Developmental Trauma Disorder

Bessel Van Der Kolk's (to me) very interesting take on the effects of cumulative trauma on the developing human being, the child.

Would it be surprising if DTD became widely accepted?

http://www.traumacenter.org/products...a_Disorder.pdf

SAWE, I haven't had time to read the whole article, but it looks interesting. It is talking about using DTD as a diagnosis for children. What strikes me is that many who experience a cumulative trauma in their childhoods don't "come to light" until a few decades later as they have increasing difficulty coping with life, the bad "secrets" from childhood are escaping or revealed, or for some, they are so very tired of being unhappy or dysfunctional. So I wonder what adult diagnosis the childhood diagnosis of DTD would match up to? Would it be complex PTSD? Unfortunately, many children who might have DTD are not identified while children. And is there a current childhood diagnosis this would replace? (Complex PTSD diagnosed early?)

I hope to have time to read more of the article later. Thanks for posting.

DTD would also be used in adults. It is about the trauma that occurs in childhood. But the consequences are long term. The likelihood of it making it into DSM 5 are very slim. And sadly it is all about politics. Well I guess you get my opinion of that situation.

There is not a diagnosis of complex PTSD in the DSM now (though the concept is talked about), and it will not show up in the new DSM. It would not replace another diagnosis, it would be a new diagnosis.

I really hate it when I see something in the WWW and forget to note where I found it, but this is something that makes so much sense to me and it's tied to "developmental trauma disorder" sort of, although I don't thik it's Van der Kolk. So here Sunny, maybe this speaks to a couple of your excellent questions.
to all (and sorry about the fonts, I have no idea)
====================================

There is a special and sad vulnerability for children. During early development, the brain enters a hyper-alert phase as part of the learning and growing process. Children absorb an amazing of information in a short time. They learn walking, talking, communication, and how to control information. Children learn the difference between their actions and themselves. They learn to separate themselves from their environment. They build their identities. One pictures that alert little amygdala busy processing all that new information from the world, storing up experiences, defining rules, figuring out language and the power of words (that’s the terrible twos.), figuring out society, and “look! See what happens when I drop the ball – it falls to the floor and makes a noise and rolls away. Will it do that again? Let’s see.” Children are wonderful scientists and natural experimenters. It must be an exciting time for the brain.
What if there is trauma? Trauma can push this alert state to such extremes that there is damage to the brain cells (PTSD). If the child stays this way for an extended time, then memories that might have become long term (and therefore retrievable later to the adult brain) are never connected. She loses her memory of childhood. And she never fully builds an integrated personality. This is not necessarily a multiple personality, although in the most extreme cases, the child can develop the Dissociative Identity Disorder (DID) that results in multiple personalities. Some people have improperly characterized all such injuries as DID. Far more common than DID, however, is the injured, traumatized personality that develops PTSD.
In the case of a young child this is especially serious. It seems as if children are born with a brain filled with templates, some complete, most needing some input from the environment to complete their structure. The child fills in these templates as she grows and learns human behavior. At some critical point the child integrates all the templates into an executive control, an identity, a self. The safer the environment the healthier the final product. Probably by the age of six, the templates are complete enough to define a whole person.
If the child completes the integration, then she/he can endure a lot of physical and mental attacks and not lose her identity. She/he will develop her own strategies for survival. If however the trauma is severe enough, then depending upon the trauma and when it occurred, one or more particular templates may remain incomplete; she does not integrate. Sadly, she does not know this has occurred. The painful future, the misunderstandings to come, the failures and confusions, these will all make little sense to her. She thinks that her brain is operating the same way that everyone else’s brain does. She thinks she has the same genetic templates and the same completed personality. She does not understand why she has problems.

van der kolk is amazingly brilliant! im reading one of his articles right now on trauma re-enactment.

I find Donald Winnicott very good to read and very easy to understand.

i'm a bit confused about how this is different to cptsd?

Me too.

perhaps because it is about cumulative trauma, rather than an episode? and the effect on childhood development as well as the trauma response.

Hmmm.....

It seems orange is the new black!!

I don't actually think that Developmental Trauma Disorder is different than CPTSD. I think that there has been so much hub-bub over the "label" of complex PTSD, and so much difficulty in creating an appropriate label for what children who have experienced multiple childhood traumas have experienced, that the scientific world might be saying....."Hmmm, people don't like the CPTSD things, so let's just call it something else. I know....let's call it Developmental Trauma Disorder!!"

