Presented by: Kathleen Adams, PhD
In Part I of this two-part special presentation, author Kathleen Adams, PhD, discusses her book Attuned Treatment of Developmental Trauma: Non-abused, High Functioning People Living Outside of Time.

Many therapists don’t even think of their patients as “trauma patients” despite descriptions of early neglect, abuse, separations and loss, and dysfunctional families without enough love to go around. Two years ago, I was invited to give a presentation on preverbal trauma in group therapy to a group of seasoned group clinicians. Only two out of the 50 present believed they had a single patient with preverbal trauma in their practices. Instead we diagnose them in the fashion most familiar to us and insert them into our therapeutic practices, undertaking defense analysis, tackling characterological issues, exploring underlying conflicts and fantasies. That’s what we do. This protocol fails to permit our trauma patients to unfold and reveal who they really are unless we broaden our scope and think trauma, listen for vertical splits, subtle Me and Not-Me states, (Chefetz and Bromberg, 2004) and look underneath their surface presentation for the depth within.

The goal of this presentation is to sensitize you to the presence of subtle dissociative states, preverbal trauma, long term attachment distress, and chronic shock in your patients. I also hope to change your approach as a group therapist to incorporate a hard look at how attachment and neglect are handled in your groups. When patients approach us with stories of early deprivation, neglect and abuse, we tend to interpret “upward,” focusing on conflict and character, and then go home to our full lives and families without a clue that we are missing the point. The point, as you shall see, is that we are working with people who are falling down into an abyss, and we are making polite conversation about their defenses and fantasies while they continue to fall, shatter, and shake. Meanwhile our patients with developmental trauma are so desperate for a secure attachment experience that they collude with our roadmaps, willingly fantasize, earnestly explore conflicts, and stolidly work on their character flaws. We will discuss assessment issues for developmental trauma and explore the management of these states in your group and individual treatments.