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Monday, December 18, 2017

Overcoming Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations

In prior articles about developmental trauma, I discussed that it's not unusual for adults, who have  developmental trauma from childhood, to have problems putting words to their feelings and sensations (see my article:  Developmental Trauma: Living in the Present As If It Were the Past and Developmental Trauma: "This is Who I Am" vs "This is What I Do").  In this article, I'm focusing more on this clinical issue.

Overcoming Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations 

For infants to develop neurologically and emotionally, their primary caregiver (usually the mother) must be emotionally attuned to the infant.  Beyond providing basic physical care, the mother must enter into an intersubjective dynamic with the infant where she interacts in an emotionally nurturing way.

Over time, this emotional attunement facilitates the infant's brain development, especially the right side of the brain which is the dominant side of the brain up until the third year of life.

Since the right side of the brain is already activated for infants, they learn quickly using the right side until the age of about 3 when dominance shifts from the right side to the left side of the brain.

The right side of the brain is involved in the processing of social-emotional information, the facilitation of attachment functions, and regulating bodily and emotional states.

If the primary caregiver's provides "good enough" emotional responses to the baby's movements, gestures and sounds, the baby will develop a secure attachment bond to the primary caregiver and, as an adult, will have the capacity to form healthy relationships with other adults.

But if the primary caregiver does not provide these emotional responses to the baby or provides them in an inconsistent or disorganized manner, the baby develops an insecure attachment to the caregiver, which has negative implications later on for adult relationships.

In addition, if the infant is neglected in this way or abused by the caregiver, there are also negative implications for emotional regulation as well as the ability to identify feelings and sensations.

Needless to say, these deficits in the ability to identify feelings and sensations have serious consequences for the adult's inner world as well as the ability to form healthy relationships.

Clients, who start psychotherapy because they're having problems understanding themselves and forming relationships and who often blame themselves for their problems, usually don't make the connection between early neglect or abuse and their current problems, which is why it's so important for psychotherapist's to provide this psychoeducation to them (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works).

Providing these clients with psychoeducation isn't a matter of blaming the mother or the primary caregiver, who often had an early history of abuse or neglect.  It's a first step in helping the clients to understand the origin of their problems.

Also, if they have children, having this psychoeducation helps them to understand the importance of forming a secure attachment bond with their own children so the problems don't continue into the next generation (see my article:  Psychotherapy and Intergenerational Trauma).

Unfortunately, many adults who have problems identifying their feelings and sensations never make it to therapy.  For some people, it's a matter of shame.  They think that, somehow, their problems are their own fault, and their parents might have communicated this to them when they were children.

Other people with developmental trauma don't come to therapy because they're confused about their problems and they think they have to be able to articulate their problems or they can't be helped.  They don't know that most psychotherapists will start at whatever point they find themselves when they begin therapy, and therapists will help clients to  understand these problems as they work towards resolution.

Then again, there are other practical issues involving health insurance and other financial concerns that keep so many people out of therapy in general.

Let's take a look at a fictional vignette, which illustrates the issues that are so common to this problem.

Fictional Vignette: Overcoming Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations

Amy
Amy started psychotherapy when she was in her early 30s because she had problems sustaining romantic relationships (see my article: The Psychotherapy Session: A Unique Intersubjective Experience and The Psychotherapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

Overcoming Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations
Attractive and intelligent, Amy had no problems meeting and dating men that she was interested in.  Typically, her problems began a few months into the relationship when the relationship became more emotionally intimate.

At that point, Amy became unsure of herself.  She usually knew when she was sexually attracted to a man and she enjoyed the sex during the first few weeks of the relationship.  But as the relationship intensified, she felt confused about what she felt for her boyfriend and she no longer enjoyed sex.

This left Amy and whoever she was dating at the time confused and frustrated.  And when these issues didn't clear up, the relationship would fall apart.

After a recent breakup where Amy found herself in this predicament again, she decided that she needed help in therapy.

At first, she was unsure how to describe her family background.  However, over time, it emerged that she was the only child of a single teenage mother, who sent Amy to live with an elderly great aunt shortly after Amy was born.

As an adult, Amy learned from relatives that this great aunt, who suffered with a multitude of medical problems, was barely able to care for Amy.

After the first year, the great aunt sent Amy to live with Amy's mother's sister, a woman who struggled with major depression her whole life and who resented taking care of Amy.

Throughout her childhood Amy was shifted from one relative to the next in different states around the country until she was 10 and her mother was in a better position financially to take care of her.