It works for me. CPTSD or DTD, it doesn't change the fact that I feel screwed for life and have way to many issues to overcome and face for one lifetime. Changing the name of something doesn't change the etiologies or the symptoms one experiences. They could call it PIZZA if they wanted to.

So yeah, it makes sense to me that this would be possibly a better way of describing what children, and adult children, have experienced. I think it's a swell label and I think it will be more widely accepted than Complex PTSD.

Just my simple opinion.

That was the whole point about "complex" PTSD -- to distinguish between episodic and long-term (childhood) trauma. But maybe it is just a change in terminology.

But this too, the importance of disrupted development. If treated earlier, the child could possibly have a more 'normal' (for lack of a better word) development and not have to wait until adulthood to find out where the early trauma affected developement, perceptions.

mmm cptsd isn't confined to childhood trauma (e.g., can be applied to adults also) but it encompasses more than the trauma response captured in the PTSD diagnosis (effect on personality, for example). i don't see anything in DTD that adds to CPTSD, other than specifying aetiology (which isn't taken into consideration for most other psychiatric disorders anyway).

im in a cynical frame of mind re: the DSM and diagnoses these days. makes me want to avoid taking up clinical training, which is sad and silly. i should take my emo elsewhere though - no need to turn this thread into a debate on the introduction of new diagnoses into the DSM. the article certainly was an interesting and engaging read.

my $0.02......

Van der Kolk: "normal" adults who undergo a trauma (say, involvememnt in 9/11) may be able to say to themselves, as horrible as that was, it was an incident in a lifetime, and perhaps they will not develop PTSD. Whereas a child, on the other hand, has few or no other life experiences to use as a self assurance that the whole world is not dangerous and threatening, and they are more likely to develop PTSD. It doesn't have to be "complex PTSD"; it can be a one incident thing; the vulnerability may have come from trauma(s) in preverbal years and the PTSD setting in later on from some other incident (or series of incidents) entirely.

The second blurb, I wish I could remember where I found it: children who undergo very early trauma(s) are more likely to develop PTSD (whether complex or no), but also may never integrate their personalities correctly, may never come to be "normal" adults at all, but will not understand why.

In my own case, which may be this last one, I find myself wondering whether therapy can help me complete the formative-brain templates; if not, I've only gone from
a) being incomplete without knowing why, to
b) being incomplete, and knowing why, and being unable to do anything about it.

Which is preferable, do you suppose....

I disagree that one can't ever fully recover. For what its worthn there comes a time when its best to stop reading and concentrate on your own recovery, there's nore gold to be found in that.

SAWE, i'm wondering - you seem to have been in therapy for many years - do you think the only thing that has changed is that you've developed insight? is therapy worth it if it helps you get from a 35% brain template to an 80% brain template? does anyone (trauma or not) ever have a completely perfect 100% brain template?

>> does anyone (trauma or not) ever have a completely perfect 100% brain template?
not qualified to say, Deli, are you?

>> is therapy worth it if it helps you get from a 35% brain template to an 80% brain template?
I would say yes but I don't see it happening. Some changes yes, but some big areas remain unchanged. It's worrying.

>>> you seem to have been in therapy for many years
gee thanks for the reminder, now I really feel like a failure.
Don't mind me, I am very down these days.

((((SAWE))))

the issue of whether i'm "qualified" seems to come up often between us, SAWE. i dont know why this is an issue for you (with me in particular), but im tired of having my goodwill concern & replies to you turned around into something i have to defend.

ive been in therapy for almost 6 years now. the reminder doesnt make me feel like a failure - it shows me how much i've improved when i reflect on where i started and where i am today. i'm sorry that you feel like a failure, but quite frankly it's not my fault for bringing up a fact -- you're pushing responsibility for your negative emotions onto me.

Dear Deli,
How nice it would be if you could just bring yourself to say something sympathetic to someone who is very down. Alas, no.
I wish you well, I have always thought very kindly of you.
I will not post any more on this thread of mine,.

reading this thread reminds me therapy is best left as a verb lol

Just a comment.

I found this movie review, there are some comments I found interesting related to trauma therapy, and DTD also

http://www.psychologytoday.com/blog/...gs-true-trauma

As a lifelong member of the screwed up club I say we should get to a vote. Who says the observers have more right to label something then those they observe. Considering the Dr's practice an art and we life with the facts.