I just received a great email question from one of you and I thought it will be a good idea to share my answer with everyone. The question was in response to my earlier post on How Early Childhood Trauma Affects Adult Mental Health and it goes something like this:
“How do we begin the process of removing the layers of impact that childhood trauma has on us when it was so early in childhood that we hardly remember?”
What a great question for psychoanalysis and psychoanalytic psychotherapy! Did you know that psychoanalysis is one of the best treatment methods of the effects of early childhood trauma on mental health? Why is that, you ask. Good question, let me explain.
Psychoanalysts often work with what are called “difficult to treat” patients – patients diagnosed with borderline personality disorder, or any personality disorders, psychotic patients, highly anxious individuals or ones that no one else really wants to work with – the common denominator for all usually being trauma.
#1. Psychoanalysis works with what is beyond language, what is unconscious: Oftentimes, the experience of early childhood trauma is beyond language; it is an unconscious and usually non-verbal, making it difficult to address with traditional talk therapy approaches. Psychoanalysis listens precisely for those difficult-to-put-into-words, unconscious experiences.
#2. What was never expressed in language, reappears in the body in the form of symptoms: The impact of early childhood trauma is that much more pronounced later in life precisely because there have never been words to describe or capture the traumatic experience. Usually, in psychoanalytic psychotherapy, one can begin to unravel the layers of the experience, slowly and often through speaking about the current symptoms that bother you or your body, which may include anxiety, substance use, self-injurious behavior, psycho-somatic symptoms, etc.
#3. Psychoanalysts work to listen for the meaning of the symptoms and do not try to shut it down unlike traditional psychiatry that aims at symptom relief: In psychoanalysis, we believe that there is a meaning behind each symptom, that the symptoms carries a message of an unconscious experience, often an early childhood experience that was traumatic and beyond words. We welcome the symptom in a trusting relationship between patient and analyst and we invite the symptom to speak of that, which was never spoken about before and which is hardly remembered.
#4. Psychoanalysis makes use of the transference relationship that you develop with the analyst: When addressing yourself to an analyst or psychoanalytic psychotherapist, you may talk about early childhood memories, dreams or experiences that have left a mark on you and impact your life today. Usually, because the traumatic experience is beyond words and has never been spoken about, the only way that you, the patient, can speak about it is through what we call a re-enactment in the transference relationship that you will develop with your analyst.
#5. Psychoanalysis listens beyond what is being spoken: Your analyst will listen beyond your words and take note of these re-enactments. What this means is that your analyst is an active participant in your treatment, not a mute, “blank screen” that many still seem to believe. Your analyst will say things, stress things, questions things and help you make sense of your actions, thoughts and behaviors.
So, in the email that I mentioned, the person asked me, “What is the first step that we need to take to begin addressing the issue of early childhood trauma?” The first step is to gather up some courage, make an appointment with a psychoanalytic psychotherapist and just get started on getting to know them and building a therapeutic rapport. Be committed to the process and the rest will follow.
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