Dr. Arthur Becker-Weidman, founder of The Center for Family Development, discusses complex trauma’s impact on childhood development and effective treatments for this. Seven “Domains of Impairment” are reviewed, including attachment, biology, emotional and behavioral regulation, dissociation, cognition and self-concept. These impairments are correlated to various difficulties in children’s lives if not addressed appropriately, such as issues with relationships, physical functioning, success in school, and more. Dr. Becker-Weidman explains attachment-focused treatment available and utilizing strategies such as PACE and PLACE. The goals of treatment for the child and caregiver include building trust, learning appropriate responses to structure and rules, correcting distorted thinking patterns, and others.
In this video lesson, Arthur Becker-Weidman, Ph.D., founder of The Center for Family Development, discusses developmental trauma disorder (complex trauma), its impact on childhood development, and effective treatments. The clinical construct of complex trauma can be defined as chronic early maltreatment that occurs within a caregiving relationship. Seven “Domains of Impairment” are explained to illustrate the different areas impaired by complex trauma, including attachment, biology, emotional regulation, behavioral regulation, dissociation or defense functions, cognition and self-concept.
These children often have disruptive attachments in their relationships with their caregivers. The attachment figure can be both the child’s safety net and their source of threat. This can cause dysregulation of normal development, as well as issues with physical functioning and other issues such as alcoholism and COPD later in life. A child’s ability to regulate their moods is impacted when their early primary caregiver is unable provide the environment needed for the child to learn this skill. Children with complex trauma learn to dissociate emotional components of trauma with the episodic component. This inability to address the emotions associated with a traumatic event can lead to issues in their relationships.
In addition to issues with emotions, cognitive difficulties are also experienced due to a child’s overactive stress response. Children may have issues with focusing and completing tasks as a result of the overactive stress response. Children also experience distorted thinking about themselves, and believe they are unlovable and unvalued. It’s been found that a high percentage of children in the foster care system had parents with substance abuse issues and other physical and mental health issues. Some common behaviors seen in these children of parents with difficult backgrounds, include relational coping difficulties, school failure, and more.
Children who experience trauma without effective treatment are shown to have a high rate of personality disorders. These children have difficulties with human relationships and is why relationship-based treatment is encouraged by Dr. Becker-Weidman. It is also found that these individuals’ developmental age is much younger than their chronological age and must be treated as such. Poor standardized test-taking and misdiagnosis are some of the outcomes of these behaviors.
An overview of attachment-focused treatment is discussed. The relationship between the professional and the child, as well as the relationship the professional helps the primary caregiver create with the child, are shown to be important. The best predictor of treatment outcome as seen by Dr. Becker-Weidman, is parents’ capacity and insightfulness. Dr. Becker-Weidman reviews the components of Dyadic Developmental Psychotherapy he utilizes with these families, including therapists’ use of self, focusing on connections not compliance, PACE (playful, accepting, curious and empathic) & PLACE (playful, loving, accepting, curious and empathic), intersubjectivity, reflective capacity, affective/reflective dialogue, commitment, and insightfulness. The phases of treatment are discussed as well, including creating the alliance, maintaining the alliance (safe base), exploration, integration, and healing
Lastly, several goals of treatment are explored including resolution of early losses, development of trust, modulation of affect, development of internal control, development of reciprocal relationships, learning appropriate responses to external structure and societal rules, and correcting distorted thinking patterns. The research shows that direct developmental psychotherapy is “supported and probably efficacious.”
For a full transcript of the video’s this course is based on, click here.