The brain learns through trusting relationships If we are with people we know and trust then our minds are more open to new experiences. We are open to trying something new or to changing our beliefs about the world and other people. The capacity of the brain to learn in everyday life depends on relationships with trusted others.
A lack of trust can make us feel isolated and disengaged – even if we are with others – and make us less able to learn. For children who have experienced abuse and neglect, a lack of trust may be one factor that explains their greater difficulty in learning. A child who does not trust those around them needs to be vigilant and wary. They may not be able to focus their attention on what excites and engages them in the classroom or at home
We know that mental health problems after abuse and neglect are not inevitable. Many children grow up to be healthy and successful adults. In this video, Linking Childhood Trauma to Mental Health, Professor Eamon McCrory explains what scientists have learned about how mental health problems develop over time in an accessible way for professionals and carers working with children.
What is trauma, what does it look like, and how does it affect the brain? These questions are discussed in this month’s Child in Mind podcast. Presenter Claudia Hammond is joined by David Trickey, Consultant Clinical Child Psychologist in the Trauma and Maltreatment Service at the Anna Freud National Centre for Children and Families.
Randomised controlled trials of individual trauma‐focused cognitive behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), non‐trauma‐focused CBT (non‐TFCBT), other therapies (supportive therapy, non‐directive counselling, psychodynamic therapy and present‐centred therapy), group TFCBT, or group non‐TFCBT, compared to one another or to a waitlist or usual care group for the treatment of chronic PTSD. The primary outcome measure was the severity of clinician‐rated traumatic‐stress symptoms.
EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. When you cut your hand, your body works to close the wound. If a foreign object or repeated injury irritates the wound, it festers and causes pain. Once the block is removed, healing resumes. EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.
More than 30 positive controlled outcome studies have been done on EMDR therapy. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy. Millions of people have been treated successfully over the past 25 years.
EMDR therapy is an eight-phase treatment. Eye movements (or other bilateral stimulation) are used during one part of the session. After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision. As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.” Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes. The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them. Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies. https://www.emdr.com/us-basic-training-overview/
According to the Donald, this poem describes how the inner world comes to the rescue of the trauma survivor. In terms of the psyche, trauma is any experience that causes unbearable pain or anxiety. Anything that leaves the child feeling that the essence of who they are is defective or missing in essential value and therefore at risk of annihilation is traumatic. Dissociation is necessary for the individual to go on living; the pain is distributed to make it more manageable. It also saves something of spirit for later growth. This is a self-care system that allows one part to regress and the other part to progress.
Donald spoke of the split between the innocent part of the self that has been saved by an ‘imaginal inner world of companions’. This self is now in hiding from the real world with its undependable attachments. This is a world of tyrannical infantilism where the victim becomes the perpetrator, where the personal is projected onto the general and vice versa. He describes a ‘Self-Care System’ that protects the personality from disintegration, a system that a) makes meaning for child’s life, b) that regulates distance from the world of others – ‘all by myself’ might be the catchword, c) establishes self-regulation to control aggression towards the other and d) promotes self preservation by keeping feelings at bay, very often through addictions – a slow suicide. This is a world where there are no memories, only flashbacks and repetition. Relationship is the conduit through which this painful work can be repaired. He articulates what we as humanistic and integrative psychotherapists have held – that relationship is the way through this impasse. https://iahip.org/inside-out/issue-55-summer-2008/the-inner-world-of-trauma-the-lost-and-recovered-soul-public-lecture-and-seminar-with-donald-kalsched-ph-d-4th-and-5th-april-2008
Today sees the launch of new resources to help bridge the gap between neuroscience and frontline practice.
An animation, guidebook and set of videos about childhood trauma and brain development have been created by University College London (UCL) in a project funded by the Economic and Social Research Council (ESRC). The resources, which are freely available, can be accessed here.
The resources are based on research, looking at how children’s brains adapt to abusive or neglectful environments in ways that help in the short term but increase risk of mental health problems in the future.
“We hope that a greater understanding of neuroscience research can help frontline professionals and carers to reframe their understanding of childhood trauma – providing a new lens through which to understand – and help – the children in their care.”
Everyone experiences stress, and learning how to cope with stresses is an important part of child brain development (Shonkoff et al, 2014).
Some stress can be ‘positive’, such as solving problems or preparing for an exam. With adult or peer support, these experiences can help children develop coping and concentration skills that will help in later life.
Other stresses can be ‘tolerable’. For example, children are usually able to cope with bereavement if they have the right ‘buffers’ or support from parents, carers, friends and family.
But exposure to prolonged or repeated adverse situations, such as child abuse and neglect, can cause ‘toxic stress’: an overactive stress response in children where they start to feel more stressed more often and for longer periods, which can disrupt the building of healthy brain architecture (Shonkoff et al, 2014).
This can affect children’s physical and cognitive development, including:
a weakened immune system
problems with memory and learning
a reduced ability to control one’s moods or emotions