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Trauma and Recovery
The following overview is of the founding professionals who have shaped the work that we champion and advocate:
In 1896, Freud suggested that “a precocious experience of sexual relations . . . resulting from sexual abuse committed by another person . . . is the specific cause [italics added] of hysteria . . . not merely an agent provocateur” (1896/1962, p. 195, cited in van der Kolk, Weisaeth, et al., 1996, p. 54).
Charcot noted that traumatic events could induce a hypnotic state in his patients and was the first to “describe both the problems of suggestibility in these patients, and the fact that hysterical attacks are dissociative problems— the results of having endured unbearable experiences” (van der Kolk, Weisaeth, & van der Hart, 1996, p. 50).
In the 1880s, Freud and Breuer as well as Janet independently concluded that hysteria was caused by psychological trauma. They agreed that unbearable reactions to traumatic experiences produced an altered state of consciousness that Janet called “dissociation.”
However, ‘Freud privileged intrapsychic theory and fantasy over external trauma, (but) he did suggest that it was possible for external trauma to influence the patient’s state of mind” (Diamond, 2004).
See: Overview: History of trauma theory https://us.sagepub.com/sites/default/files/upm-binaries/40688_1.pdf
Freud. A. (1946a). The ego and the mechanisms of defence. New York. International Universities Press.
Freud Revisited: Psychoanalytic Themes in the Postmodern Age Roger Horrocks 2019
Freuds Approach to Trauma Crimson Publishers
The fact of transference points to an important fact about the nature of trauma: the compulsion of the human psyche to repeat traumatic events over and over again …https://cla.purdue.edu/academic/english/theory/psychoanalysis/freud5.html
Childhood and Trauma https://pubmed.ncbi.nlm.nih.gov/18301372/
Carl Jung said: “In every adult there lurks a child—an eternal child, something that is always becoming, is never completed and calls for unceasing care, attention and education. That is the part of the human personality which wants to develop and become whole” (Jung CG. “Development of Personality” in Collected Works of C.G. Jung, Vol.17. Princeton NJ: Princeton University Press; 1954).
“He also said that the feminine is lacking in our culture. Jung sees the feminine in terms of the Anima principle and a soulfulness. But this is not fanciful; he is talking about play, imagination, fantasy, creativity, birthing and active imagination. Jung is talking about a cultural movement from a solar consciousness to a lunar consciousness, away from the white hot left side of the brain, literal, fixed, limited and conceptual toward the cooler right brain that is symbolic, relational and contextual.”
This idea has been more recently taken up and expanded on by Allan Schore
YouTube Allan Schore: The development of the right brain across the life span
Jung’s ideas around the archetypes of mother and child are important here. When a baby experiences the loving gaze of the mother and sees itself reflected back then the dynamic of the great mother and divine child enables the repeated experiences for the child of feeling safe, pleasure and soothed when distressed. The positive “feeling toned complex” will be integrated into the child’s ongoing development so that the child will be well placed to enjoy fruitful, satisfying relationships as he grows up. In contrast, a child who has been neglected, belittled, humiliated by the primary caregiver (the archetypal cruel, terrible mother) will grow up to experience a negative feeling tone in relationship and that ‘mother complex’ will surface and affect and limit capacity to live in a mutually fulfilling relationship.
Memories Dreams and Reflections C Jung Collins 1995
Trauma and the Soul A Psycho-Spiritual Approach to Human Development and Its Interruption Donald Kalsched Routledge 2013)
Jung: A Very Short Introduction 2001 OUP Anthony Stevens
The Inner World of Trauma Archetypal Defences of the Personal Spirit Routledge 1996 Donald Kalsched
The Archetypes and the Collective Unconscious (Collected Works of C.G. Jung) 1991
Anthony Stevens Archetype Revisited: An Updated Natural History of the Self
(Studies in Jungian Psychology by Jungian Analysts #105) 2003 Inner City Book
Anna Freud (1895-1982) was one of the founders of child development psychology who, among other things, pioneered a way to help children who have departed from normal development return to normal development. She recognised that, before the age of six (latency) it is better to attend to the child’s environment to support the child’s development and prevent neurosis from taking hold. She, like Klein recognised that it would be vital to allow children to express themselves through drawing or to move freely around the room in a session (and would join in). She developed important work relating to defence mechanisms and she emphasised the importance of child development over time.
