Blog

When I meet a new client for the first time and conduct an initial interview, one of the questions I ask is whether the person has experienced any trauma.  Sometimes clients can talk about experiences that they recognize as traumas. However, they often tell me something like “Me, no.  I had a great childhood.  My parents were always there for me.”  And, this may be true. But very often people have, in fact, experienced trauma and not thought about it as trauma. This is where looking at attachment trauma and early life experiences may help.

How Early Experiences Shape Who We Are

When we think of trauma, we usually imagine a dramatic event. Such as a plane crash, warfare, or physical or sexual abuse.  Trauma that comes from failed protection by our primary caregivers is more subtle but much more widespread.  This attachment trauma is very common and while many people overcome it, many others carry scars.

What is Attachment Trauma?

Human babies come into the world helpless and need care and protection to survive.  There is some debate about why this is the case. One argument is that the skeletal adaptions making upright walking possible limited the size of the birth canal.  This means that infants need to leave the womb before their large brains are fully formed.  Another hypothesis is that the energy required to keep growing a fetus becomes more than a woman can sustain after about nine months.

Attachment is about our Biology and Survival

In either case, human babies are born long before they can fend for themselves leaving an extended period of dependence on parents for survival.  And survival is the key here when thinking about attachment.  John Bowlby, the father of attachment theory, suggested that biological survival is what drives attachment behaviors in both infants and caregivers.  Proximity, physical closeness, is the goal of attachment behavior since being close to the caregiver maximizes the likelihood of surviving attacks or dangerous events.

When an infant or child is afraid and sends attachment signals (crying, reaching, moving toward the caregiver) and the parent responds appropriately, the child’s attachment system is calmed, and they can move from over stimulation.  This does not have to be perfect every time, just “good enough” over the course of development.

Over time, this teaches the child how to regulate his or her moods, self-soothe when upset, and manage frustration.  They learn that it is ok to explore the world because the caregiver is keeping an eye on things.  Their curiosity develops and their spontaneous sense of self blossoms.

This is ideal with Attachment Trauma…

This is ideal, but there are lots of things that can interfere with a parent’s ability to be attentive without overwhelming the child.  Take a mother who must care for several young children all at once or a single father with a history of trauma.  These caregivers may be too overwhelmed themselves to be fully available to their children.

The key here is a balance between protecting and encouraging exploration and play.  If a caregiver is overly anxious and hovers over the infant, the infant fails to develop self-soothing capacities and learns that the world is unsafe.  If the caregiver is preoccupied with other things and misses the child’s attachment signals altogether, the child learns that care is not dependable and either learns to ignore it or becomes frantically preoccupied with the whereabouts of the parent.  Finally, if the caregiver, who should be a haven of safety, is frightening, the child again learns to turn away from support.

Trauma is much more common than we think

If a caregiver is repeatedly unavailable or responds with behaviors that are frightening, the child is forced to contend with overwhelming fear without the aid of the caregiver.  This is what attachment theorists call “failed protection” and is a common developmental trauma.  In fact, it may be so common that it is the root cause of diagnoses like ADHD and Depression.

What are the signs of Developmental Trauma?

Because this is experience is so common, an exhaustive list of signs is not possible, but here are some indications that I have found in my clinical work that suggest developmental trauma.  These signs of attachment measure these identifying signs of developmental trauma.

• Irritable or unstable mood

• Feeling empty

• Unstable relationships

• Feeling like something is wrong with me

• Reliance on substances to soothe

• Feeling the need to care for others compulsively

• Concentrating

• Feeling the need to rely only on myself and never ask for help

• Lacking true enjoyment and spontaneity

• Racing thoughts

• Nightmares or sleep problems

Essentially, these individuals learn to dampen their emotions so that they did not experience overwhelm.  But this comes at a severe cost in terms of emotional vitality and aliveness.  They create a protective shell that keeps them going but saps them of real emotional experience.  They often deny anger and are compulsively self-reliant leaving them feeling empty and lonely.

John Bowlby, put it this way: “The individual remains in a state of suspended growth in which he is held prisoner by the dilemma he cannot solve” (Bowlby, 1980).  The dilemma, in this case, is that the child is left with the impossible task of managing terror alone. Especially without the support of the attachment figure.  This causes rage that cannot be expressed because that would threaten what relationship does exist with the attachment figure.

“The individual remains in a state of suspended growth in which he is held prisoner by the dilemma he cannot solve” (Bowlby, 1980)

How can Attachment Informed Therapy Help?

Attachment-informed therapy, like we specialize Salt Counseling Solutions recognizes the signs of attachment trauma and uses state-of-the-art assessment techniques to confirm the presence of defenses that imperfectly contain it.  Using assessment techniques like the Adult Attachment Projective developed by Carol George, we help clients see the defenses they are using and begin the process of mourning the loss of protection.  Once this morning process begins, the individual can begin to feel whole again.  They are freed from the “dilemma he can’t solve” and start to move forward.

Try Attachment Informed Therapy in Philadelphia, Pittsburg, West Chester, or Kennett Square, PA Today!

