Thoughts on Psychotherapy with Trauma

by Kathrin Stauffer

This paper originated as an outburst of bad temper that I allowed myself at a workshop in September 2002. I am deeply grateful to David Boadella, who was teaching the workshop, for encouraging me to put it on paper. It has been published in Energy & Character 2003, 32: 60-62, and in the German version in Energie & Charakter 2003, 27:15-19.

Introduction

At a recent discussion on the psychotherapy of trauma, a colleague raised the following, rather baffling point: neuroscience has shown that the brains of traumatised people are damaged (de Bellis 2002; Hull 2002). Assuming that brain damage is irreversible, how can we attempt to do therapy with such clients, when they are obviously doomed to carry these wounds to the end of their lives?

It seems to me that this line of reasoning makes a number of assumptions about the relationship between brain and mind that need clarifying. I want to offer some of my thoughts about this.

Comments

Cause and effect

Nancy Verrier, an adoptive mother, wrote about a Primal Wound that is being inflicted by maternal abandonment, (hoping, I suppose) this would make adults more aware of the importance of safe bonding with their adopted children.  I believe she's half right.  Her assumptions are based on the basic biologic loss an infant experiences from natural maternal absence.  Even a newborn can miss familiar scent, sound and taste formed in utero.  The loss a fostered or adopted child experiences is far greater in scope and depth than the loss of just one family member.  In fact, her "new found theory" published in 1993 was nothing new to any health-care practicioner who has dealt with patients or family members seen in acute-care settings where tragedy has hit home for them, on a very personal level.  Loss through death or injury has stages, and each age group has both physical and emotional symptoms that follow the grieving process.  (For details, read:  http://poundpuplegacy.org/node/5343 ) Kubler-Ross defined the grieving stages DABDA:  Denial, Anger, Bargaining, Depression and Acceptance.  The process is as individual as the person, so the length and time spent grieving over a missed loved-one cannot be judged or measured by another, it simply has to be accepted "as is", and it can be easily triggered throughout the life-span of the survivng family member.  Part of being human is lending compassionate support when another is hurting.  [Perhaps this is where adapting and adopting got lost in the lines of communication with profiting law makers?]

As a RN, I fully believe there is injury and damage caused by the permanant removal of the maternal life-source soon after an infant's birth.  This "injury" can be transient and short-term, or it can be permanant with deep scarring and it can be seen as areas of compensation or concentration in the brain; those results depend upon the type of care given to the child, and if that child is ever returned to his/her origins.  After so many years writing on so many websites, going in so many seemingly random tangents, on yet the same topic, I have to say, "where am I going this time with adoption, scars and brain scans?" 

Simple.  Loss can be seen as an area of black concentration in the non-invasive fMRI and MEG brain scans;  they can show absence due to inactivity.  How many mothers have had to relinquish care of their newborns, or older children, due to depression?  How many single-parents mourned the loss of adult companionship, forcing choices that left a child into the care of another?  How many women found themselves with dead-beat dads, or dads with women who couldn't stay because "love wasn't enough"?  When two people make three, (or more), and that creates a depressing situation, will that become a blame-game, or a story where a child needs to be taken away?  It's a shame profit through another set of parents can be seen in moments of misery, isn't it? 

Permanant placement does not have to be the solution if time and patience was given to the family of origin.  I believe this is a matter of health-care standards that's not given to those the adoption industry want to horde and covet for their own private practices.  I've already posted an article that notes the effects stress has on the unborn fetus.  [What pregnant woman wouldn't be stressed about the outcome of her baby, if she knows her baby is going to strangers, no matter how "nice" they look or seem?]

Now read how common depression hits households, and how this can affect child placement , and the prevention of abuse and neglect everyday.

http://www.medicalnewstoday.com/articles/14653.php

One in ten women who are pregnant will experience depression and approximately 13 per cent of new mothers experience postpartum depression.

Maternal depression can have serious and lasting consequences on a child's development. That is why the Canadian Paediatric Society's Psychosocial Committee has released a new statement that explores the issue of maternal depression and its affect on child development. The statement reviews the role of the child's physician in the detection of symptoms of maternal depression, and in the coordination of appropriate support and management.

"The role of the paediatrician or the physician caring for the infant is to make sure that he or she is thriving in an adequate, nurturing environment," says Dr. Anne-Claude Bernard-Bonnin, the author of the statement Maternal depression and child development. "Early recognition of depression is important because a depressed mother will not be in the best position to understand the cues or signals of her baby. Their interaction will be hampered by the fact that she will not be able to respond to her child's needs appropriately. Because the physician who takes care of infant also sees the new mother regularly, he or she might be able to pick up a problem and take action."