In her book, Infants without Families, written in 1944 with D. Burlingham based on the experiences observed in the Hampstead Nursery (which she set up for children who had lost their homes, and/or parents) she asserted that:
“The lack of continuous and intimate emotional relationship with the mother and the absence of the other contacts of normal family life produce a retardation in emotional development, intellectual and speech development, and habit training. The institutional children are insecure, more clinging to adults, and more aggressive to one another, and indulge in more fantasy life and autoerotic gratification. It may be also that the development of character and conscience is impeded by the lack of the normal love objects”.
The ego and the mechanisms of defence, Volume 2; 1966 International Universities Press
Normality and Pathology in Childhood: Assessments of Development. New York: International Universities Press, 1965. 273 pp
Melanie Klein (1880- 1960) another early pioneer understood that play could be helpful for children’s recovery and also introduced important, if controversial, ideas of the paranoid schizoid position, depressive stage, phantasies, projection, introjection and splitting.
“In her work with children, Klein noticed that their play and the toys they used carried important symbolic meaning for them, and that this could be analysed much in the same way as dreams could be analysed in adults.
Melanie Klein asserted that all human beings relate to others from birth and, consequently the transference in psychoanalytic treatment is always alive and active”.
I have seen babies as young as three weeks interrupt their sucking for a short time to play with the mother’s breast or look towards her face. I have also observed that young infants – even as early as in the second month – would, in wakeful periods after feeding, lie on mother’s lap, look up at her, listen to her voice and respond to it by their facial expression; it was like a loving conversation between mother and baby.”
Klein, ‘On observing the behaviour of young infants’ (1952)
However, her views on analysis and interpretation in sessions with children brought her into conflict with the educational and social construct ideas encouraged by Anna Freud.
Introduction to the Work of Melanie Klein (Maresfield Library) 31 Dec. 1988 by Hanna Segal
Who the Hell is Melanie Klein?: And what are her theories on psychology all about? 2019 Bowden and Brazil by Lucy Etherington
The Clinical Paradigms of Melanie Klein and Donald Winnicott: Comparisons and Dialogues Routledge 2017 by Jan Abram (Author), R.D. Hinshelwood (Author)
Winnicott (1896-1971) was a paediatrician and psychoanalyst working in Paddington Green Children’s Hospital from 1923-1962. During this long period of service in a part of London with significant deprivation he saw thousands of families. While Freud’s focus was on psychosexuality and the Oedipus complex, Winnicott’s focus highlighted the very start of life as his psychoanalytic clinical findings illuminated the significance of the parental role in early object relations. Thus, at the core of Winnicott’s contribution is the parent-infant relationship and the sense of self that derives from the context of the “facilitating environment”.
He was trained by Melanie Klein but became increasingly independent in his thinking over the course of his career, ultimately contributing original ideas that emphasised the importance of play in psychological development. He also introduced the ideas of ‘the holding environment, and maternal preoccupation, and the idea that there is “no such thing as an infant” – that where there is one there is the other. Winnicott also made it clear that the infant develops within the context of the facilitating environment provided by the “good enough” parent and that manageable failures within it allow the caregiver and child to remain together and separate and the child can move towards independence.