If any of this sounds like you, contact us, and let’s see if we can help you move forward! Attachment-based therapy with Salt Counseling Solutions can inform so many issues related to our childhood. Our therapist’s services can help you. Whether that is anxiety treatment, trauma therapy, collaborative assessment, or a group, we can help. Our caring online therapists specialize in psychotherapy, To start your counseling journey, follow these simple steps:

1. Contact Salt Counseling Solutions

2. Meet the therapist

3. Feel free to explore my profile:

https://www.psychologytoday.com/profile/1229076 

4. Start getting the support you need!

Sometimes all we need is community and people to help us with our mental health. 

Some new clients, state hear they’re looking for something different from previous therapy experiences. They usually describe meeting regularly with a mental health counselor or psychologist, talking about their past week(s) since their last session, sometimes feeling validated and better, but noticing that this feeling often doesn’t last long. Although traditional talk therapy can be effective in alleviating some symptoms or challenges, sometimes a change of pace or a more nuanced form of treatment might be needed.

In recent years, there has been a growing interest in evidenced based psychotherapy (EBP) approaches to mental health treatment. Two of the most commonly used approaches are Recovery Oriented Therapy( CT-R) and CBT are both evidence-based therapies (EBT) that are commonly used to treat a diverse range of mental health issues. While they share some similarities in their approaches, there are also significant differences between the two. In this blog post, we will explore the key differences between CT-R and CBT.

What is Recovery-Oriented Cognitive Therapy (CT-R)?

Recovery-Oriented Cognitive Therapy is a newer form of therapy that is based on the important foundational principles of Cognitive Therapy (CT), but places a greater emphasis on the client’s recovery journey and personal growth. It is designed to help people with mental health conditions to develop their own goals and take an active role in their recovery by focusing on their own beliefs, values, and most of all aspirations.

CT-R is based on the idea that mental health conditions can be activated by negative/defeatist beliefs that will result in changes in mood and behavior. CT-R emphasizes that the best way to help people recover is by placing importance on self-determination and empowerment, as well as the development of coping skills and strategies to manage symptoms. The therapist works with the client to develop a collaborative relationship, where the client is an active participant in their own recovery journey while finding new ways to think and behave.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a widely used therapeutic approach that aims to change negative patterns of thinking and behavior. It is based on the idea that negative thoughts and beliefs can lead to negative emotions and behaviors, and that by changing these negative thoughts and beliefs, people can improve their mental health. CBT is often used to treat anxiety disorders, depression, and other mental health conditions.

In CBT, the therapist works with the client to identify negative patterns of thinking and behavior and develop strategies to replace them with more positive ones. This may involve cognitive restructuring, where the therapist helps the client to identify and challenge their negative thoughts, and behavioral techniques, such as exposure therapy or relaxation training, to help the client change their behaviors.

How are CT-R and CBT Similar?

CT-R and CBT share many similarities as they are both evidenced based and designed to help individuals with various mental health disorders, which include depression, anxiety, trauma, psychosis, etc. Here are some areas that both therapies share:

Focus on thoughts and behaviors: Both CT-R and CBT focus on changing negative thoughts and maladaptive behaviors that can contribute to mental health disorders.

Goal-oriented: Both therapies are goal-oriented and aim to help individuals achieve specific, measurable, and realistic goals.

Time-limited: Both therapies can be time-limited and typically involve a set number of sessions.

Collaborative: Both therapies involve a collaborative approach between the therapist and the client, with the therapist providing guidance and support.

Empowerment-focused: Both therapies are empowerment-focused, helping individuals to take control of their thoughts and behaviors and learn new coping skills.

Person-centered: Both therapies take a person-centered approach, meaning that they are tailored to the individual’s unique needs and circumstances.

Overall, while there are some differences between CT-R and CBT, they share many similarities and are both effective in helping individuals recover from mental health disorders.

What are the key differences between CT-R and CBT?

While CT-R and CBT share some similarities, they differ in several key ways:

Focus on recovery

One of the main differences between CT-R and CBT is the recovery orientation of CT-R. While CBT focuses on changing negative thoughts and behaviors and alleviating symptoms to improve functioning, CT-R emphasizes the importance of the client’s own recovery journey and personal growth. The therapist works with the client to identify their own aspirations and develop strategies to help them achieve them with the aim of the client regaining a sense of purpose and meaning in their lives.

Emphasis on resiliency

CT-R emphasizes the importance of resilience and self-determination. This approach encourages individuals to take an active role in their recovery while developing the skills and strategies they need to recognize their own capability in managing their symptoms.

Focus on strengths and integration of lived experiences

CT-R also places a greater emphasis on the client’s strengths and resources. The therapist helps the client to identify their strengths and build on them, rather than focusing solely on their weaknesses and negative thoughts. CT-R integrates an individual’s lived experience into the therapy process. This approach recognizes that individuals have unique experiences and challenges that may not be adequately addressed by traditional therapies.

Conclusion

Recovery Oriented Cognitive Therapy (CT-R) and Cognitive Behavioral Therapy (CBT) are two commonly used evidenced based therapeutic approaches with some fundamental differences. While CBT is effective in treating a wide range of mental health conditions, CT-R is designed for individuals who struggled to gain benefit from other approaches. CT-R’s focus on recovery, empowerment, lived experience, and collaboration can help individuals with severe mental illness regain a sense of purpose and meaning in their lives. If you or a loved one is struggling with mental health, either approach will be worth considering.