Since Amy's mother made no effort to maintain a relationship with Amy, Amy described how awkward it was for both of them.

Although her mother provided her with food and shelter, her mother didn't know how to develop a mother-child relationship with Amy because she never had that experience with her own mother.  She treated Amy was if Amy was a small adult with no understanding of what Amy needed from her.

If Amy was upset, her mother, who didn't know how to soothe Amy, would tell her, "If you're upset, it's your own fault."

When Amy was 18, she got a scholarship to an out of state college and jumped at the chance to get away from her mother.  After college, she got a job and moved in with women she knew from college, and she hardly saw her mother after that.

Amy's last relationship ended in much the same way that her other relationships ended.  She and Tom met through friends.  There was a strong attraction between them from the start.  But after a few months, Amy felt confused about whether she still liked Tom or not.

Tom was confused and couldn't understand the change in Amy, and Amy couldn't explain what happened. Soon after that, Tom ended the relationship and Amy felt she was to blame, once again, for a relationship not working out.

Amy's therapist provided Amy with psychoeducation during the initial stage of psychotherapy.  She also explained to Amy that core emotional issues tend to come up as a romantic relationship becomes more emotionally intimate, which would explain why Amy began having problems when her relationships became more intimate.

In addition, Amy's therapist explained how psychotherapy could help Amy.

With regard to Amy's developmental trauma, her therapist explained that, as a result of Amy's childhood history where her caregivers were unable to form an emotional attachment with Amy, Amy experienced emotional neglect (see my article: What is Childhood Emotional Neglect? and How Your Attachment Style Affects Your Relationship).

Her therapist also explained that when she went to live with her mother, Amy experienced emotional abuse because her mother blamed Amy whenever Amy had problems and, due to her own lack of maternal nurturing, her mother didn't know how to nurture Amy.

As a result of these issues, Amy never developed the skills she needed to form intimate adult attachments.  Amy's developmental trauma also had negative implications for Amy being able to identify her feelings and sensations.

Since Amy's psychotherapist used mind-body oriented psychotherapy, like Somatic Experiencing, she was able to help Amy to begin to identify her feelings using her body (see my article: Somatic Experiencing: Tuning Into the Mind-Body Connection).

For instance, Amy learned to recognize that when she felt fearful, which was often, her stomach would clinch.  She also learned that when she felt angry, she felt a tightness in her throat.

Using this mind-body oriented "bottom up" approach, rather than a "top down" approach which is used in cognitive behavioral therapy (CBT), Amy's therapist helped Amy to recognize her feelings and to be able to put words to those feelings.

This work in therapy was neither quick nor easy since Amy was working to overcome early developmental trauma and to develop skills that she never developed early on.

As time went on and Amy got better at connecting to her body to identify feelings and sensations, she and her therapist were able to process her early developmental trauma using EMDR therapy (see my articles: What is EMDR Therapy? and How EMDR Therapy Works: EMDR and the Brain).

Over time, as Amy became more adept at connecting with her emotions, she also developed better relationship skills.  When she entered into a new relationship, she was able to remain connected to herself emotionally and physically as well as being attuned to her boyfriend.

Rather than shutting down emotionally and physically, as she did in the past, Amy was able to remain open in herself and her boyfriend as the relationship became more serious.  Eventually, she and her boyfriend moved in together and they began talking about getting married.

Conclusion
When an infant's needs aren't met because the primary caregiver is unable or unwilling to meet those needs or because there has been multiple and inconsistent caregiving over time, the infant's brain development, in particular the right brain, suffers.

These developmental deficits have negative implications for adult relationships and often result in the individual being unable to identify feelings and sensations.

There is now a greater understanding of developmental trauma due to infant research and the development of trauma-informed therapy.  Within the last 20 years or so, there has also been many advances in psychotherapy to help clients to overcome developmental trauma.

Getting Help in Therapy
A skilled trauma-informed psychotherapist can help clients to overcome developmental trauma.

Trauma treatment modalities, such as Somatic Experiencing and EMDR therapy, help clients to overcome developmental trauma.

Somatic Experiencing and other Somatic psychotherapies help clients to begin to identify their feelings and sensations.

EMDR therapy helps to process traumatic experiences.

If the problems described in this article resonate with you, you owe it to yourself to get help from a trauma-informed psychotherapist (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than continuing to suffer internally and in your interpersonal relationships, you could work with a trauma-informed psychotherapist to overcome your problems.

By resolving your trauma, you free yourself from a history that has been an obstacle to your happiness.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

I have helped many clients to overcome developmental trauma so they could go on to lead happier lives.

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.






















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