Books and and reference points:
Babies and Their Mothers (Classics in Child Development) D.W. Winnicott, Benjamin Spock (Introduction) ..Offers insights into the central issues of infancy, with an introduction by Benjamin Spock, M.D 1992 by Da Capo Lifelong Books
Deprivation and Delinquency D. W. Winnicott Routledge, 2011
Playing and Reality by D.W. Winnicott (Routledge Classics) Paperback – 20 Jan. 2005
Winnicott by Adam Phillips Penguin Published: 01/11/2007 ISBN: 9780141031507
Video #TheSchoolOfLife PSYCHOTHERAPY – Donald Winnicott
Winnicott, D.W. (1960). The theory of the parent-infant relationship. Link below
Barbara Dockar-Drysdale (1912-1999) developed aspects of Winnicott’s work. She focused again on the role of the primary care giver shaping personality development and the importance of understanding the needs of children, which led her to create the first therapeutic communities.
“In Dockar-Drysdale’s view, for chaotic ‘unintegrated’ children the traditional ‘psychoanalytic hour’ was not enough, they required a total environment in which therapeutic interactions could take place within the daily routines of child care, she did not place the primacy of therapy as being outside of daily child care routines, hence the development of the concept and methods now known as ‘therapeutic child care.’” (From the Mulberry Bush website).
Dockar-Drysdale.B. (1990) The provision of primary experience: Winnicottian work with children and adolescents. London. Free association books.
John Bowlby’s (1907-1990) theoretical work on attachment, together with later research by Mary Ainsworth (1913-1999), Mary Main and Patricia Crittenden has been central to most understanding of the impact of neglect and “maternal deprivation” on the capacity to build secure relationships. He believed that babies have an innate need to attach to one main attachment figure. Loss, prolonged separation and fear – the breakdown of the primary attachment would lead to serious negative consequences.
The child’s attachment relationship with their primary caregiver and secondary attachment figures leads to the development of an internal working model (Bowlby, 1969).
This internal working model is a cognitive framework comprising mental representations for understanding the world, self, and others. A person’s interaction with others is guided by memories and expectations from their internal model which influence and help evaluate their contact with others (Bretherton, & Munholland, 1999).
Diagram: Internal working model of attachment
Around the age of three, these seem to become part of a child’s personality and thus affects their understanding of the world and future interactions with others (Schore, 2000). According to Bowlby (1969), the primary caregiver acts as a prototype for future relationships via the internal working model.
There are three main features of the internal working model:
(1) a model of others as being trustworthy,
(2) a model of the self as valuable, and
(3) a model of the self as effective when interacting with others.
It is this mental representation that guides future social and emotional behaviour as the child’s internal working model guides their responsiveness to others in general.
Ainsworth’s (1985) and Main and Solomon’s (2000) description of four different types of attachment can be helpful to provide a simple overview of the different ways that children learn to relate to firstly their primary caregiver and then others. The four styles are: secure, avoidant, anxious and disorganised. When a child experiences trauma, their attachments can become disrupted. Disorganised attachment is the developed response in homes where the primary care giver is also the source of fear and inconsistent and volatile reactions that create terror for the child.
John Bowlby and Attachment Theory (Makers of Modern Psychotherapy) Routledge 2014
by Jeremy Holmes
Bowlby, J. (1998) A secure base. London and New York: Routledge
The Making and Breaking of Affectional Bonds (Routledge Classics)2005 by John Bowlby
Nurturing Children: From Trauma to Growth Using Attachment Theory, Psychoanalysis and Neurobiology Routledge 2019 by Graham Music (Author)
Video from #TheSchoolOfLife PSYCHOTHERAPY – John Bowlby
The Search for the Secure Base: Attachment Theory and Psychotherapy Jeremy Holmes pub: Routledge 2001
The Making and Breaking of Affectional Bonds John Bowlby (Routledge) 2005
Working with Attachment Difficulties in Teenagers Practical & creative approaches Sue Jennings (Hinton House 2019)
Procedures for identifying infants as disorganised/disoriented during the Ainsworth strange situation. In M.T. Greenberg, D. Cichetti & E.M. Cummings (Eds) Attachment in the Preschool Years: Theory, Research and Intervention. Chicago: University of Chicago Press, pp. 121-160.
