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Tuesday, December 5, 2017

Developmental Trauma: "This is Who I Am" vs "This is What I Do"

Developmental trauma occurs over time starting in childhood (as compared to shock trauma, which is usually an event).  Developmental trauma can occur when young children learn who they are from their parents, who might value certain aspects of the child and not others.  According to Philip Bromberg in his book, Awakening the Dreamer: Clinical Journeys, the aspects of the child that are not validated by the parents, become dissociated "not me" parts of the self and the parts that are valued become, "This is who I am."

Developmental Trauma: "This is Who I Am" vs "This is What I Do"

According to Bromberg, one of the reasons that developmental trauma is significant is that it shapes the child's core self through the attachment patterns that the child develops with the primary caregiver.

In order for the child to maintain a sense of core self as s/he matures, s/he has to preserve the early attachment patterns with the primary caregiver, which includes the aspects of self that were validated to the exclusion of the aspects that weren't.  This pattern continues as the child becomes an adult and  forms new relationships with significant others later in life.

When adults, who have a history of developmental trauma, come to therapy, they often have no awareness of the aspects of themselves that are dissociated due to the early invalidation in their attachment pattern with the primary caregiver.

When they were children, not only did they have to do what the primary caregiver needed them to do, they also had to be who the caregiver needed them to be with regard to the aspects that the caregiver validated.

To help these individuals to become more self reflective and aware that they're continuing to be who their primary caretaker needed them to be and that aspects of themselves have been sacrificed, the therapist helps these clients to see themselves within the enactments in therapy (for more about enactments, see my articles: Mutual Enactments Between the Psychotherapist and the Client in Psychotherapy and Why Your Psychotherapist Can't Be Your Best Friend).

With the increased awareness that develops in psychotherapy, these clients can learn to distinguish "This is who I am" from "This is what I do."

Being able to make this distinction is crucial for these clients to be able to make the changes in themselves that they're hoping to make.

The following fictional clinical vignette illustrates these concepts:

Fictional Vignette:  Developmental Trauma: "This is Who I Am" vs "This is What I Do:"

Ted
Ted came to therapy because he was having problems in his relationship with his wife.

Initially, Ted told his therapist that his issues as communication problems with his wife.  He said they frequently argued about money, and his wife saw him as a tightwad.  Although he acknowledged that he could be overly thrifty at times and he wanted to salvage his marriage, he saw his thriftiness as, "This is who I am" and he saw no way to change it.

Developmental Trauma: "This is Who I Am" vs "This is What I Do"
It became apparent, as the therapist listened to his early history, that Ted's mother was also thrifty and she encouraged Ted to do everything he could to save his money.  He told the therapist that his mother praised him for being parsimonious and told him, "You're just like me," which pleased Ted very much as a child.

He also told his therapist a story about how he bought flowers for his third grade teacher with birthday money that he saved.  He loved his teacher and he was thrilled to see how happy she was when he gave her the flowers.

But when he got home and told his mother about it, she scolded him for "wasting" his money.  She told him, "Saving your money is important."

Ted told many similar childhood stories where he was initially elated to give a gift to someone and then he felt ashamed when his mother scolded him and refused to talk to him for the rest of the day when she found out that he used his money to give a gift to someone.

Ted learned early on that if he wanted to remain in his mother's good graces, he would have to conform to her way of thinking.

As an adult, Ted felt he learned a valuable lesson from his mother when he was a child.  But now his wife was complaining because he had such a hard time spending money even when it came to giving birthday gifts to his wife.

Although Ted understood somewhat why his wife was upset, he told his therapist, "My wife wants to change me, but she just doesn't understand that this is who I am."

He was concerned because his wife's birthday was coming up and he was sure that she wanted a gift from him.  He wanted to "keep the peace," so he planned to get her a gift, but he felt he was going against a basic part of himself in order to do it.

His therapist suggested that Ted buy his wife a gift and they could talk about how he felt afterwards.

A week after Ted gave his wife the gift, he came to his therapy session looking upset.  He told his therapist that, even though it was against his basic sense of self, he bought his wife something that she had been hinting about, a makeup mirror in the shape of a shell.  She was so happy that she threw her arms around Ted and kissed him, but Ted felt miserable for going against his sense of self.

Ted's therapist explored Ted's feelings about giving his wife this gift that she really wanted, and Ted told his therapist that he felt he disappointed his mother--even though his mother had been dead for more than 10 years, "My mother would have been angry with me if she was still alive and, even though she's been gone for several years, I feel like I let her down."

Ted's therapist tried to help Ted to remember how he felt as a child when he gave his teacher the flowers and he saw how happy she was.  Ted remembered that he felt happy, but he couldn't separate out this part of the memory from how unhappy his mother was afterwards.

He recalled other childhood memories when he wanted a certain toy or picture book, and his mother discouraged him from having them.  She told him that it would be a waste of money.  After a while, Ted stopped allowing himself from even wanting these things.

Looking back on those memories, Ted knew that his family was upper middle class, so his mother could well afford to buy him these things, so he wondered why his mother discouraged him from wanting toys or books, "At first, it made me feel sad, but then I learned to do without them and not want them any more."

His therapist noted to herself that this was the first time that Ted reflected on his mother's dynamics and how it affected him.

Gradually, over time, Ted became more self reflective and he began to make the distinction between who he is as a person and his behavior.  He realized that, when he was a child, he was too afraid to go against his mother's wishes because she would ignore him when she was displeased.

Resolving Developmental Trauma in Therapy: "This is What I Do and I Can Change."
More importantly, Ted realized in therapy that he was still trying to hold onto his mother's love by behaving the way she wanted him to behave.  It was his way of holding onto her even though she was gone.

As his therapy progressed, Ted realized that he no longer had to behave in a way that would honor the memory of his mother.  And, as he came to terms with this, other aspects of himself that were invalidated by his mother, came alive.

Not only was he more generous with his wife, but he also allowed himself to want and have things again, which was liberating for him.

Conclusion
When aspects of children are invalidated by their primary caregiver, children learn to disavow these aspects.  This is part of developmental trauma.

On an unconscious level, children dissociate these aspects in order to maintain the attachment with the caregiver, which is essential to children's sense of well-being.

This disavowal comes at a great cost to children as they grow up unconsciously dissociating parts of themselves to maintain the attachment.

Children who learn to maintain only the aspects of themselves that are validated by their caregiver and disavow the aspects that are invalidated continue this pattern as adults and believe, "This is who I am."  This makes change difficult for them because they believe that their behavior is intrinsic to who they are.

Developing the necessary self awareness to realize that who they think they are is really not an intrinsic part of themselves and it's really their behavior is usually a gradual process in therapy.

Being able to separate out "who I am" from "what I do" can be a freeing experience because it allows the true self to emerge (see my article:  Becoming Your True Self).

Getting Help in Therapy
If you're having problems changing because you believe that your problematic behavior is part of who you are, you could benefit from seeking help from a licensed psychotherapist (see my article: The Benefits of Psychotherapy).

Self awareness is the first step in making changes

Developing the necessary awareness and insight into ingrained problems is often a gradual process, and a skilled mental health professional can help you in your journey (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples (see my article: The Benefits of Integrative Psychotherapy).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

See my other articles about Psychotherapy.



























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