Developmental trauma is more common than many of us realize. According to the National Child Traumatic Stress Network, 78 percent of children reported more than one traumatic experience before the age of 5. Twenty percent of children up to the age of 6 were receiving treatment for traumatic experiences, including sexual abuse, neglect, exposure to domestic violence, and traumatic loss or bereavement.
Adults who suffer from developmental trauma may go on to develop Complex Post Traumatic Stress Disorder, or "cPTSD," which is characterized by difficulties in emotional regulation, consciousness and memory, self-perception, distorted perceptions of perpetrators of abuse, difficulties in relationships with other people, and negative effects on the meaningfulness of life.
Although we do not have statistics on the rates of cPTSD, risk factors for cPTSD are disturbingly commonplace. According to the CDC, in 2012 there were 3.4 million referrals to state and local child protective services for cases of abuse or neglect. It is estimated that in 2012 alone, 686,000 children, or 9.2 per 1,000, were victims of maltreatment. However, experts believe that these numbers underestimate the true frequency, and that up to 1 out of 4 children may actually experience some form of maltreatment. It is estimated that the total lifetime economic cost of child maltreatment in the US is $124 billion. More recently, the World Health Organization calculated that the cost of Adverse Childhood Experiences totals $1.33 trillion for North America and Europe combined — per year!
While thankfully not all children who experience maltreatment go on to develop cPTSD, many will — and recovery is challenging even for those who do seek treatment. Recent work looks at factors which are protective in childhood and may counterbalance ACEs, one example of which is the Positive Childhood Experiences scale.
How Does Developmental Trauma Impact Identity Formation?
Identity formation is an important part of normal development, and takes place across the lifespan. Identity — including one's sense of being good enough, integration of emotion and intellect, basic awareness of emotional state, feeling secure and coherent as an individual, and even the basic experience of who one actually is — is disrupted by developmental trauma, because basic survival takes precedence over, and uses resources ordinarily allocated for, normal development of the self. Early trauma shifts the trajectory of brain development, because an environment characterized by fear and neglect, for example, causes different adaptations of brain circuitry than one of safety, security, and love. The earlier the distress, on average, the more profound the effect.
The task of identity development in adulthood, challenging enough (though rewarding) for those with a secure, safe, and enriching upbringing, is especially fraught for those grappling with the aftermath of developmental trauma. Because of developmental delays and the adult consequences of trauma, which often include substance abuse, eating disorders, depression, higher risk for many health problems, behavioral issues, and difficulty in personal relationships and professional development, identity development gets stuck.
Identity for adults with unresolved developmental trauma is often organized around being a survivor and maintaining basic safety in relation to others, leading to re-traumatizing and disheartening repetitions, preventing growth-oriented experiences. Individuals in this situation become highly identified with a "traumatic self," at the expense of a more inclusive, flexible sense of self. People with significant developmental trauma dissociate from their environment and from themselves early on — a last ditch survival mechanism — and may remain disconnected from themselves throughout childhood, adolescence, and early adulthood, only recognizing what has happened when there is no other choice but to do so.
With these considerations in mind, I am highlighting key ways that identity tends to be shaped by earlier traumatic experiences. Understanding these basic themes, which are often a result of dissociative effects on the traumatized personality, can help people recognize areas of difficulty so they can begin doing the work of recovery, repair, and personal growth.
1. Loss of childhood: "I never really had a childhood" or "I can't remember much from growing up."
People who experience a very distressing childhood often can't remember large swathes of their early life. They may remember particularly vivid moments, sometimes called "flashbulb memories," which don't have any context to them. They often don't have a clear story of themselves as a child, up through adolescence, early adulthood, and sometimes even later in life. This autobiographical sense is called a "coherent narrative" in attachment theory, and can be absent, underdeveloped, false, or oversimplified. Many people have told me that they feel like their childhood has been stolen, and without such a foundation, adult identity is compromised.
2. Missing parts of oneself: "I've always felt like something was missing, but I don't know what it is."
With chronic developmental distress, children often disconnect important parts of themselves in order to survive, a form of dissociation. They may come to rely on one major persona in order to have stability and make it appear as if everything were OK — such as being an exemplary student — while having little or no real personal life. Later in life, they may feel like parts of themselves are missing. Through personal growth and therapy, they may rediscover and even create anew these missing parts. Sometimes they are there, stowed away for better times if you will, but younger-feeling than their everyday persona. It's common for these missing parts to be associated with particular emotional states and memories, and reuniting leads to a fuller sense of identity.
