What is Toxic Stress?

Stress is a common response to daily experiences in life--both positive and negative.  It can be beneficial when it motivates you to make positive changes in your life.  

What is Toxic Stress?

However, when stress is chronic and overwhelming and you don't have internal resources or emotional support to deal with stress, it can become toxic stress (see my article: Responding Instead of Reacting to Stress).

This article will focus on the connection between toxic and trauma as it begins in early childhood and continues into adulthood (see my article: Stress Management: Taking Time For Self Care).

What Are the Different Types of Stress?

• Positive Stress: Positive stress is also known as eustress. Positive stress responses are normal responses to infrequent, short lived and mild stressful experiences. During childhood, if a child is given emotional support to deal with positive stress, the child develops motivation and resilience.  Over time, as a child develops skills to deal with positive stressors, the child also develops self confidence.  Examples of positive stress for children include:

• Meeting new people
• Learning a new task
• Learning a new game or hobby

• Tolerable Stress: Tolerable stress is more frequent, sustained and severe.  Tolerable stress has more of an impact on the mind and body as compared to positive stress. With emotional support, once the tolerable stress is removed, a child's mind and body usually return to their normal level of functioning.  Examples of tolerable stress for children include:

• Parental divorce
• Death of a loved one

• Toxic Stress: Toxic stress often begins in childhood where prolonged exposure to stress has a damaging effect on a child's mind and body. When children are exposed to unrelenting stress without emotional support, the mind and body are often unable to recover. Toxic stress is related to adverse childhood experiences (see below) also known as ACEs. Examples of toxic stress include:

• Abuse
• Emotional neglect
  
• Poverty
• Food scarcity
• Poor health
• Violence
• family dysfunction including, but not limited to, caregivers with substance abuse or mental health conditions

What Are Adverse Childhood Experiences (ACEs)?

Adverse childhood experiences (ACEs) are potentially traumatic events, as mentioned above, that occur in childhood (ages 0-17 years) that can result in toxic stress.

Toxic stress related to ACEs can result in health and mental health problems especially if these experiences are unmitigated by emotional support from loved ones.

How Common Are Adverse Childhood Experiences (ACEs)?

Unfortunately, ACEs are common.

Adverse Childhood Experiences and Toxic Stress

Approximately 64% of adults reported they had at least one experience with ACEs and about 17.3% of adults reported having four or more experiences as children with ACEs. 

All children are potentially at risk for ACEs, but ACEs are more likely to occur with girls, racial minorities and in families where adults are unemployed or unable to work.

What is the Effect of ACEs and Toxic Stress?

Without emotional support ACEs and toxic stress can result in one or more of the following problems:

• Permanent damaging effects to brain architecture

• Epigenetic change alteration (modifications to DNA which determine whether genes are turned on or off)

• Long term health consequences, including

• Immune dysregulation
• Persistent inflammatory state and health conditions related to inflammation
• Increased risk for cancer and heart disease
• Other chronic health problems

• Long term mental health consequences, including:

• Anxiety
  
• Depression
• Emotional dysregulation
• Other mental health problems

How Do ACEs and Toxic Stress Effect Adults?

Adults who grew up exposed to ACEs without emotional support are more likely to get into unhealthy relationships.

Toxic Stress and Adult Relationship Problems

Without emotional and mental health support, this can have a traumatic intergenerational traumatic impact where one generation after the next form unstable relationships.

Adults who experienced ACEs as children have an increased risk for having an unstable work history, financial problems, debt and other related problems.

How to Reduce the Risk of ACEs and Toxic Stress

Adverse childhood experiences (ACEs) are preventable.  

The Centers for Disease Control and Prevention (CDC) is the national public health agency for the U.S.  It is a federal agency under the Health and Human Services Department.

