On Trump and Childhood Trauma: Clinical Considerations

Understanding the impact of the current environment on clients with early abuse.

Posted Jun 05, 2018

Free-Photos/ Pixabay
Source: Free-Photos/ Pixabay

Since the emergence of Donald Trump as a prominent figure on our national political stage and the start of his administration in January 2017, clinicians have been tasked with understanding the relative clinical impact that both tangible policy changes of and generalized shifts in sentiment that stem from his influence and rhetoric are having on their clients.

There are certain groups of people for whom discrete policy changes stand to have a direct psychological impact, consideration of which is crucial for any clinician treating one of these individuals to consider and incorporate into the conceptualization of the client. Clients who are immigrants, non-citizens, or even green card holders, for whom increases in the use of Immigration and Customs Enforcement (ICE) and state and local law enforcement to make deportation and arrests, may be immediately effected by increases in legitimate fear about being deported or separated from their families. Those who may feel protected by their legal status may have close family and friends who remain at risk, concern about whom may contribute to clinical symptomology that inhibits functioning. Individuals who belong to religious groups which have been intentional targets of changes in immigration policy, as was the case in Trump’s Muslim Ban, which sought to ban individuals from Muslim-majority countries from entering the United States, face similar anxieties. This includes increases in hate-crimes, threats and vandalism, particularly towards Muslim and Jewish populations, who are also dealing with concrete threats to safety and quality of life. Ongoing changes in the current administration’s approach to protections for LGBTQ individuals open up this population to increases in discrimination as the Trump White House simultaneously seeks to expand the ability for both health care providers and businesses to deny care or service to individuals if they feel it challenges their religious beliefs. This is all to say nothing of the gesturing that has been made towards future policy changes, which of course stands to impact on certain clients in the future but also impacts their mental health at current, creating anxiety for what may come down the line and when, including threats to the Affordable Care Act and potential loss of access to critical abortion services. Clinicians are also grappling with the clinical impact of various forms of verbal degradation that has been targeted towards several groups, that have come in large part from the President, the likes of which we have not seen from a prominent American leader in recent history, begging the question of how public verbal abuse from those in power may influence an individual who’s ethnicity, religion, or sexuality is the target of that abuse.

While clinicians have begun important conversations around the inevitable clinical issues that will arise for individuals facing direct consequences from the administration’s policies and influence, there is another population of clients for whom the President’s governing and personal styles and the subsequent societal changes may be less obvious but just as concerning and worthy of discussion: individuals who grew up in abusive family homes.

Clients who grew up in an abusive home environment, whether the abuse be emotional, psychological, or sexual, may not present to treatment reporting symptoms or concerns having anything to do with the current political climate. While some may be part of the targeted groups discussed above, others may not, and in fact may not appear to be vulnerable to immediate changes from the President’s policies or even targets of his personal attacks. However, it is imperative for clinicians to consider the ways in which the current climate may be mirroring aspects of an abusive family environment and in turn intersecting with presenting problems for certain clients. Jasmin Cori cogently summarizes the parallel processes at play with the President and his administration and the abusive family environment, including gaslighting, humiliation and verbal abuse, volatility and chaos, authoritarian control, forced loyalty, gag orders, narcissism, invasive or predatory behavior, and incompetence. Other parallel experiences may be a feeling of helplessness (inability to control or change the circumstances), being forced to accept reality of injustice and lack of consequences for those in power, and feeling an inability to escape, especially in an era of 24-hour news cycles and what can feel like daily reports demonstrating the above processes.

The concern is that this current climate may be experienced by clients with a history of family abuse as a retraumatization, an opening of old wounds, some of which may never have fully been healed to begin with. When undetected or unprocessed, the ongoing experience of retraumatization presents a barrier to effective treatment, and like any other stressor, it demands to be brought to the forefront, understood for the individual impact it may be having (including the personalized interaction with the client’s existing symptoms) and teased apart as related but separate to the original traumatic atmosphere.

Tumisu/ Pixabay
Source: Tumisu/ Pixabay

Therefore it is crucial that the clinician consider broaching the topic, and exploring with the client their relationship to, interaction with, general exposure to and experience of the political climate. This is undoubtedly a sensitive subject. This requires the clinician to use their clinical judgment to intuit whether this is appropriate or relevant. There are undoubtedly clients with family abuse histories for whom the ascension of this administration’s particular brand of governance is not experienced as retraumatizing or triggering, or those who have either intentionally or passively restricted their exposure to political news, or those who do not generally do not pay attention to it enough to be impacted. Some clients may feel empowered or comforted by the style of the current administration. While it is certainly not the case for all individuals with chronic abuse histories, the potential for the current climate to be bringing up remnants of past trauma, either within or outside of the clients awareness, is important enough that the clinician should be tuned into this as a possibility, and open to using current reactions as a vehicle for understanding and healing from trauma.

