National Center for Effective Mental Halth Consultation
   

Trauma in the Context of Relationships

Infants and young children experience their world as an environment of relationships and these relationships affect virtually all aspects of their development — intellectual, social, emotional, physical, behavioral, and moral. The quality and stability of these relationships in the early years lay the foundation for a wide range of later developmental outcomes (National Scientific Council on the Developing Child, 2004). The importance of caregiver emotional availability and empathic responsiveness in helping the infant and young child to regulate affect and organize internal experience has been described extensively. This bond begins with the mother-child or primary caregiver-child bond, representing a time when unconditional care helps the child feel perfectly understood, accepted, and protected. (Lieberman, et al, 2005)

The relationships children have with their caregivers play a critical role in regulating stress and a child's response to stress during the early years of a child's life. The experience of an infant who is hungry or wet, cries in discomfort, and has a caring adult come and care for him/her in care giversa timely manner, is less stressful than that of an infant who is left to cry, alone or handled harshly by his/her caregiver. The repeated experiences of either type of response can influence the child's ongoing stress response.

Those children who have secure relationships have a more controlled stress hormone reaction when they are upset or frightened. They are able to explore the world, meet challenges and be frightened at times and calmed without sustained reactivity to stress and threat. In contrast, children whose caregiving relationships are insecure, disorganized, or unpredictable demonstrate higher stress hormone levels when they are even mildly frightened and their expectations for a safe and predictable world are shattered (Groves, B., 2002; National Scientific Council on the Developing Child, 2005). The influence of relationships on development continue throughout the lifespan — and includes those caring relationships from multiple-caregivers (grandparents, aunts and uncles, etc.) and those outside of the child's family like Early Head Start and Head Start early care and educators and staff.

When young children experience a trauma — are injured in an accident, witness violence, or other types of trauma — their recovery from that single experience is enhanced if they can rely on secure relationships with caring adults. This does not mean that they don't experience stress or completely avoid potential signs of post-traumatic stress disorder. However, they can be comforted, guided, and supported by attuned and trusted caregivers, including those who understand the impact of trauma, and move toward a positive outcome.

Young children under chronic stress, especially maltreated children and those exposed to trauma within the context of their caregiving relationships or in the context of unavailable caregiving relationships, have often failed to develop a secure attachment to their caregivers and do not have a sense of basic security or trust in the world (Cohen & Walthall, 2003; Osofsky, 1995). In complex or chronic trauma, the caregivers may be unable to protect or may actively harm the child so that his or her interpersonal world is in a constant state of crisis. The "holding environment" so critical to a young child's health and development is affected, and ongoing stress and trauma in a family disrupts the scaffolding for the growth of many developmental competencies. (Rice & Groves, 2005; Cook et al, 2003). Without intervention, these circumstances make recovery and return to typical development difficult.

Individual protective factors, coping strategies, and resilience can support recovery from trauma and traumatic stress. Characteristics of the child, the family, and the community can be part of the dynamic process of development, recovery, and positive outcomes for children and families impacted by trauma. Again, nurturing relationships — or a community of caring adults — are a critical factor in promoting resilience and recovery from trauma (Masten, A.S.,2001; Rice & Groves, 2005).

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Georgetown University Center for Child and Human Development National Center for Effective Mental Health Consultation