The CDC recommends the following steps to prevent ACEs:

• Strengthening family financial security
• Implementing family-friendly work policies
• Promoting public education campaigns to educate people about ACEs
• Promoting legislative approaches to reduce corporal punishment
• Promoting bystander approaches
• Promoting men and boys as allies in prevention
• Implementing early childhood programs to ensure a strong start for children
• Implementing high quality child care
• Promoting preschool enrichment with family involvement
• Teaching social-emotional learning
• Teaching safe dating and relationship skills
• Teaching parenting and healthy family relationship skills
• Developing mentor programs
• Developing after school programs
• Developing enhanced primary care
• Developing victim-centered services
• Developing treatment approaches to reduce the harm of ACEs
• Developing treatment to prevent problem behavior and future involvement in violence
• Developing family-centered treatment for substance abuse

Getting Help in Therapy

As an adult, if you have been impacted by toxic stress, you could benefit from seeking help in therapy.

Getting Help in Therapy

Working with a skilled psychotherapist, who has an expertise with toxic stress and trauma, can help you to overcome the damaging effects of toxic stress.

Rather than struggling on your own, seek help from a qualified mental health professional.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

As a trauma therapist, I have helped many individual adults and couples overcome the impact of toxic stress and trauma.

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.

    

Developmental Trauma: Living in the Present As If It Were the Past

My prior articles about psychological trauma discussed how unresolved childhood trauma, also known as developmental trauma, affects traumatized individuals as adults (see my article: Overcoming Trauma: When the Past is in the Present).  In this article, I'm focusing specifically on how developmental trauma often affects clients' relationship with their psychotherapist, especially during the early stage of psychotherapy.

Developmental Trauma: Living in the Present As If It Were the Past

In his paper, Developmental Trauma Disorder, trauma expert Bessel van der Kolk, MD indicated that developmental trauma, which includes abuse and neglect, is probably this country's biggest public health challenge.

He estimated that approximately 3,000,000 children are reported as being abused or neglected per year--and these are only the cases that are reported.  Many cases go unreported, so that number is probably much higher.

According to Dr. van der Kolk, approximately 80% of these cases are the result of abuse and neglect by the children's own parents.  As a result, developmental trauma is a significant problem in this country, and much remains to be done.

Since untreated trauma does not simply go away when children become adults, it's important to understand the impact of trauma (see my article: Untreated Trauma is a Serious Issue With Negative Consequences).

What is Developmental Trauma?
Before going into more clinical material, let's define "developmental trauma."

Developmental trauma occurs in childhood. It causes overwhelming stress for the child, especially when the stress is not alleviated by the parents.  This includes:

• physical abuse
• emotional abuse
• sexual abuse
• physical neglect
• emotional neglect

The dysfunction in the home can include, among other things:

• mental illness
• substance abuse
• domestic violence
• an incarcerated relative
• divorce

Developmental trauma is also called Adverse Childhood Experiences (ACE) and has serious long term health and mental health implications (see ACE Childhood Study).

Since adults, who experienced Adverse Childhood Experiences, were unable to trust their parents, who were supposed to love and protect them as children, it makes sense that they often have problems trusting people in their adult relationships, including their psychotherapist (see my article: Adults Who Were Neglected or Abused as Children Often Have Problems With Trust).

What Are the Clinical Implications in Therapy For Adults With Developmental Trauma?
For adults, who experienced developmental trauma as children, it takes a lot of courage to come to therapy to be emotionally vulnerable enough to work through their trauma (see my article: Starting Therapy to Overcome Untreated Trauma and Developing the Courage to Change).

It's not surprising that these adults often come to therapy with a great deal of ambivalence and mistrust (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious or Ambivalent).

Since most trauma-informed psychotherapists recognize these dynamics, they are aware of the importance of trying to establish a trusting relationship with these clients.

It's not unusual for these individuals to go from one psychotherapist to the next as soon as they feel emotionally vulnerable in therapy--especially since they often come to therapy unconsciously anticipating that the therapist will fail them in the same way that their parents failed them.

Their unconscious anticipatory fear that the psychotherapist will fail them in much the same way that their parents failed them usually indicates that they are living in the present as if it were the past.

The following fictional clinical vignette, which represents a common scenario for adults with developmental trauma, illustrates these points:

Fictional Clinical Vignette: Living in the Present As If It Were the Past
Nina

Nina, who was in her mid-30s, began therapy after her relationship with John ended six months after they started dating.

John ended the relationship because of Nina's jealous accusations.  John vehemently denied that he was cheating, but Nina didn't believe him.

Developmental Trauma: Living in the Present As If It Were the Past

Although they got along well during their first three months together, Nina began to suspect that John was cheating after their relationship became more emotionally intimate in their fourth month together.