Patterns of Infant-mother Attachments, antecedents and effects on development. Bulletin of New York Academy of Medicine, 66(9)
Review and links to other theoreticians
The central thinking and observation with regards to disruptions, impingements and failures in the experience of the developing child can be described as failures and catastrophes in relationship. When a baby cries in protest and no one comes to relieve the intolerable sensations, or a child is being physically hurt by a “trusted” adult, this repeated experience disrupts the developing brain and physiognomy and a child responds to the world from a state of fear.
When, the baby/infant doesn’t have an experience of a caring, attentive, positive and secure relationship the impact can be catastrophic and as a consequence the growing child will only expect bad outcomes from interacting with others and consequently feel the need to control their interactions with others and take charge even though they do not have the skills to do so and are also extremely anxious. They believe that their model is true and if it appears otherwise they make it true through their actions.
Triggers in the environment (a tone of voice, a noise, a smell, a look) will thrust that child into an internal state as if he is experiencing that trauma at that moment and will be ready to fight, flee, or freeze. This state is compounded by the view a child develops which blames himself for what has happened rather than the carer. So he will regard himself as “bad” and therefore deserving of these experiences and the caregiver as “good” because it would be intolerable if otherwise. This is akin to what Fairbairn describes as the split ego response where a child internalises the unresponsive aspects of the parents and fantasises those features as being a part of him, because they aren’t available in reality.
Bion’ significant contribution to psychoanalysis is the idea of the ‘container and the contained”. This idea developed from the sense that an infant cries or screams or expels energy or mess and the mother transforms them:
“Where do these projected bits of experience go? They go into the mother who modifies them through an emotional function that transforms the baby’s raw sensations into something that – if all goes well – the baby takes back into herself and becomes the basis for the baby’s awareness of her feelings and, eventually, thoughts. At first, of course, the baby cannot do this by herself, and it has to be done by the mother through a function which Bion calls ‘reverie’ and describes as a function of the mother that is based on her love for her baby – and the baby’s father (1962b)”.
The theory of containment can be described therefore “as the capacity of one individual (or object) to receive in himself projections from another individual, which he then can sense and use as communications(from him), transform them, and finally give them back (or convey back) to the subject in a modified form. Eventually, this can enable the person (an infant at first) to sense and tolerate his own feelings and develop a capacity to think”.
Quotes from Bion’s theory of containment by Ruth Riesemberg Malcolm in Kleinian Theory A contemporary Perspective Wiley 2001
Bion describes the experience of working with a boy who was generally quiet, disengaged and soiled himself and how for weeks on end the child would scribble blackness and Bion experienced something that was put in him and felt by him and reflected back in a way that the child could understand and begin to make sense of in the relationship. He wrote:
“I told him that my words threw some light either on the mess he seemed to be in, or that he felt he had inside him, and that he was now experiencing some slight hope (following two clear circles drawn near the blackness) that together we could understand this. It was more or less at this point that he stopped using paper and crayon and began to talk…Incomprehensibility, be it his or mine, was ‘felt and sensed by me’ and I allowed him to convey it to me and me to feel it, while trying to make sense of it and to describe this to him” (ibid).
This experience reminds us that the healing takes place in relationship and that a child needs to experience his expression of fear/anger/rage/misery and for that to be understood, acknowledged and held by the parent/therapist/teacher/mentor. It is not the theory that is important in helping an adult or a child recover from unbearable experiences but rather the capacity of that other to tolerate what words or objects that are “thrown” at them in the home/therapy room/classroom and take that communication so that the child knows that you have understood them.
We will be looking at the importance of modern theoreticians and practitioners including Bruce Perry, Bessel Van der Kolk, Daniel Stern, Peter Fonagy, Steven Porges, Dan Seigel, Allan Schore and Pat Ogden