Effect of early trauma on parenting skills - 9/19/2011 - Community Care
Early-life traumatic experiences can affect a parent's ability to cope if proper closure is not reached. Gordon Carson explores this often overlooked issue
A deep-seated loss or trauma suffered by a parent or child that is unresolved can have specific implications - and present particular challenges - for social workers and the families they support.
David Shemmings, a specialist in attachment theories and professor of social work at the University of Kent, says parenting problems, such as neglect and child abuse, can occur when losses or trauma experienced by parents have not been resolved.
"'Unresolved' here has a very precise meaning," says Shemmings, who is also director of the Assessment of Disorganised Attachment and Maltreatment (Adam) project in London. "For example, it doesn't mean that the person cries at the thought of their loss. The term indicates post-traumatic stress disorder and/or dissociation."
Jim Walker, an independent social worker and psychotherapist, says in a Community Care Inform guide to unresolved loss and trauma that a traumatic childhood in itself "is not predictive of maltreatment of children. What is predictive is if the adult has not been able to come to terms with their traumatic experiences".
The guide says a common reaction to unresolved trauma is parental dissociation, with parents "likely to neglect the emotional needs of their children and/or have difficulty in assessing risk in their partners".
Walker adds: "There is also a strong correlation between unresolved loss and trauma and disorganised attachment in children. 'Unresolved' parents tend to have children whose behaviour is disorganised."
Social workers need to be in a position to judge if they suspect unresolved loss or trauma is a factor in parenting problems?
One way of identifying whether a person is harbouring an unresolved loss or trauma is the adult attachment interview, in which open-ended questions are asked about childhood relationships and experiences.
Meanwhile, Shemmings' Adam project has developed a Maltreatment Pathway Model which identifies three key predicators of maltreatment from parental behaviour, one of which is unresolved loss and trauma.
Unresolved loss
This model formed part of a training course he delivered to Croydon Council social workers in south London this year.
The course also highlighted the relevance of unresolved loss to the wider children's services sector, particularly those working with young people who may have experienced severely traumatic events in their home countries before travelling to the UK.
Katherine MacLeod, a social worker in Croydon's unaccompanied minors team, attended the course. MacLeod, who has just completed her first 18 months of practice after joining Croydon when she qualified, says the Adam training has "given me the tools to identify unresolved loss".
She says the issue of unresolved loss and trauma might be explored as part of core assessments of unaccompanied young people.
Shemmings says that talking with an "empathetic, non-judgemental listener goes an awful long way to helping" people showing signs of unresolved loss or trauma if they aren't also mentally ill.
"Certainly the evidence from event-based tragedies, such as Hillsborough, the Zeebrugge ferry disaster and the Bradford football stadium fire, is that survivors needed to talk and that helps enormously," he says. "But they need to be given the time to do it, and often they need to go over the same ground again and again. The worker can't rush this process."
Shemmings says it can be more difficult to help people if the loss or trauma occurred when they were very young, and if the trauma is "relationally based", such as child abuse or rape, rather than based on an event such as a car accident.
"The most important thing to emphasise is that practitioners need training in this field of work," he adds, "as people experiencing unresolved loss can start to 'relive' aspects of the trauma in the room with the worker.
"It is sights, sounds and smells that (unconsciously) remind a person of the trauma, but they are usually unaware of the connection.
"This is why, if there has been early loss and trauma which is unresolved, the presence of a baby or toddler can 'activate' the original loss, because the infant's vulnerability reminds the adult of their own."
Walker, in an interview for this article, says social workers "must be prepared to explore in depth any unresolved loss or trauma".
"It takes some courage to do it. You have to ask questions in detail and try to find ways to help people to talk. People can be frightened and anxious about talking about it.
"They might not volunteer information and it may only emerge over time if they feel social workers are trustworthy and resilient enough to take it on board."
Sample questions, says Walker, could be to ask parents to recall three happy and three sad memories from their childhood, or the most frightening thing that happened to them as a child.
"If you keep coming back to questions like that, people may give up more and more information," he adds. "But if you just ask them blandly once, you are not going to get the whole picture. You have to be prepared to keep plugging away. You also have to be sensitive and not just go barging in."
To illustrate his point, Walker cites a child protection assessment he was carrying out, and it was only at the end of the final session with a parent that she revealed she had been abused by her grandfather.
There will be cases, however, that require more in-depth expertise in dealing with post-traumatic stress disorder, and psychotherapy could be appropriate.
Behavioural therapy
The National Institute for Health and Clinical Excellence (Nice) also recommends trauma-focused cognitive behavioural therapy or eye movement desensitisation and reprocessing as possible treatments.
Walker believes that, though understanding trauma and loss has been given greater priority in the past 20-30 years, particularly in relation to neuroscience and the functioning of the brain, there is still more that could be done to map its impact on child protection.
"I would think that in the majority of child protection cases where I'm assessing parents, there's a significant element of unresolved loss and trauma," he says. "The area of addictions and trauma is important too; for a lot of people who abuse substances it's about self-medication against emotional distress. My guess is that unresolved loss and trauma would be a major factor in the addictions field too."
How loss and trauma can be resolved
In a new book on understanding disorganised attachment, David and Yvonne Shemmings, a continuing professional development specialist, say resolving trauma, without help from a trained counsellor or therapist, depends on four factors:
● The severity of the event and circumstances surrounding it.
● Whether a close, intimate person to the victim is involved in the trauma as a "persecutor".
● The person's circumstances, especially their close relationships at the time.
● The level of security within the person's attachment history.
"The second two factors act as buffers against the first two," they write. "If we have a relatively secure childhood and the 'state' of our current relationships and circumstances feel solid and supportive, then we are likely to survive emotionally almost any loss or trauma."
• Understanding Disorganized Attachment: Theory and Practice for Working with Children and Adults, David Shemmings and Yvonne Shemmings, 2011, Jessica Kingsley Publishers,
More information
• Jim Walker
• Professor David Shemmings
• Assessment of Disorganised Attachment and Maltreatment (ADAM) project
• Guidelines on post traumatic stress disorder
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Inform subscribers
Guide to unresolved trauma in parents and its implications in terms of child protection
Author: Jim Walker, psychotherapist and independent social worker BIOG
Publication Date: 08 January 2008
Published in Community Care magazine 22 September 2011 under heading 'Traumatic consequences'
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