Healing From Childhood Trauma: What is the Difference Between Abuse and Emotional Neglect?

I've written about childhood trauma in prior articles, including articles about childhood abuse and neglect.

Childhood Abuse vs Neglect

A common question that clients ask when they are in trauma therapy involves understanding the difference between abuse and neglect, which is the subject of this article (see my article: How Trauma Therapy Can Help You to Overcome Unresolved Trauma).

What is the Difference Between Abuse and Neglect?

The main difference between childhood abuse and neglect is action versus inaction of the caregiver as well as the intent of their behavior. 

• Abuse: Abuse is often an active, intentional, effort to harm, threaten or injure a child. It is an act of commission. Examples include (but are not limited to) physical harm, emotional abuse and sexual abuse. Abuse usually involves intentional, reckless and premeditated behavior.

• Emotional Neglect: Emotional neglect is often passive. It is an act of omission. The caregiver does not provide the necessary basic care (food, shelter, medical care) and emotional nurturance which includes the emotional support, validation, empathy and secure emotional connection for healthy childhood development.

Clinical Vignettes

The following clinical vignettes illustrate the difference between childhood abuse and neglect.  All identifying information has been removed to protect confidentiality.

An Example of Abuse: Sara

When Sara was a young child, her father would often come home drunk and beat Sara and her siblings. He would also hit their mother who felt powerless to stop him from hitting her and the children. By the next day, when the father was sober, he didn't remember hitting his wife and children. But after Sara's maternal uncle moved into the home, he put a stop to the abuse by restraining the father and calling the police. After several incidents where the police were called, the father was court mandated to get into alcohol treatment and the family received mental health services from a local community mental health service.

An Example of Neglect: Tom

When Tom was a young boy, he was emotionally neglected by both of his parents. His mother focused on her design business so that she rarely went to any school activities that Tom participated in. She would frequently place Tom in front of the television while she entertained clients in the house. His father was usually away on business trips and, when he was at home, he spent most of his time in his den watching sports while Tom was alone in his room. When a young family moved next door, the mother would invite Tom to come over to play with her children. She was also kind and compassionate with Tom because she realized he was a lonely boy.

The Trauma of Childhood Abuse and Neglect

Both abuse and emotional neglect are traumatic.

There are times when emotional neglect can be more damaging than abuse because:

• Emotional Neglect is Often Invisible: Emotional neglect can be hard to identify because it's often invisible. Neglect is characterized by what didn't happen (lack of love, attention or validation) as opposed to certain forms of abuse that can be detected based on marks or scars on a child's body that are noticeable.

Childhood Abuse vs Neglect

• Children Internalize Neglect: Whereas children who are abused might blame the abuser, children  who are emotionally neglected often blame themselves. These children believe they are flawed in some way and, as a result, they were unlovable (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

• Brain Development: Many children who are severely and chronically neglected can experience cognitive and language deficits.

What Are the Long Term Effects of Childhood Abuse and Neglect?

Both abuse and neglect can have a long lasting potential psychological effects including:

• Mental Health: Anxiety, depression and post-traumatic stress disorder (PTSD)

• Relationship Problems: Problems with trust, fear of intimacy or self abandonment in relationships (see my article: What is Self Abandonment?)

• Problems with Emotions: Difficulty identifying, managing and expressing emotions 

Conclusion

Although both abuse and neglect can have long lasting effects, studies have shown that neglect is often particularly damaging especially when the neglect is unseen, ignored or overlooked.

Although I have discussed abuse and neglect separately to distinguish one from the other, there can also be a combination of abuse and neglect.

Many adults believe their experience wasn't bad enough to get help.  However, the trauma of abuse and neglect usually require the therapeutic interventions of trauma therapy.

Getting Help in Trauma Therapy

Trauma therapy includes a group of therapies that were specifically developed to help clients to overcome the traumatic effects of their history (see my article: Why is Experiential Therapy More Effective at Resolving Trauma Than Talk Therapy?).

Getting Help in Trauma Therapy

Trauma therapy includes:

• EMDR Therapy (Eye Movement Desensitization and Reprocessing)

• Somatic Experiencing

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

• Parts Work (IFS and Ego States Therapy)

Rather than struggling on your own, seek help from a licensed mental health professional who is trained as a trauma therapist.

Working through unresolved trauma can help you to free yourself from your history so you can live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Certified Sex Therapist.

As a trauma therapist, I have over 25 years of experience helping individual adults and couples.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.