Some clients may let you in on their experience, starting session with an exasperated report on the latest news story, allowing an emotional reaction to come into the room, facilitating the ability to use that reaction to process it’s relationship to old experiences. However, some client’s may be less likely to bring this material to the room. The client may be uncertain about the clinician’s political stances and concerned about how they would react, or, perhaps more likely, the client is unaware of how their interaction with and experience of political news is exacerbating or stirring up past trauma. Like any other force which may be unconsciously influencing our client’s experience, it is our role as therapist, if deemed germane, to bring the influence into conscious awareness.

A particularly important line of inquiry is into your client’s habits of consuming news. With 24-hour access to “breaking news” across a myriad of domains (television, social media, radio, etc.) it is easy for clients (and therapists too!) to consume political news to an extent that may be compulsive, overwhelming, and self-defeating. Asking your clients about how often they check various new sources, how much time a day they spend interacting with relevant stories on social media, and, most importantly, what emotional reaction this engagement brings up for them provides crucial information for treatment planning. In some cases, clients may be attempting to gain some sense of control over the uncontrollable, trying to get ahead of news stories as to not be blindsided by them, gain knowledge or understanding of the overall situation, or, as Freud would perhaps suggest, participating in the repetition compulsion, compulsively exposing themselves to this atmosphere which mirrors the original trauma. It is useful to understand the news watching habits as to help clients understand the impact that their level of consumption has on them; the risk is that overexposure may lead to burnout, re-experiencing, anxiety or depression in a manner that makes it difficult for clients to a) participate in their lives in meaningful, vitalizing ways and b) to have the energy to take actual steps to increase a sense of control or to create change in the political sphere.

Finding the appropriate balance of engagement with the news cycle is of course an issue many of us face. However, it is important to be cognizant that a history of childhood abuse, particularly when chronic and in instances where more than one type of abuse (emotional/ psychological, physical, sexual) occurred, is associated with difficulties in emotion regulation, tolerance of negative emotional states and boundary setting (Dvir et al, 2014). Unregulated consumption of political or politically-influenced information, much of which has elements of the processes paralleled in abusive upbringings,  may stir up more intense and less manageable emotions for these individuals, particularly as they touch on unprocessed earlier traumatic experiences. Individuals with history of abuse may find it more difficult to set necessary boundaries for themselves when it comes to managing the extent of content that they engage with. Further, these individuals may struggle generally with a sense that they lack control to change or affect their circumstance, carried over from their experience of being a child who may well have had minimal control, which may make it more difficult to imagine solutions or plan active methods of involvement in either politics or community activism that could allow them to assert some control.

Simply helping the client understand the way that the current environment may be triggering or stirring up old wounds could be helpful, particularly if the client had not been in touch with the impact it has been having. If the client is engaging with the news in a manner which is further exacerbating their symptoms, working with them to develop healthier habits that increase a sense of control and empowerment will be equally important. Normalizing client’s reactions may be an effective intervention, as some may feel a sense of guilt for their feelings, judging themselves (if is the case) to be lucky to not be direct targets of the administration’s policies (“Others have it worse”) or feeling weak, as if they shouldn’t be so affected by something they perceive as remote (“Why am I making such a big deal out of this?”). Introducing emotion regulation skills, including increasing tolerance of negative emotional states, can be constructive not just in helping client’s manage emotional reactions to political content or discussion, but targets a key deficiency often seen in clients with abuse histories.  

The parallels between this political atmosphere and abusive, traumatic family systems are too striking to ignore. Individuals with a history of abuse in childhood are finding themselves immersed in a political climate which is ubiquitous and difficult to get distance from. Just as clinicians are being thoughtful of how direct policy changes stand to impact clients who belong to groups that are being targeted, the situation demands that clinicians too understand the impact that this environment could have for individuals who with abuse histories.

Broaching the Topic: Suggestions for Getting Started

  • I’m hearing you talk about [feeling out of control] [feeling like the world isn’t fair] ; I know you’ve mentioned your frustration with politics lately…I’m wondering how what’s been going on in politics may be contributing to how your feeling.
  • I know the political climate has been different over the last few years than it was in the past, some people are having reactions to it. What has been your experience of it?
  • You mentioned you’ve been watching the news a lot lately. How often to you watch it? What do you get out of watching it?  How does watching the news make you feel? Where do those feelings go?
  • I’m noticing the way you talk about what’s going on in Washington is very similar to how you describe your home life growing up. There seem to be some parallels there.
  • I can’t help but think that when you talk about what your life was like growing up, there are some real parallels to the way that our country is being led right now.
  • [As client is discussing political topic] What are you feeling right now? When have you felt that way before?

References

Cori, J. (2017, February 4). Trump Era Mirrors Abusive Family, May Trigger Childhood Trauma [Blog post]. Retrieved from http://www.jasmincori.com/trump-mirrors-abusive-family/#

Dvir, Y., Ford, J. D., Hill, M., & Frazier, J. A. (2014). Childhood Maltreatment, Emotional Dysregulation, and Psychiatric Comorbidities. Harvard Review of Psychiatry, 22(3), 149–161.

Pierce, S. and Selee, A. (2017). Immigration under Trump: A Review of Policy Shifts in the Year Since the Election. Migration Policy Institute, Washington D.C. Retrieved from https://www.migrationpolicy.org/research/immigration-under-trump-review-policy-shifts.