3. Attraction to destructive relationships: "I'm the kind of person that always dates people who are bad for me."
It is not uncommon for people traumatized by key caregivers to end up with friendships, romantic relationships, and even work settings which are not good for them. They find people who fit their traumatic identity, even when they are trying to make different and better choices, leading to re-traumatization through repetition of the past.
They may end up being around emotionally unavailable people, abusive or narcissistic people, or end up trying to rescue and fix people they date. Consciously, they want to find someone who can provide what they intellectually know they need and want, yet unconscious influences lead them down unwanted, familiar paths. Frequently, there is a powerful "chemistry" with new relationships, which makes it seem like the relationship will be different, only to learn with disappointment that it is all too familiar. When friends try to warn them, it's not unusual for them to pick the new romance over a trusted friend. Repeatedly getting into destructive relationships can be disorienting and confusing, leading one to question one's self-understanding and locking one into the old identity, while preventing new identities from taking root.
4. Avoidance of relationships: "I'm someone who is better off alone."
Alternatively, people with negative developmental experiences involving intimate relationships may opt to avoid closeness and isolate themselves. Sometimes this starts early on and sometimes later, as an attempt to break the cycle of harmful relationships. But healthy relationships with other people are crucial for personal development, presenting opportunities for growth and change. Missing out on them in adulthood as a self-protective measure further impairs development of a fully adult identity, solidifying a self-perception of unworthiness and self-condemnation. There are many exceptions to the feeling that we are too flawed for others, who deserve better. Most of us have the capacity to offer more than we think we do, and thereby become more appreciative of ourselves. It's too complicated for here to talk about hope, faith in oneself, and how a long process of recovery unfolds. It's worth noting that sometimes we unconscious push people away, appearing to ourselves be a threat when we do not so intend.
5. Avoidance of oneself: "I don't like to think about myself; it only makes me feel bad."
Especially when childhood trauma was a defining component of key relationships — parents, siblings, and other important people — any reminder of those experiences may lead to efforts to manage painful emotions and experiences through escape from oneself. Taken to the extreme, this may lead one to self-destruction.
Connection with oneself, as with others, is a powerful reminder of prior trauma, activating memories and emotions which are often too much to handle. Self-care is impaired, and one learns to live apart from oneself as a matter of habit. They may not be able to reflect upon themselves at all, and flee from any encouragement to do so. Sense of self is often characterized by disgust and essential badness, reflecting a rigid traumatic identity.
6. Difficulty integrating emotions into one's identity: "I'm not the kind of person who has strong feelings about things."
When feelings had no place in one's family of origin, emotions become split from identity. They continue to have influence, leading to confusion and an unstable sense of self, because one is unable to predict, let alone manage, strong emotions. We need that emotional data to be fully ourselves and to make decisions. Emotional dysregulation leads to problems with impulsive decisions and gets in the way of forming healthy relationships with others.
People may experience a sense of emotional numbing or (paradoxically) feel they don't have any emotions at all. They may experience a limited range of emotions or feel muted emotions. They may, for example, only be able to feel vague emotions, such as frustration or boredom, or they may block out dissatisfaction until anger explodes. They may only feel negative emotions about themselves, such as disgust and self-loathing — and recoil from anything or anyone presenting a positive view of them, feeling uneasy with gratitude from others, "not knowing how to take a compliment" or feeling mistrustful when people express kindness. They may adopt an overly intellectualized identity, acting stilted or awkward around others.
This leads to difficulty in personal relationships, as emotions are required for intimacy and shape career choices, while often limiting advancement. Identity is narrow and flat, and re-integrating emotions into one's sense of self, while rewarding and necessary for growth, can be very challenging, full of fears and difficult learning experiences.
While it can be disheartening to read about the effects of developmental trauma in adulthood, and daunting to contemplate doing the work of recovery and identity formation beyond that of the traumatized self, therapeutic efforts are effective. Addressing these issues pays off, though the fact that there are no guarantees is a therapeutic opportunity as well as a point where a lot of people get stuck. For some, flexibly and ethically embracing an element of darkness, rather than rigidly resisting one's nature, can hold an important key to kindling adult development.
Recovery, grieving, and growth often take place over a longer time period than one would want, and re-connecting with oneself has many layers. Developing a sense that long-term goals are attainable and worth working toward is important, even if it doesn't feel possible or true. Working toward getting basic self-care in place is a vital first step, as is working toward feeling comfortable seeking help when trust in caregivers has been broken. Developing compassion for and patience with oneself can be difficult, but useful.
Please send questions, topics or themes you'd like me to try and address in future blogs, via my PT bio page.
Click here for ways to work on developmental trauma.