“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 harsh or traumatic experiences 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 don’t remember 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.
"Angels in the Nursery"
In 2005, Alicia Lieberman and her colleagues presented the concept of "angels in the nursery"— early experiences characterized by intensely shared positive feelings between parent and child in which the child feels fully understood, accepted, and loved. She proposed that these experiences provide the child with a core sense of security and self‐worth that can be drawn upon when the child becomes a parent to interrupt the cycle of abuse.
And, Lieberman suggested that uncovering angels is as important to the process of healing with traumatized parents as is exorcizing ghosts.
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 father’s and stepfather’s violence were some 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 attune 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."
Sarah and Lucy have more work to do. But Sarah is beginning to identify and acknowledge the ghosts and angels of her past and this is the crucial first step in the healing process.
Gael Thompson, MSW, LICSW, is the Clinical Manager of Children's and Adult Mental Health & Wellness Services at Wilder. This blog post was originally published on October 1, 2014 and has been updated.