How to Identify and Treat the Invisible Wounds of Neglect
with Bessel van der Kolk, MD; Janina Fisher, PhD; Karlen Lyons-Ruth, PhD; Pat Ogden, PhD; Ruth Lanius, MD, PhD; Margaret Sheridan, PhD; Eboni Webb, PsyD; Usha Tummala-Narra, PhD; Martin Teicher, MD, PhD; Megan Schmidt, PsyD; Ruth Buczynski, PhD
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ThIs was a good lens to look at clients who are shut down and disconnected, and remember that childhood neglect is as much a trauma as other childhood experiences. i liked the breakdown of different types of neglect and the reminder of the importance of going slow and pacing, and practicing attunement. Thanks for the application discussion. I am grateful to be able to watch these sessions at my own pace.
The first education session to me was a very good reminder that nobody knows what anyone is or has went through… it was really heart breaking hearing about how mothers or fathers just didn’t come home for days. But the scary part is that the children were use to this and the children were “ok” with other children not wanting to be friends with them because of how they dress or how their family is living…. That’s is so heart breaking but I can imagine it happens so much more then I think it does. But it also opens up my eyes towards the mother or father with their struggle with addictions or trying to survive and understand their addictions or challenges that theybare facing too… all around sounds heart breaking but that in reality is what folks are struggling with day to day…
I loved the module on neglect. But there is a masterful new-ish book on the subject by Kathrin A Stauffer, “Emotional Neglect and the Adult in Therapy: Lifelong Consequences of the Lack of Early Attunement.” One thing she reiterates is that with neglect clients it’s important not to use challenge. They are already swimming in shame, and therapeutic challenges usually generate more shame.
Neglect has been an area that I found did not fit with a lot of the traumatic presentations I have encountered. You made neglect so clear and helped me to make sense of why so many clients are experiencing something so different to what most present with when talking about complex trauma. Thank you
As a client who had complex trauma and neglect, I’ve had bad experiences in finding an attuned and understanding therapist. Thanks for highlighting this. It’s good to hear that there are people who understand and validate my experience and that more are becoming aware of my reality.
I appreciate this so much. The therapeutic understanding is great. I’m a patient. Not unaware, in need of more support than I’ve got, and also overwhelmed, Not least, because insurance for getting treatment is almost impossible to come by, especially on a limited income, and needing to use Medicare. Talk about a sense of hopelessness and bitterness at systemic neglect. But thank you. This much that you provided is something.
I think I will not so readily check on emotional release mechanisms or validate emotional release so much as just being willing to meet the client where they are and perhaps use my own emotional sense of the person and name what I am sensing. Or check in with how they are experiencing internal body states welcoming whatever comes up.
The application of what I have heard and noted is right in the foreground. I still work on Zoom, for many reasons, yet manage to make vital contact and connection with most of clients who attend. I love Pat Ogden’s gesture of bringing towards the self what we are creating. I now have more awareness about why I would introduce some vigorous somatic practice for some people, those who are feeling numb or stuck in a funk, a ditch, a trough. I will introduce some other ways to elicit pleasant sensations, e.g handhugs, wiggling toes, stretching out toes, flexing ankles, pulling earlobes and such.
I will use the experiment of offering the client look up into my face or eyes. asking her if she prefers me to have my eyes closed or open.
this reminds me of here urge to touch eyes on pictures in an early stage of therapy…
I am curious.. what might come out of this suggestion..
Thank you
I will try the titrated exercise addressing issues with eye-contact. Also Pat’s approach to make a client feel more comfortable with the idea of being cared for. Thank you vey much!
As a psychologist and also dance-movement therapist, I appreciate Pat Ogden’s use of the body in noticing the client and using reflection of posture, eye contact and other body expressions in her interventions. I also appreciate the differentiation of different types of neglect, although I am not sure I truly understand the difference between systemic and societal neglect.
Thank you for making this available!
See you next time.
I will continue to be aware that one of the “3 legs of stress management” that I use will be more useful to some clients than others. Thank you.
For example, rather than a relaxation technique that is the “recuperative leg” I might focus on how they can use a calendar for the “time management/scheduling leg”. I might keep to myself the importance of the “self worth leg” knowing that they are not yet ready and do not have the brain areas develop to assess self worth.
Thank you so much.
this was very thought provoking, especially around patients who are unable to make eye contact, what may have seemed like extreme anxiety i can now see could be from childhood neglect and lack of development in this area of cognitive abilities plus i can recognise the emotional fear of being expected by other people to just be able to carry out, what to us are simple actions. The fear of having to try and engage when not knowing what threat is present and expecting a threat no matter how many times a person has forced themselves to behave in the expected way when pressed to.
very interesting. thank you
This single session was phenomenal! I’m retired from professional practice but I interact with other humans — and animals — frequently.