Even though she saw no direct signs of John's infidelity, her suspicions alone were enough for her to assume that he was cheating, and she was relentless in her accusations.

When she came for her first session with her therapist, Nina expressed regret that she had destroyed her relationship with John with no objective evidence that he was cheating.  In hindsight, she understood her mistake and why John got fed up.

She also explained to her therapist that this was her pattern in relationships--she always assumed that her boyfriend at the time was cheating, even when there were no objective signs of infidelity.

When she came to therapy the following week for her second session, Nina had a completely different take on why her relationship with John ended.

She told her therapist, "All men cheat and since all men cheat, I know that John was cheating on me.  He ended the relationship because I called him on it and he didn't like it."

When her therapist attempted to explore Nina's feelings about the relationship in the current therapy session versus what Nina said in the first session, Nina acknowledged that she had initially said that  she had made a mistake with John.  But she maintained that she was wrong in her first session and what she felt today was the truth, "Men can't be trusted."

Her therapist realized that, although Nina did a 180 degree turnaround from her first therapy session to her second session a week later, she knew that Nina did not meet the clinical criteria for multiple personality disorder or, as it is now called, Dissociative Identity Disorder (DID).

She recognized Nina's turnaround as a matter of shifting self states, which is a dissociative process, but not as dissociative as DID (see my article: How Shifting Self States Can Affect You For Better or Worse).

And, while everyone has shifting self states to some degree, people who are not traumatized usually have barely perceptible shifts as compared to people with unresolved trauma.

So the fact that Nina had a completely different view about the demise of her relationship when she returned to therapy on the second week was understandable considering her history of childhood trauma.

When Nina talked about her childhood, she vacillated between idealizing and denigrating her mother.

When she idealized her mother, Nina thought that her mother could do no wrong.  But when she denigrated her mother, she blamed her mother for not leaving the father, who had a long history of cheating on the mother.  Once again, her therapist understood these shifts as being part of Nina's shifting self states which were emotionally unintegrated.

Nina also had a long history of aborting therapy.  She explained to her current therapist that she had seen 10 therapists in the last two years, and she left each one when she felt that she couldn't trust the therapist (see my article: When Clients Leave Psychotherapy Prematurely).

Based on what Nina told her, her current therapist could see that Nina's pattern was that she left therapy as soon as the therapeutic work intensified and she felt too vulnerable.  Before that, Nina tended to idealize her therapists.  But once the work progressed and came close to her core traumatic issues, Nina became fearful, she developed a mistrust for the therapist and left therapy abruptly.

Forewarned of Nina's pattern in therapy, her therapist knew that there was a real possibility that Nina might abort the current therapy--even if it seemed like she developed a trusting relationship with the therapist before they processed Nina's traumatic experiences.

During most of her therapy sessions, Nina made it clear to her therapist that she understood that her traumatic childhood, including her father's infidelity, impacted her ability to have lasting relationships with men.

Most of the time, she expressed regret for her mistrust and wanted to "...hurry up and get over my trauma, since I'm not getting any younger and I'd like to get married and have children."

Nina sought therapy with her current therapist because the therapist specialized in working with trauma using EMDR Therapy.  Nina wanted to try EMDR therapy because she heard that it tends to work faster than regular talk therapy.

On the days when Nina acknowledged how her childhood history affected her adult relationships, she was in a hurry to get relief from her traumatic symptoms.

But on the days when she came to therapy blaming "all men for being dogs," she disavowed any connection between her childhood history and the demise of her relationships.  Once again, her shifting perspective was due to her shifting self states.

As part of the therapeutic process, Nina's therapist was the "container" for these different self states (see my article: The Holding Environment in Psychotherapy).

She knew that, even when Nina was in a hurry to process her childhood trauma, Nina wasn't ready.  Nina needed to develop internal resources and a greater sense of emotional integration before she would be ready to process her childhood trauma--otherwise, she would be flooded with anxiety and completely overwhelmed by the trauma therapy.

Her therapist also helped Nina to recognize her different self states by doing Ego States therapy (also known as Parts Work therapy) with Nina.  In this type of therapy, the therapist helps the client to get to know each of her shifting self states in order to foster greater emotional integration.

