an understanding of the process of development, how all of these factors work together in an ongoing way over time" (p. 168). Unfortunately, most people do not realize the complexity of those we encounter or have the awareness of all that others may be carrying with them into life. And, furthermore, most people do not have the capacity to see their own trauma history within themselves. 

Kaplow, J. B., Saxe, G. N., Putnam, F. W., Pynoos, R. S., & Lieberman, A. F. (2006). The long–term consequences of early childhood trauma: A case study and discussion. Psychiatry: Interpersonal and Biological Processes, 69(4), 362-375.