CMT and Trauma

• Call for questions and comments....... by Jessica Boitman, 10/14/98
  • Control-Mastery and Trauma by Michael Simon, 10/27/98
    • Trauma and children? by Jessica, 11/4/98
      
      

In order not to let this important subject lie dormant here with no attention for the time being, I wanted to make the following submission that may not, unfortunately, address prcisely what is being sought.

I don't know, that is, whether the following can properly be considered ideas on treatment applicable to severely taumatized children (i.e., the degree of severity may be an important qualifier). And I am uncertain about the applicability of the following ideas to children whose traumas are unrelated to mistreatment (such as, say, a child who suffers massive burns in an accident or the unexpected sudden death of a beloved parent, and so on).

Thus I am passing along a reference to a fine journal artlcle employing CMT and dealing with the difficulties persons face presumably as a result of trauma from mistreatment. I am referring to an article authored by Diane Raisman Suffridge that appeared in the journal PSYCHOTHERAPY (Vol. 28, 1991, pages 67 to 75) under the title "Survivors of child mistreatment: Diagnostic formulation and therapeutic process."

The article presents a handy summary of how Control Mastery Theory could account for many otherwise seemingly inexplicable behaviors. The behavior of traumatically mistreated children makes more sense from the standpoint of someone who has adapted to strain and other trauma and is left with pathogenic beliefs about oneself and one's chaoic world in accord with the best and most desperate interpretive effort a young mind can muster under egregious circumstances.

Control Master Theory understands that a youngster's already-established interpretations (formed from his or her existing adaptations) will not be surrendered when placed in a more benign enviornment UNTIL the new enviornment is first tested and eventually found (after numerous dense affective and behavioral pyrotechnic encounters) to be one that can in fact endure a lot of what the child earlier had endured.

This testing, as I understand it from the standpoint of CMT, is a process of finding a safe enough place in which to find new and less self-sacrificing beliefs in the context of a more benevolently enlightened relationship with others.

Testing includes, I think, the experience of dense negative affect in a situation in which new beliefs about the worthiness of one's own goals in a more supportive interpersonal world become possible.

These intense testing situations must be repeated often enough in a context of safety and understanding so that the youngster eventually is free to formulate more satisfying adaptations to a more turstworthy world.

Some of the beliefs that are part of a mistreated younster's existing adapatations are listed in the Suffridge article. Some of these beliefs are that s/he expects to feel bad and be treated badly, to regard oneself as the cause of this badness, as unworthy of caring or better treatment and as unworthy of protection--by either oneself or by others-- from harm. The badly mistreated youngster would be likely to also believe s/he is unentitled to privacy or protection.

Most important of all, the younster is likely to feel guilty even even wanting privacy, protection, caring, or less mistreatment. Thus the desire to want to know more, feel better, or improve one's skills can itself be a desire that induces guilt.

It may be worth noting that Winnicott's notion of a "holding enviornment"--one that withstands successfully numerous trying tests in a climate of safety for all parties--is also apt in understading this issue in a way that seems to me compatible with a CMT approach.

I hope Jessica or others may be able to amplify or change this presentation according to their own clinical experience.

• The role of attachment in trauma by Diane Suffridge, 11/30/98