Nina understood most of the time that the internal resourcing and the Ego States therapy was preparation to eventually process her traumatic memories.  But there were times when she came to therapy feeling angry with her therapist for "dragging out the process and not helping me to get over my trauma."

During those times, Nina was ambivalent about her therapist and about the therapy.  Nina feared that she was being "duped" by the therapist and that she shouldn't trust the therapist.  She threatened to leave therapy and accused her therapist of being "no better than all the other therapists that I've had before."

But Nina and her therapist weathered these storms and, most of the time, Nina was able to see that her doubts and mistrust were the result of a particular self state that got triggered when she became anxious about the therapy (see my article: Coping With Trauma: Becoming Aware of Your Emotional Triggers and Expanding Your Window of Tolerance in Therapy).

She could see that what she was experiencing was the result of her traumatic past which she was living out in the present with her therapist.

Along the way, there was enactments in therapy, as there often are with clients who have been traumatized:  There were several sessions in a row where Nina "forgot" to bring a check to pay her therapist, she "forgot" to come to her sessions, and she was annoyed when her therapist held her accountable for her broken appointments.

All of these enactments were unconscious on Nina's part and were part of her dissociative shifting self states.

Most of the time, her therapist did not get caught up in these enactments but, being human, there was one time when she found herself right in the middle of an enactment with Nina: Nina's therapist had to take a couple of weeks off for a medical procedure.  She made a conscious decision not to disclose her medical problem, which was not serious, to Nina because she assessed that Nina was not ready emotionally to handle this disclosure.  She also wanted to preserve her right to privacy by not disclosing her medical problem.

When her therapist told Nina that she had to take a couple of weeks off, Nina exploded.  She was angry because she felt she was being abandoned by her therapist and with only a couple of weeks notice (see my article: Abandonment Issues Can Get Triggered While Your Therapist is Away).

Nina's therapist had little notice from her doctor that she needed this medical procedure, which could not wait, so she couldn't provide Nina with more notice.  But her therapist didn't want to reveal this to Nina because, as previously mentioned, she thought Nina was too emotionally fragile at that point.

Her therapist did the best she could under the circumstances to contain Nina's upset as well as her own feelings of being misunderstood.  But, after two sessions where Nina ranted about the two week break, her therapist told Nina in an angry tone that she would have a backup therapist that could consult during that two week break.

Even though her therapist got caught up in a mutual enactment by talking to Nina in an angry tone, something shifted for Nina where she stopped ranting and realized that she was being unreasonable (see my article: Mutual Enactments in Psychotherapy Between Client and Psychotherapist).

They were able to talk about what had just happened between them, and Nina expressed that, while she didn't like that her therapist spoke to her in an angry tone, she could feel the genuine nature of her therapist's upset and this caused her to "wake up" and see her therapist as a "normal human being" with her own experiences and feelings.  This was a major breakthrough for Nina.

As I mentioned in an earlier article about enactments, there are times when mutual enactments can have a positive effect on the therapy if the therapist is able to repair the rupture between the therapist and client and they come to a new understanding of their therapeutic relationship (see my article: Ruptures and Repairs in Psychotherapy).

Of course, although these enactments can be repaired and advance the therapeutic work, a therapist should never plan an enactment.

Gradually, over time, Nina became much more perceptive of when she was going through a self state shift.  She had developed a much more observing sense of self so that she could step back, even when she was in a mistrustful state, and see, "It's happening again," which made it easier for her to be more objective and shift into a more emotionally balanced state.

Developmental Trauma: Living in the Present As If It Were the Past

As Nina became more emotionally integrated with fewer dramatic self state shifts, she was now ready to process her earlier traumatic experiences using EMDR therapy.

By processing her childhood trauma in therapy, eventually, Nina freed herself from her traumatic history so that she was no longer living in the present as if she were in the past.

Conclusion
Reenacting unresolved childhood trauma is an unconscious process.

These reenactments occur in personal relationships, work relationships, and in the client's relationship with his or her psychotherapist.

There are times when traumatized clients are able to get a glimpse into these reenactments in therapy but, due to the nature of their shifting self states, this new understanding can be tenuous and change back and forth over time until the client becomes more emotionally integrated as a result of the work in therapy.

