Neglect IS Abuse and Abuse IS Trauma and Trauma Causes PTSD
Trauma and PTSD are thick topics and there is a lot of talk about Trauma and PTSD out there right now and we really honing in on some of less traditional ideas of trauma these days like Community Trauma and Historical Trauma and Racial Trauma. These are ALL very valid form of trauma that can be and are certainly the topic of many people’s writings these days and maybe some day I will try and talk about them as well. But in this post, I just want to hone in on Neglect as Trauma. Specifically, Childhood Emotional Neglect as Trauma.
There are a lot of definitions of trauma floating around out there, but I like this one:
One or more distinct events OR a chronic condition or situation experienced as both inescapable and intolerable and abnormal.
This covers a lot of area and I think is important because it describes all of the things that we are now realizing can be traumatizing for us; again, we can think about how this applies to things like Community Trauma and Historical Trauma and Racial Trauma or even chronic poverty, which is often not talked about as trauma. But unlike the DSM’s definition of trauma it includes neglect as being something that is potentially traumatizing. Especially for children who have no choice but to endure the abnormal chronic condition of not being given the love and emotional connect that a parent or caregiver should normal want and be able to give a child growing up, creating the experience of childhood emotional neglect.
Why is this such a big deal? I think when I work with people this is one of the most insidious things that I see. People who have been traumatized or abused in the more traditional way we look at trauma and PTSD have an event or events to look at; they can point to them and say, “This was wrong or this really was hard for me.” “Other people point to it and say that was messed up or How can I help you, you are hurt or being hurt?” But often that does not happen for the child of childhood emotional neglect, they suffer in silence wanting more connection, but not getting it, feeling bad or sometimes being made to feel bad that they want and need this emotional connection, until they eventually, like all chronic abuse, just normalize it. “This is how life is” “This is what my life will be.” “My needs are not important” or even “I’m bad for even having needs.” And they grow up this way thinking this is normal, everyone feels this.
It tends to leave people sad, depressed, anxious, worried, self-critical, and closed off from themselves and therefore healthy relationships with others and feeling isolated and alone and disconnected.
On top of all that. It doesn’t mean their parents and caregiver did not love them. Children are often emotionally neglected by parents and caregivers who love them incredibly. But, things happen a parent is sick, they have to work 3 jobs, a parent dies, a sibling is sick or dies, the list goes on and on about why a loving parent or caregiver just might not have the capacity to give a child the emotional attention and connect that they needed.
An this makes it incredibly hard to see as an individual and talk about and for even some clinicians to see. So we through medications at depression; Celexa, Lexapro, Prozac, Trintellix, Zoloft and we do CBT for depression. We through medications at the anxiety; Xanax, Librium, Klonopin, Valium, Ativan and we do CBT for Anxiety. But it never really sticks, because there is a visceral and neurological reaction to things that can’t be thought cognitively through, it lives in the body like all trauma does and it is so hard to talk about because, “I had loving parents” “They didn’t hurt me I know they love(d) me” and it is just a feeling of being empty but not knowing why. Because we don’t know what we don’t know and as children we have no other relationships to test this relationship with our caregiver against and it just seems normal. “So why am I always so sad?” “Why do I always feel so bad about myself.” “Why do I feel like the people around me are going to find out something about me or point something out and I am so fearful of that?”
We need to heal this childhood emotional neglect like would any trauma, by doing trauma resolution therapy. The traditional talk version for this is not usually very effective for trauma of any kind. I imagine that models like IFS or EMDR could be effective at The Therapeutic Workshop we use a model called Brief Solution Oriented Trauma Resolution (BSOTR) this model like some others, does not require a client to talk or re-tell a trauma story, so in has little risk of driving trauma deeper which some models can risk doing. But aside from that childhood emotional neglect is hard to describe, so talking about it at all can be hard so this model works great. Also, really has a strong thread through thee model of becoming and taking on the role now as an adult of parenting yourself and taking care of your own emotional needs, which is where the work really starts moving after resolution. The trauma treatment is the healing but then we need to help the client grow and develop the way they were stunted from growing as a child.
This self-parenting perspective leads into work of self-compassion, self-care, and self-discovery and growth that will be the work for session to come. That work can be done in a lot of creative ways and is really exciting to see motivated and creative clients grow and become the happy, healthy, emotionally aware and intelligent people they want to be. We start by healing and growing the relationship with the individual and then relationships with everyone else change and improve, family member, partners, potential partners, children, etc..
It doesn’t mean that you will be able to be taken off medications, but maybe they will work better and people will be happier and more stable while on them; of course, there are always genetic predispositions to anxiety and depression, but medications treat symptoms they don not make people happier or less lonely or increase over all wellbeing. We do that through therapy and healing and growth.
So currently there is really no official diagnosis in the DSM for childhood emotional neglect and therefore treating it is not billable through insurance. There could always be some creative ways to treat this through the current, broken, mental health /insurance system; you could rightly call it PTSD, but you wouldn’t necessarily meet DSM criteria for that the way it is written, or depression and anxiety treatment, a savvy therapist might bill for this and then be able to treat the core issue.
Anyway, I hope this helps some people who may be struggling with this issue. It is real and is, like anything on a spectrum, to just mildly affecting my life an relationships to devastatingly impacting me and my relationships.
For me, I am not the expert, but I think that Dr. Jonice Webb is she has written two of the best and books about childhood emotional neglect that I have ever read. Here is a link to her web page where you can learn more about her and her work and Childhood Emotional Neglect., there is even a test on her web site to help you assess yourself. https://drjonicewebb.com/