Angels and Ghosts in the Nursery
Sarah sits across from me in my office, staring down at her hands. Her eyes fill with tears and she shakes her head.
“When Jake was sober, he was funny and nice and he was a good dad to Brandy and Lucy, he really was. I guess that’s why I stayed with him through all the awful stuff. I hated it when he hit me, but I don’t know…my stepdad used to hit me and, I know it sounds stupid, but I thought maybe all guys were like that. We had a fight and I kicked him out but I never, never thought he’d show up with a knife and threaten to kill me in front of the girls. Brandy ran out of the room, but Lucy, she was right there, sitting in her high chair, she couldn’t get out and she saw all of it. My poor baby…”
“Lucy is so different since this happened,” Sarah later tells me. “If I get up to leave the room, she starts to cry and scream. She’s so clingy! I even have to take her into the bathroom with me. She used to be curious; she liked to play and get into things but now it doesn’t seem like she’s interested in doing anything except watching me to make sure I don’t go anywhere. She was starting to walk, but now it doesn’t seem like she even wants to crawl.”
You might remember one year-old Lucy from my last post. Lucy is now 16 months-old and I’ve started to work with her and her mom, Sarah, using Trauma-Informed Child-Parent Psychotherapy (TI-CPP). A crucial part of this therapy involves exploring parents’ own trauma history and helping them to understand how it might affect their child.
"Ghosts in the Nursery"
In 1975, Selma Fraiberg, a clinical social worker and child psychoanalyst, introduced the metaphor of “ghosts in the nursery.” This concept refers to the relationship between a parent’s early, often negative experience of the way they were raised and their own parenting style. Young children who are abused by their parents can exhibit similar behaviors when they become parents themselves. Sometimes they have repressed the abuse, sometimes it’s what they consider to be “normal” because it’s how they were raised. These “ghosts” can reappear throughout generations, contributing to a cycle of abuse. Trauma-informed therapy like TI-CPP helps parents to recognize ghosts from their past so that they and their children can heal together.
Trauma can have a profound influence on growth and development, leading to developmental disruptions
Restoring a Sense of Safety
As Sarah and I work together, she begins to realize how she has minimized her own history of abuse and in doing so, has missed some cues about how unsafe Jake’s behavior had become. Restoring a sense of safety is one of the primary goals of TI-CPP. The realization that her stepfather’s violence was one of her own “ghosts” helped Sarah to better understand Lucy’s behaviors and fears and to learn strategies to support her sense of safety. In our therapy sessions, Sarah is learning to read Lucy’s cues, “narrate” when she thinks Lucy might be feeling scared, reinforce safety and offer comfort. As she picks Lucy up she says, "Lucy, you look really scared right now. But you’re with mommy and I will keep you safe. I’ll hold you and we’ll sit right here until you’re not feeling so scared."
Another goal of TI-CPP is the return of typical developmental functioning. Trauma can have a profound influence on growth and development, leading to developmental disruptions such as regressive behavior (for example, toileting accidents or “baby talk” in preschool or school-age children) and hesitation or inability to engage in developmentally expected behaviors. As babies learn to walk, they use their caregivers as a “secure base” from which to explore, play and learn, later returning for emotional refueling. But Lucy has lost the typical toddler desire to explore the world and her control over it. Her body is always on high alert and being away from her mom to test her independence is terrifying.
Understanding the Cues
An interesting thing happens as Sarah becomes better able to notice and respond to Lucy’s emotional cues; she starts to anticipate in advance when Lucy might become fearful and plans accordingly. One day she told me, "I’ve noticed that Lucy always starts to cry when we drive past our old apartment, you know, the one where all the bad stuff happened. She was so little, I didn’t even think she knew where it was! I avoid that part of town now and take different routes to get where we need to go. It seems to help."
But there are times when reminders can’t be avoided and with guidance, Sarah is starting to help Lucy differentiate between the past and the present. "Lucy," she says at these times, "when you were a little baby, you saw daddy hurt mommy. And then daddy got hurt by the police. But that’s not happening now. Now you’re with me and we’re safe. Squeeze my hands and look at me. We’re safe."
"Angels in the Nursery"
In 2005, Alicia Lieberman and her colleagues proposed the concept of "angels in the nursery"—positive early experiences between a caregiver and child that result in the child developing strong feelings of security and self-confidence. When the child becomes a parent, she/he can draw on these feelings in order to interrupt the cycle of abuse. Lieberman suggested that uncovering angels is as important to the process of healing with traumatized parents as is exorcizing ghosts.
Trauma-Informed Child-Parent Psychotherapy has been used extensively with a wide range of cultural groups and clinical and research data have documented the effectiveness of this approach with culturally diverse groups. Wilder therapists from Southeast Asian and Kofi services have been trained in TI-CPP. In the next article, we’ll talk about some of the cultural considerations that they feel contribute to the success of this model with their clients.
Gael Thompson, MSW, LICSW, is the Early Childhood Intervention Program Coordinator for Wilder’s Child Guidance Clinic.