A skilled trauma-informed psychotherapist understands that clients often go back and forth in their understanding of their problems because the shifting self states are unconscious.

Developing a trusting relationship with a traumatized client is of the utmost importance before any processing of trauma occurs.

The therapist must also help the client to develop the necessary internal resources and coping skills before processing trauma.

Each client is unique as to when he or she feels safe enough in therapy and prepared to do the therapeutic work.

When a client has worked through developmental trauma, s/he is free to live life without constantly reenacting the past.

Getting Help in Therapy
Making the decision to start therapy is an important step which most people don't take lightly, especially people with a history of trauma (see my article: The Benefits of Psychotherapy).

People with developmental trauma often come to therapy after they have had a series of major disappointments or setbacks in their life.

It takes courage to face a painful history of trauma, and most trauma-informed psychotherapists are aware of this and the clinical implications for the client (see my article: How to Choose a Psychotherapist).

If you think you might be living in the present as if it were the past, you owe it to yourself to get help from a licensed trauma-informed mental health professional.

Although the therapeutic work isn't quick or easy, once you have worked through the trauma, you can live a more fulfilling life without the burden of your past.

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 Therapeutic Benefits of Integrative Psychotherapy).

I have helped many clients to overcome trauma so they could go on to live a more fulfilling life.

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 or email me.

How One Person Can Make a Difference in a Traumatized Child's Life

One person can make a difference in an emotionally traumatized child's life (see my article: Overcoming Emotional Trauma and Developing Resilience).  More about this later in this article.

How Even One Person Can Make a Difference in a Traumatized Child's Life

First some background:

The ACE Study
A landmark study that was conducted in 1998, called the CDC-Kaiser Permanente Adverse Childhood Experience (ACE) Study found that the more types of emotional trauma a person experienced, the more likely it is that they  will develop social, behavioral, and emotional problems and the adult onset of chronic medical problems.

These adverse childhood experiences (ACEs) include:

• direct emotional, physical and sexual abuse
• a mother being treated violently
• a family member with substance abuse or mental illness
• parental separation and divorce
• a house member incarcerated
• emotional and physical neglect

Some specialists also include experiencing racism or witnessing violence, which I believe are also very important categories.

At around the same time that of the ACE study, Harvard researchers and pediatricians were conducting research on toxic stress.

They discovered that repeated and continuous exposure of toxic stress can have a negative impact on a child's brain development.  Their findings led them to question whether childhood trauma could be prevented or it's impact could be reduced.

How One Person Can Make a Difference in a Traumatized Child's Life

As a psychotherapist, who specializes in helping clients to overcome emotional trauma, I've worked with many clients who have experienced both shock trauma and developmental trauma.

I have found that it is often the case that, even where there was emotional, physical and sexual abuse or neglect, adults, who experienced trauma as children, can often name at least one person in their childhood who made a difference in their life.

How One Person Can Make a Difference in a Traumatized Child's Life

These often include relatives outside the immediate family, teachers, guidance counselors, coaches, family friends, therapists and others who provided emotional support that helped to mitigate the emotional trauma they were experiencing as children.

Even when clients come to therapy and they can't immediately think of someone in their life who made a difference, over time, while working in therapy, they often remember people that they haven't thought of in a long time and realize how important those people were to their emotional survival.

The following is a fictionalized vignette, which is a composite based on many different cases with no identifying information, illustrates these points:

Mike
Mike came to therapy after many years of experiencing very little joy in his life.

How One Person Can Make a Difference in a Traumatized Child's Life

He was married and gainfully employed, and he was able to function in his daily life.  But he always felt "there's something missing."  Mike felt an emptiness in his internal world.

When his therapist explored his family history, it became evident that, as an only child with emotionally distant parents, he was lonely and emotionally neglected (see my article: Looking at Your Childhood Trauma History From an Adult Perspective and Overcoming the Trauma of Parental Alienation).

How One Person Can Make a Difference in a Traumatized Child's Life

His parents, who were both focused on their professional careers, didn't plan to have children.

At a young age, Mike learned from his parents that he was "a mistake" (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).  Even though his parents joked about this, Mike felt emotionally wounded by it and he sensed the truth behind their jokes:  They didn't want him.

