The concept of 'relational trauma' needs a serious overhaul TW (precautionary)

[GoSlash27]

All,
 I promise I will try to be as vague as possible so as to avoid upsetting anyone unnecessarily.

 The definition of 'relational trauma'(IRT childhood induced cPTSD) is, at its broadest, *any* experience where a child's trust in their safety is undermined by an ostensible 'guardian' to the point where the child is in fear for their life and fears that there is no escape. It is the accumulation of these traumas without treatment over a long span that rewires the brain for survival instead of development.

 The current definition of what counts as a 'trauma' is *way* too narrow and rigidly defined IMO.
 Like a Chinese menu; "This" happened to you at the hands of your guardian. "That" happened to you at the hands of your guardian. Maybe a half dozen specific events.

 What about all the *rest* of it? All the stuff that *doesn't* fit into these neat boxes?
 What if the trauma happens at the hands of someone the guardian allowed into the environment? What if the trauma happened as a result of a situation the guardian permitted? What if the trauma happened to a sibling and the child witnessed it? Or even the guardian him/herself?

 It is *all* trauma. It *all* puts the child at risk for their life and in mortal fear. It *all* accumulates and it *all* leads the children to this point in the end.

 You see... *All* of this stuff happened to me throughout my childhood and more. Not just the conventional stuff, but all the *unconventional* permutations that ostensibly "don't count" as well.
 I would argue that it's all bad. If it leads you here, then here you are. 

Best,
-Slashy 
 

[Chart]

I'm gonna respond by way of thinking out loud. The psychological system was modeled after the medical system. Medicine has two ways of viewing illness: Exterior disease and exterior accidents. Both come from "outside" the individual. There are genetic diseases, but these too are "isolated" and singular. So this paradigm was taken up for psychological pathologies as well. Either there is an (exterior) event that disturbs the equilibrium of the brain, or the brain itself has a "dysfunction" (like genetic diseases). But both are singular. Relational trauma is completely different in that is has an evolutive aspect. It progresses in parallel with a developing infant brain. It changes the structure of the brain, nothing "breaks down" like other physical maladies. The new structure is adapted to fit the environment. This, I agree, is profoundly misunderstood in the psychological realm.
Carolyn Spring talks about this in the seventh podcast (I think, it's the 7th...)
https://youtu.be/MwPdw0gk9uM?feature=shared

[Kizzie]

Slashy:  I copied a section from the book several of us are working on to give you an idea of exactly what Complex Relational Trauma is.  Hope it helps.

Complex Trauma (CT) is the overall umbrella term used to describe various traumatic stress experiences that are protracted/repeated, overwhelm the individual in an ongoing way, and from which escape is not possible or is perceived as such. There are several different types of CT, some examples of which include:

Group: This type of trauma is inflicted on groups of people by others based on certain identifiable characteristics (e.g., race, gender, sexual orientation), and/or beliefs (e.g., political, religious). The Black Lives Matter movement is one example of group trauma.

Impersonal: This type of CT involves more natural events which are ongoing to an extent and create overwhelming traumatic stress for individuals (e.g., natural disasters, chronic illness).

Institutional: This refers to trauma inflicted by the ongoing actions or lack thereof on the part of institutions that are responsible for the welfare/well being/safety of individuals (e.g., police, justice system, religious organizations).

Relational: This type of CT is also referred to as interpersonal trauma.  It refers to trauma in which an individual is trapped for an extended period of time in an abusive/neglectful relationship with someone who has a degree of authority/power over them (e.g., parent, partner, coach, teacher, employer, religious leader).

Our book is about the last type of CT – relational.  Our focus is on adults who developed CPTSD as a result of Complex Relational Trauma (CRT) beginning in childhood or adulthood. CRT refers to abuse/neglect that is interpersonal, intimate and soul crushing. As Ford and Courtois (2020) describe it, the "i's" have it when it comes to CRT. It is "intentional, injurious, invasive, intrusive, and intimate", and "calls into question the safety, sanctity, and even the very possibility of being a unique and integrated individual who can be intimately involved with others" (p. 7). What distinguishes us from other CT survivors is that the perpetrator focuses on us as individuals, believing we are vulnerable and can be abused in secret without repercussions. They do so because they have some degree of power over us and want something from us such as control, sex, money and so on. It generally does not have anything to do with a particular group we may belong to–for example, race, religious, political, sexual orientation– although that may be part of the reason in some cases.

There are two diagnoses relating to the relational traumatization of children and adults; for children the diagnosis being proposed is Developmental Trauma Disorder (DTD), and for adults it is Complex PTSD. Complex PTSD has been accepted as an official diagnosis by the World Health Organization (WHO) in its classification of diseases manual the ICD-11. DTD has not been accepted by the WHO and neither diagnosis has been accepted by the American Psychiatric Association (APA) for its classification manual the DMS.

DTD relates to CT in childhood because the trauma interrupts the developmental stages and attachment processes that are normal in the early years of life. DTD is characterized by insecure attachment styles, poor self-identity development, interpersonal sensitivity and consistent problems in relationships, including with peers, adults, and primary caregivers, high rates of psychiatric comorbidities, and chronic and debilitating medical/neurological illnesses (Cruz et al, 2022). It is not difficult to see that the seeds of Complex PTSD are sown in childhood trauma, and that prevention and intervention are imperative. Clearly, it is important in the case of children who are experiencing CT that there be a separate diagnosis to assess and treat them effectively.

[Lakelynn]

Thanks for a great post Kizzie!