I plan to listen better to the tiny things they reveal about themselves in slips of conversation.
The eye contact thing was major! I definitely will pursue others’ behaviors and feelings about that.
Thank you so much.
yes, the eye contact awareness and process is an interesting exercise.
Thank you very much for this broadcast!
I liked the idea of containement… and physical touch, to be noticed, ask for attention, and straighten up body posture! It seems what
and how we feel shows on the ‘body’ posture…
I’m going to use the shawl technique as well as gesture for reaching and taking in. Really simple, warm and effective!
If survivors of Neglect often can’t feel … could they possibly obey any demand as adults… even become potential candidate for becoming a psychopath… or torture physically others (even if those ones often wont come to therapists)
Many thanks for your brilliant broadcast
Excellent summary of this very large field. Information paced at an easily absorbable pace for me. Thank you.
Thank you for this webinar. It truly is an amazing opportunity to hear directly from such an esteemed group of experts in the trauma field. I had several of my clients in mind and I hope to use some of the assessment tools and interventions mentioned.
Thank you for being so informative and caring at the same time. The well-being of the participants is so important, as many of us are patients. I am one of them, and I am on my path to healing the wounds of the past.
It was shocking to realise that my mum’s look activates my brain’s fear centre. Now I know why I am shrinking and feeling so uncomfortable in front of her. Sitting at the table with her is so challenging.
The above is an example, but this knowledge applies to many situations. The look is a trigger, especially with women who remind me of my mother. However, awareness is a great tool to help me work on mother-related issues.
Kind regards from Poland, where somatic psychology isn’t mainstream yet.
Thanks all. I will use ideas to inform how to translate lived experience of trauma for patients, practitioners and community. NICABM series will help in reviewing, applying, and naming various trauma experiences and therapy approaches and as nascent programs are being developed in my community to approach healing in new ways, from personal to local, regional and one day internationally. More aware than ever what Ruth said in closing, that helping one person heal from trauma will change the course of civilization. This course offers hope we can plant seeds to bring benefit from lived experience to our community, society and beyond.
This first session has pointed out how there is a pattern throughout the history of my relationships caused by childhood neglect. To assess my future clients I will ask more questions about their relationships with friends, relatives, and lovers to see what kind of pattern they have.
With Loving Kindness & Compassion, Wayne Hough
..Also, I see that there are clinicians who seek trauma-informed training to be used in a virtual setting (“tele-sessions”). Is that a good idea? Does something significant not get lost when treating a traumatized person happens over a screen? I am committed to in-person sessions (unless some dire circumstance warrants a video session). I would like to hear if there are professional arguments for and against screen-based intervention. Thank you.
I absolutely agree & wonder what is being lost when having sessions online. I understand the benefits of online when situations like Covid prevented getting together in-office. It was better to have something rather than no connection to the therapist, especially when already working together. Since being able to gather again, I really feel something is often lost when doing online sessions. It’s interesting however to have the proximity of the other person onscreen verses the physical distance in the office. How should this be addressed? What does it change when dealing with neglect?
As a client, I’ve really suffered for the past few years not having in-person sessions. The screen removes so much of what a person can offer and contributes to a sense of detachment. I don’t think I would have recovered to such a degree if I hadn’t had in-person sessions in the past. It’s kind of the inverse of removing someone from a perpetrator. Senses and awareness are diminished and so are hopes for acceptance and closeness. It’s harder to be present when you aren’t really there. There’s an easy escape to my own surroundings when I really want a path to a relationship. Virtual sessions work against my goals. (I’m struggling to write something sensible and it may have to do with my language development being thwarted because of neglect.)
How important: the principle of meeting a client where they are, with how they are feeling, and what they believe about themselves, without challenging their beliefs or trying to help them think more effectively. First and foremost, meet them, be with their experience, see them, be there for them. Not trying to change their way of thinking until they have felt seen and understood, and then only with their permission and willingness to change.
the important of attunement with client, pacing and focusing on skills rather than relaxation and verbal reassurance
eye contact could be the red flag of neglect and can used as the starting point for the engagement
This was useful. Thank you. I look forward to next session, next week. ~Jane
i loved Pat Ogdens approache with her patient that démonstrated her “tending” to her patient and respecting the paitients physical boundries of touch. the example of the shawl is very powerful. Would love to hear more practical exemples. i will be integrating these ideas into my inner child art therapy workshops.
Thanks for this!