Mike was often left in the care of a full time nanny, who was efficient, but cold and emotionally withholding (see my article: What is Childhood Emotional Neglect?)

As he explored his feelings about himself, he realized that he felt like an unlovable person (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

Mike's therapist prepared Mike to do EMDR Therapy to help Mike overcome the trauma he experienced as a child which resulted in his feeling unlovable (see my article: How Does EMDR Therapy Work?).

As part of EMDR therapy preparation, EMDR therapists often ask clients to remember people in their lives, either past or present, who were nurturing, protective or wise figures in their life (see my article: Developing Coping Strategies and Resources Before Beginning Trauma Processing in Therapy).

When his therapist asked Mike about people in his life who were emotionally supportive of him when he was growing up, Mike couldn't think of anyone from the past or present.  Not even his wife--they were together, but they were emotionally estranged.

How Even One Person Can Make a Difference in a Traumatized Person's Life

As mentioned earlier, his parents were cold and withholding, and Mike had no siblings.  He and his parents also had very little contact with extended family, so there were no relatives that Mike could think of from his childhood who were nurturing.

During the preparation phase of EMDR, clients can identify any emotionally supportive people--whether they are "real" (people that they've known) or people they don't know but whom they imagine are nurturing, including people from a movie or TV programs, historical figure, characters from a book, and so on.

The important aspect of this part of the work is for clients to be able to have internal access to an emotionally supportive figure that they can imagine while they're doing the trauma work.  This helps them to sense emotional support, especially during the therapy work.  This, of course, would be in addition to the emotional support from the therapist.

When there has been emotional neglect or abuse, clients often have a hard time coming up with anyone from their life or someone imagined.

There can be such a pervasive feeling of being "unlovable" that, even when there actually were people who were supportive, these clients often don't have immediate access to those memories because they feel so unlovable and undeserving of love and nurturance.

After thinking about it for a while, Mike couldn't think of anyone from his life, so he chose a person from a program that he used to watch as a child, Mister Rogers of Mister Rogers' Neighborhood.

Initially, Mike said he felt "silly" imagining Mister Rogers being there with him, but he understood the importance of re-experiencing his traumatic memories while sensing the presence of a nurturing figure, so he imagined Mister Rogers sitting next to him.

At first, it felt contrived to Mike, but as he continued to do it, he was surprised that he could actually feel the love and support of this kind person that he used to watch on TV.

As an emblematic memory of his feeling unlovable, the memory that Mike chose to work on was being told by his mother that he was "a mistake."

Even as he recalled his mother's words and how she laughed, as if she were making a joke, Mike felt profound waves of sadness and shame.

But, when the sadness and shame felt overwhelming, he was able to temporarily shift his attention away from the memory to imagining the emotional comfort of Mister Rogers.   At that point, he really understood the importance of the EMDR preparation work and using nurturing figures.

Several weeks into processing this memory, Mike suddenly remembered Mr. Blake, who had been like a Mister Rogers to him when he was a child.

Remembering Mr. Blake was part of the memory reconsolidating aspect of EMDR therapy. It helped Mike to access these positive memories about Mr. Blake.

How One Person, Like Mr. Blake, Can Make a Difference in a Traumatized Child's Life

Once he remembered Mr. Blake, Mike was surprised that he didn't think of Mr. Blake before when he and his therapist were working on the EMDR preparation phase.

Then, Mike remembered many of his talks with Mr. Blake and, for the first time in his life, Mike became fully aware of the positive effect that Mr. Blake had on his life.  It was like an epiphany to Mike.

Mike remembered that he did well in school, but he was very quiet and kept to himself.

He also remembered that the school bullies would pick on him, taunting and harassing him all the way home from school because they sensed his vulnerability.

One day, as Mike was leaving school, the same bullies followed him and began calling him names.

Just as one of the bullies started tugging on Mike's jacket, their teacher, Mr. Blake, who was nearby, confronted the bullies, reprimanded them and threatened them with disciplinary action if they ever bothered Mike again.  This frightened the bullies and they ran off.

