Raising awareness about children and adolescents with complex trauma and dissociation

 

Raising awareness about children and adolescents with complex trauma and dissociation

Written by Dr Renée Potgieter Marks

From ESTD Newsletter Volume 3 Number 8, September 2014 > read the original article in our newsletter

All over Europe and England therapists working with children and adolescents are struggling in treating a certain group of these children and adolescents effectively.  These children and adolescents often have a history of long standing problems and failed previous interventions or multiple diagnoses with escalating negative behaviours and difficulties. 

In consultations with individual therapists and training in Europe and England there is an echo of desperation and a sense of confusion and inadequacy that these children and adolescents are leaving the therapist with.  Therapists often have a sense that they are “stuck” with this group and unable to help them effectively.  As soon as these therapists start to understand the dynamics of complex trauma and dissociation in the children and adolescents, the whole picture starts to change.  Therapists often say “My whole practice changed since I learned about trauma and dissociation”; “Since the training, I am seeing dissociation in so many children”; “Thinking back, I realised how many children I could have helped in the past if I only knew about trauma and dissociation”.  In this process of understanding trauma and dissociation better, therapists finally regain their confidence to work with the group of children and adolescents suffering from complex trauma and dissociation.

Many of these children and adolescents have experienced very early trauma and the only way they could survive was to develop an elaborate dissociative system, which is mostly a “hidden world” inside the child.  Children suffering with complex trauma and dissociation, have a very real internal world which is also much more comfortable to live with than to live in the reality of their external world.  As the only external “result” of the presence of this internal world is the child’s behaviour, professionals and parents across the world still follow familiar model to use some sort of behaviour modification to try and rectify the child’s behaviour.  As this model implies that the child or adolescent has to take “responsibility” for his/her behaviour, and the young person is unable to do so, and then starts to increasingly feel worse (“rubbish” from the child’s perspective) about him/herself and retreats increasingly to a safe internal dissociative world, which of course escalates the behaviour.

The consistent embracing of behavioural model strategies combined with the dismissal of the existence of dissociation appears to be the winning recipe to promote the ongoing dissociation in children and adolescents.  Thanks to the growing awareness of professionals about the presence of trauma and dissociation in children and adolescents, more for them are starting to get the help that they need, with a resulting radical change in their behaviour. 

The reality, though, is that there are still too many children and adolescents suffering from complex trauma and dissociation in Europe and England with too few therapists who are presently aware and trained to work in this field.

As the ESTD Child and Adolescent Committee we want to start to raise more awareness of the presence of trauma and dissociation in children and adolescents and also start to train more therapists in this field.  This will hopefully lead to more children and adolescents, presently suffering from complex trauma and dissociation, to start to value themselves as survivors and free themselves of the growing fear that they are “weird”, “mad” or “insane”.