Have you heard of the ACEs study?
I won’t go into detail of the entire study, but hit the highlights. CDC-Kaiser Permanente Adverse Childhood Experience study, 1985 to 1987 is one of the largest study on childhood trauma and its lasting effects, In a nutshell, the study found that ACEs negatively correlated with adult problems such as alcoholism, addiction, mental illness, relationship failures and even physiological outcomes such as obesity, heart disease, etc. It’s a very interesting study, which, if you are into that sort of research, you would find enlightening.
But for the sake of my blog today, I hang my hat on the understanding that childhood trauma potentially negatively affects the person well into adulthood. That knowledge bolstered my determination to take the necessary extra courses to become a certified clinical trauma professional. In my private practice I have seen multiple examples of current mental/emotional and behavioral issues linked to past ACEs, Once identified, the client and I can work together to address the underlying trauma experience and utlize CBT, DBT and Mindfulness to move forward.
This is all well and good if the client is open and ready to share their truth. Clients who are closed or detached often means that they have not yet developed the therapeutic relationship and the trust that goes with it. I am patient and do not mind spending more time developing that trust. After all, trauma is a very personal and painful thing to discuss. Without trust, disclosure is often masked by distraction and deflection.,
For some reason, I found this to be most common when working with teenagers. While building that trust and therapeutic relationship, I often encountered heavy deflection. It was almost like the teen considered me an alien speaking another language.
But I found an universal translator.
Music.
The discovery came quite by accident. I had been working with a particularly closed-off teen. I knew from her history that she had ACEs with her father, but she usually spent the entire session talking about her current relationship issues and friend drama. This girl was talented, intelligent and very personal, but had deflection down to an art. If I got too close to anything remotely beneath the shallow mental garden she had created for herself, she would laugh and tell me that she didn’t know what I meant. Then she would change the subject.
I knew that she really liked a popular music artist. She talked about the artist all of the time. Knowing that we sometimes listen to the music that moves us, I became interested in the artist when the client was with me. I asked questions about the music: why she liked the artist; what songs did she like the most; what was it about certain songs that moved her. With the conversations around her favorite artist, the teen opened up a little more each time. But again, when I got too close, she deflected again.
One day I asked her to play me her favorite song by this artist. She did. The song was full of lyrics about being abandoned, hurt, trying to rise above the pain. Wow! The song really did capture the feelings she had kept so tightly in her chest.
AT the conclusion of the song, I just took a chance and asked the client pointedly, « This is how you feel about your dad. ». To which she replied, with her eyes cast down, « yes ».
The window was open.
My challenge to you today is, when working with someone who is closed off and holding their trauma close to their heart, be patient. Find an outlet for the client, that is a safe expression of their pain and emotions. Creative outlets offer that safety. In my case, it was music. And I subsequently used that technique with other teen clients with success, But it doesn’t have to be music. It can be art, drama, journaling, any creative expression, that creates that safe space, For example, I had another teen client who loved to write stories. She would read her stories to me and they were her window.
Opening up and exposing the trauma is difficult. Realizing that closing off with deflection can be a defense mechanism against that difficulty is important when building that trust. Try creating a safe environment for the expression of that trauma as a tool in opening that window.
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