What is Developmental Trauma?

Developmental Trauma technically doesn’t exist. It is not currently formally recognised as a diagnosable condition and yet it is widely talked about and accepted within fostering and adoption.

So, let me tell you how I understand developmental trauma and why I think it is essential that we begin to recognise it more.

What is Developmental Trauma?

In my last post I talked about primary, secondary and triggered trauma. Developmental trauma is, quite simply, when a child is exposed regularly to traumatic events and situations from a young age. Most agree this begins before the age of 5.

How’s It Different To Other Types Of Trauma?

Trauma always affects us holistically. If someone has had a generally good life and then experiences trauma in their 40’s they usually have the resources to heal themselves or to seek the help they need. This is not the case for repeatedly traumatised children. They will lack the internal resources to resolve the trauma themselves. They will most likely have a distrust of adults and therefore will not be able to ask for help to feel safe again.

Also, we know that trauma effects the brain. If a child is repeatedly traumatised it will effect their ability to develop typically. This means that they will likely be impacted by the trauma in a lasting way. In the more severe cases we are talking about long term brain damage.

Why Isn’t It Recognised?

Unofficially I think it probably is. It is certainly discussed by all of the psychiatrists and therapists I know working with children who’ve experienced long term abuse.

Conditions of mental health are typically diagnosed according to what is written in the Diagnostic and Statistical Manual (DSM). Quite simply, this book names recognised mental health conditions, describes the possible causes and lists the expected symptoms. It also highlights what kind of treatment may be helpful.

When the fifth version of the DSM was released in 2013 I think a lot of practitioners were surprised to see that Developmental Trauma had not been added as a new condition. The reason given for this was that the condition doesn’t have enough evidence to back it yet. This does not mean that it doesn’t exist, just that enough research has not been done. I suspect one of the main reasons for this is that it is really hard to research child trauma in a way that is ethical and does not cause any further harm to the child. Also, until it is recognised it will be hard to get funding for research – creating a catch-22 situation.

What is interesting is also the political issues around this diagnosis. An acceptance of developmental trauma could call into question all mental health diagnosis by showing that the impact of trauma is more significant than originally thought. This article is interesting for further reading.  Mental health has traditionally been understood from a medical and largely biological model. Accepting that trauma has such significance impact would suggest that many mental health conditions may well be more a result of nurture than nature. This has been a growing thought over recent decades but there are still some professionals who do not accept it.

An acceptance of Developmental Trauma may also open doors to other definitions such as Transgenerational Trauma. This one suggests that trauma can be passed down from one generation to the next – a traumatised parent acts in a traumatising way toward their own child. I personally would be interested to know if trauma can be passed biologically. We know that trauma changes a person’s brain but can this then be passed down genetically to their children? If so, trauma could also be behind conditions considered to be genetic.

The reason all of this is political is that mental health is big business. There are many different therapies and medications out there which would be effected if research showed all of this to be true.

And yet it also offers hope. We can work with trauma, and healing is possible in the vast majority of cases.

I Thought You Weren’t Keen On Diagnosing?

Generally, I’m not. There are many reasons for this and I will do a post in the future. However, I do recognise that there are some benefits to a child having a diagnosis. The main one is that the child can get better support. If developmental trauma officially existed, then parents and professional could be educated to understand it more and appropriate support could be put in place.

What Happens Now For Children?

What I see in my work is that children present with a list of symptoms (often behavioural) and are given diagnosis that are officially recognised but might not actually be right for that child. Most commonly I see children with diagnosis of Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD) or Oppositional Defiant Disorder. The symptoms are often very similar but the underlying cause is completely different and needs to be worked with very differently too.

For me, recognising developmental trauma would truly honour the experiences of our young people and provide them the best possible support.

But I’d loved to know your thoughts, so please do pop them below……