The consequences of maternal postpartum depression are not restricted to infancy, but can also extend into toddlerhood, preschool age, and even school age children. Children of depressed mothers are at risk for developmental and behavioural problems and may be predisposed for developing depressive disorders themselves.

"Maternal depression can affect children through childhood and adolescence in various degrees," says Dr. Bernard-Bonnin. "A child not only needs good nutrition and care but also a needs nurturing mother. It is important that the physician be thinking of this issue."

The statement reviews treatment options and their affect on the infant during pregnancy and breast-feeding. Among the statement's recommendations:

-- As long-term studies have not shown adverse affects, mothers who have taken anti-depressant medication during pregnancy should be reassured about the neuro-development of their child.

-- Mothers who have taken anti-depressant medication during lactation should be reassured that much of the evidence to date shows that there are no neurological or developmental abnormalities in children exposed through breast-milk to such medication.

The Canadian Paediatric Society is a national professional association, representing more than 2,200 paediatricians, that advocates for the health needs of children and youth. Its peer-review journal, Paediatrics & Child Health, is published 10 times a year and circulated to 15,500 child health care professionals. For more information about depression in pregnant women and mothers and how children are affected visit http://www.cps.ca & http://www.caringforkids.cps.ca.

Media inquiries:
Christine LaRocque
(613) 526-9397, ext. 234
media@cps.ca Canadian Paediatric Society


Trust is a two-way street, and relinquishing that trust to a stranger must be done with a profound responsibility to safety and guardianship, with the understanding that each person is accountable for the temporary care of another woman's baby.  If and how that baby gets returned to the original family certainly reflects how much that government values its people. 

The multi-million dollar question I should be asking is:  how many adoptees have been sold to depressed or emotionally scarred parents, and have suffered the consequences as a result?  I think all I need to do is look at our current prison system and start counting the numbers of those who have fallen through the cracks and have been left-behind without proper follow-up by agents who promised to keep one mother's baby safe and clean.  Where better to begin than with a captive audience in need of serious scar- assessment and life repair?

tit for tat, I guess they paid for it

Baby blues, too?

http://poundpuplegacy.org/node/4745

The general population recognizes post-partum blues as a natural and expected part of the birth process. Most people identify those feelings of anxiety with "just getting those hormones back into kilter." But, the truth is that many adoptive parents suffer from the same post placement blues, and feel very confused when they cannot rely on the "hormone theory" to explain their feelings.

There are several other very likely reasons to explain theses common feelings shortly after the placement of the baby. Perhaps one of the most reasonable explanations is the completion of one of life's biggest goals. Parenthood has loomed as an almost unattainable goal for so many adoptive families for such a long time. Reaching that goal has required time, money, effort, emotional strain, and patience.

Suddenly the emotional rush from the attainment of this long desired goal is exhilarating. I sometimes relate the attainment of this goal to the Jewish nation reaching the promised land after forty years of struggle. How can almost anything compare ever again in terms of emotional satisfaction of finally being in the land of milk and honey...the land of parenthood? Likewise, how can any of us keep that level of emotional high forever?

I just thought I was a chronic disappointment and let-down to people who expected better from their investment, sorta like buyer's remorse, but it's nice to know someone came up with a quasi-hormonal replacement name for it.  What's the cure, two shots before dinner?  

charade

I just tried to reread the complete article you quoted from and I simply can't. Has anyone ever discussed the notion of adoptive parent finally having the child they want, only then to discover they cannot love it as much as they would want to and are expected to, simply because it is not their child. I wonder if much of the charade of adoption is attributable to that.

Industrialization

Sadly, I think the more things change, and grow, the more they stay the same, adoption practices being no different from any other era or error in time.  As long as profit is being made, and trade can be seen as "supply and demand", (even with a child's life), what chance do first families have to heal and repair themselves?  Face it, adoption is a thriving business, and no one wants to touch it.  Until more people see how adults and children are victims to greedy government officials who want more, yet still pay less, all will remain the same, and the results will continue to speak for themselves.  [See http://poundpuplegacy.org/node/5300  "The Holy Cost of Living and Lying", for more.]

I bet back in the 60's and 70's the small agencies never dreamed of ever having such large needs and services for adopting families as the big thriving companies/organizations do now!  In just therapy-sessions, medications, and books on special bonding needs alone, for children, there must be billions of dollars made each year in revenue!  I wonder if there's stock-investment opportunities in the adoption market.  Ya think?  I suppose that's why so many find themselves joining the ranks of those who sell children for private profit:  "If you can't beat them, join them".  What do people expect when a child learns early on, there is indeed a price-tag to be had on each and every one of us; yes, even family has no meaning if money can come between them.