Mr. Blake took Mike aside and told him that he could come to him at any time if the bullies bothered him again or if he needed to talk about anything else.  Mike was grateful, but he was too shy to say anything except "Thank you" in a near whisper.

During the next few years, Mr. Blake would often talk to Mike after school to find out how Mike was doing, even after Mike was no longer in his class.

Unlike his parents, Mr. Blake was kind and empathetic and took an interest in what Mike had to say, and  Mike began opening up more to him to tell him about his interests.  Mr. Blake listened and praised Mike and encouraged him to pursue his interests.

When Mike was in high school, he would sometimes drop by his old school to talk to Mr. Blake.  During those visits, Mr. Blake encouraged Mike to go to college, even though Mike was filled with self doubt about applying to college.

Based on Mike's hard work in high school and Mr. Blake's encouragement, Mike got into the college of his choice.  Mike maintained contact with Mr. Blake for a while, but the demands of college soon overtook Mike's time and they lost contact.

By the time Mike came to therapy many years later, he had initially forgotten about Mr. Blake but, as previously mentioned, EMDR therapy helped him to access these memories, even though he wasn't consciously aware of them.

When he was younger, he didn't really understand the difference Mr. Blake made for him.  But now that he was accessing these memories about Mr. Blake, Mike was able to look back at those times and realize how pivotal his interactions with Mr. Blake were in his life.

Mike talked to his therapist about how, without Mr. Blake, he probably wouldn't have developed some of his interests and he wouldn't have gone to college.  He knew his life would have been very different without this mentoring and guidance.

As Mike talked about this, he realized that Mr. Blake really cared about him, and Mike was emotionally moved by this.  He couldn't believe that he went through his life feeling that no one really cared about him when Mr. Blake took the time to talk to him and obviously cared.

From then on, Mike used his memory of Mr. Blake as a nurturing figure to continue to do the trauma work.

As he continued to do the work, Mike suddenly remembered other people, who were kind and nurturing to him in small ways but, until then, Mike had forgotten all about them.

Mike also realized that, despite the emotional neglect that he experienced as a child, he was also a resilient person and he overcame many obstacles in his life from childhood through adulthood.  This really helped Mike to feel good about himself.

Working Through Early Childhood Trauma as an Adult 

Over time, Mike was able to overcome his feelings of being unlovable and, as he did, he opened up more to his wife.  He discovered that, until then, his wife experienced him as emotionally detached and didn't know how to approach him.  She assumed that he didn't love her anymore.

She didn't realize what an emotional rut he had been in for such a long time until he processed his childhood trauma and began coming out of his rut. As Mike felt more alive, he was able to rekindle his relationship with her.

Conclusion
Even in situations where children are abused or neglected, one person's can make a positive difference in a child's life by being emotionally attuned and caring.

At the time, children might have little to no understanding of the impact that this person is making in their life.  But later on in life, when they look back, especially if they're in therapy, they often become aware of how important this person was to them for their emotional survival and well-being.

As time goes by, it's not unusual for some people to forget about these pivotal people in their lives, especially if there is significant emotional trauma.

EMDR therapy and other forms of experiential therapy, like Somatic Experiencing and clinical hypnosis often help clients to have access to these memories, which can have a profound healing effect (see my article: Experiential Therapy, Like EMDR, Can Achieve Emotional Breakthroughs).

Getting Help in Therapy
As discovered in the ACE study and many years before that, going back to the time of Freud and the early days of psychoanalysis, childhood emotional neglect and abuse can have an adverse impact on adults' emotional and physical well-being with the adult often developing chronic physical ailments.

These detrimental effects usually carry over into adulthood.  But many adults, who feel anxious, depressed, emotionally numb or who have chronic ailments don't realize that what they're feeling is the result of their earlier childhood experiences.

They also don't realize that they can be helped in therapy to overcome these problems.

If you're feeling unhappy with yourself and your life, you're not alone.

You can be helped to overcome your problems with the help of a skilled mental health professional (see my article: How to Choose a Psychotherapist).

The first step is making a phone call to set up a consultation.

While it might be the hardest step in the process, it can lead to positive changes in your life (see my article: The Benefits of Psychotherapy).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

One of my specialties is helping clients to overcome psychological trauma, and I have helped many clients to overcome trauma to live fulfilling lives.

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.