Psychotherapy for people who have survived interpersonal trauma

Part 1 - Early attachment trauma

One of the central aspects of my work as a psychotherapist relates to working with people who have survived interpersonal trauma. By interpersonal trauma I mean the various types of experiences which people may have, in which they are treated by others in any way that leads to their being psychologically overwhelmed. The feeling of psychological overwhelm resulting from interpersonal trauma is one in which a feeling of fear, anxiety, panic, or intolerable pain results from the actions of one person against another. By this definition it is clear that very many types of human experience can be traumatic. Trauma, as such, is defined in terms of the subjective experience of the person who has been traumatized. One person’s hell may be experienced very differently, if the same experience were to happen to another person. Mostly we think of trauma in terms of catastrophic events which occur either in isolation or over time. For example, the sexual abuse of a child is a catastrophic event which takes place, either once, or many times over an extended period of time. Such traumatic experiences are more often than not remembered, and form a part of the individual’s conscious life. Aside from the more consciously remembered and identifiable forms of trauma, such as sexual and physical abuse, there are also the less conscious forms of trauma, which the individual cannot recall. Such traumas are either “forgotten”, that is to say they are pushed down to the unconscious because the person cannot bear to think them, or they are not remembered because they occurred before the person was able to form an internal representation, or a story, of the trauma, in his or her mind.

Traumatic experiences that take place in a person’s very early life, their infancy and very early childhood, cannot be thought about, and are therefore very difficult to access and work through in therapy. Apart from traumatic experiences such as sexual or physical abuse, the pain and anxiety associated with very early problematic relationships form a very important part of what we think about when working with trauma. The infant’s or very young child’s experience of relationships with others, and particular with the people who are taking care of them, is labelled under the category of “attachment experience”. If our attachment experience in early life is consistently good enough, then we can develop enough of a sense of security to feel safe, comfortable and supported within our families, and within the world beyond our home. This kind of consistently good enough experience gives us a feeling of safety, a feeling of being free from overwhelming anxiety, because our difficult feelings are held or contained by the compassionate embrace of the loving person who is there with us to help us manage our distress. Trauma, by definition, is the experience of being overwhelmed by distressing feelings. If, when we were young, we had the experience of being loved by someone who helps us manage our distressing feelings, then it can be said of our early attachment relationship, that it helps us by protecting us against being traumatized by painful experiences which take place in our early life. In the absence of a caring and supportive parental figure we are not helped to learn how to manage painful feelings. The absence of a supportive and loving parental figure, which we can experience as a feeling of abandonment and loss, and which evokes feelings of grief or loneliness in us, is a potentially traumatic early life experience.

It is a trauma taking place as a result of an experience of early deprivation or neglect. This kind of trauma, which we call attachment trauma, is often most difficult to identify, and, for the person who was traumatized in this way, most difficult to think about. This is so because attachment trauma can occur in small doses over a long time. It is not only the loss of a parent through death or some other form of traumatic separation that is traumatic. It is also the experience of there never really being a present, consistently loving and consistently empathic parent who can help us cope with our pain when we are very little that is traumatic. The impact of this very early trauma can be seen to play out in various ways in our lives beyond childhood. I will explore the manifestation of early attachment trauma in later life in the next few posts. For today though, my aim was to introduce the idea of attachment trauma, as something that takes place over time, within the context of an insecure relationship with a caregiver, and which results from the absence of a supportive and emotionally attuned person who is able to help us manage the variety of overwhelming feelings which we can experience in our earliest years. Although this trauma is often a central explanation for much human suffering, it is very seldom that we can actually think about it, because it took place too early in our lives to be thought about.

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