Day 3 Part 1 - Who was there for you?

It's been a while since I have written my thoughts and insights about the sessions I attended at the 34th Annual Boston International Trauma Conference. I actually wanted to rewatch the Day 3 session on Basic Clinical Science before writing about it since it contained so much information. 2 The session starts with Psychiatrist Bessel Van Der Kolk, who talks about the Adverse Childhood Experiences (ACE) scores, which are in simple terms a way to measure the negative experiences a person may have had during their childhood. The ACE score is based on a questionnaire that asks about various types of adverse events such as abuse, neglect, household dysfunction, or exposure to violence. Each type of adverse experience is assigned a score of one, and the scores are added up to create an overall ACE score. The higher the ACE score, the greater the likelihood of experiencing negative effects on physical and mental health later in life, such as increased risk of chronic diseases, mental health issues, substance abuse, and social problems. "As your ACE score increases, so does the risk of disease, social and emotional problems. With an ACE score of 4 or more, things start getting serious. The likelihood of chronic pulmonary lung disease increases 390 percent; hepatitis, 240 percent; depression 460 percent; suicide, 1,220 percent." - Source: www.Acestoohigh.com – ACE’s Connection Network

This shows us just how important our early experiences are, in Bessel's words: "If u get beaten at 1, you have a different brain than if you get beaten now." What is trauma exactly? While some people might say it is a distressing event that happens to you, Dr. Gabor Maté (and I 🙃) would disagree.

Trauma is not what happens to you, but what happens inside you as a result of what happened to you - Dr. Gabor Maté.

When people talk about trauma, sometimes they might ask: What happened to you? Bessel van der Kolk presented a different question that might be worth looking at: Who was there for you? Our brain is formed by the environment. Trauma is not just the event, it's the response to the event, it's the whole concept of how you and your tribe experienced that event. We humans are social creatures, and we are born with attachment needs, this is crucial to survival. If babies are not cared for, they will surely die. Heck, babies who are deprived of touch can fail to thrive, lose weight, and even die (https://www.psychologytoday.com/intl/blog/born-love/201003/touching-empathy)

It makes sense just how important the early attachment to our primary caregivers is, attachment is a fundamental aspect of life, it was mentioned in the session how the disruption of the attachment system can have more profound effects than other traumas (developmental trauma).

Bessel stressed the importance of talking about who one feels safe with as a person. For many people with attachment traumas, the broken attachment is more powerful than the events themselves.

Bessel continued to present some results of brain imaging studies which showed that when people are in their trauma, they are like a ball of emotions, there is very little, if any reason or left brain activity. Together with a group of professionals, Bessel even went as far as proposing a new diagnosis in the DSM: "Developmental Trauma Disorder". Unfortunately this was not approved.

My own experiences

This brings me back to my own experiences. This actually happened to me in my own healing journey, I have a huge mental toolbox with healthy tools learned during the years in therapy. However, not long ago, I had a conversation with my therapist about how when triggered, it feels very hard to access these more cognitively-based tools. It was brought up that I might need to first engage in the somatic/ physical part (tapping, butterfly hugs or any form of bringing awareness to my body) before I am better able to access these tools that might require some degree of thinking.

What I also noticed was that the part about attachment really resonated with me during my first year in therapy. A big portion of the early part of my healing journey was focused on my own attachment difficulties, learning what it was like to have a compassionate witness and what healthy attachment looked like, and trying to find that safety from within. Luckily I had a very lovely first therapist whose kindness and grace taught me how to be kind to myself.

A lot of what I was experiencing during my healing journey very much resonated with a book I read:

Complex PTSD Disorder, from surviving to thriving by Pete Walker M.A. MFT

In short, CPTSD is known to be caused the psychological impact of prolonged, recurrent and often interpersonal trauma, such as psychological, sexual or physical abuse in childhood, or chronic partner violence in adulthood. When it happens in childhood, it is usually known as developmental trauma. (https://www.psychologyexperts.org/2019/04/01/complex-post-traumatic-stress-disorder/#:~:text=This%20type%20of%20trauma%20has,event%20and%20avoidance%20or%20numbness.)

In the book, Pete explains that one of the aspects of how he treats clients with CPTSD is by facilitating the clients in forming earned secure attachment: a healthy and secure attachment through reflections, interactions, and healthy relationships in adulthood.

I could go on and on about this but I will probably write another post about CPTSD to avoid making this post too long.

I will leave you with the following questions.

What are the prices that we as a society are paying for allowing trauma to continue?

How much attention is being paid to developmental trauma here in Aruba?

How can we facilitate caregivers to be as attuned as possible to their children? How can we best protect children from developmental trauma?

Do we give enough importance to who was there for us instead of only what happened to us? ACE Studies: https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean

More about Bessel van der Kolk: https://www.besselvanderkolk.com/ More about Gabor Maté: https://drgabormate.com/ More about Developmental Trauma Disorder proposal: https://traumaticstressinstitute.org/wp-content/files_mf/1276541701VanderKolkDvptTraumaDis.pdf More about the book Complex PTSD Disorder, from Surviving to Thriving: https://www.pete-walker.com/complex_ptsd_book.html