DUBLIN BUISNESS SCHOOL

EVAN DWAN

AN EXPLORATION OF THE ROLE OF INTEGRATION IN HEALING

DEVELOPMENTAL TRAUMA

THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS OF

THE HIGHER DIPLOMA IN COUNSELLING AND PSYCHOTHERAPY

SUPERVISOR: STEPHEN MCCOY

25/04/20
 TABLE OF CONTENTS

Abstract

Introduction………………………………………………………………….1

Chapter 1: Developmental trauma…………………………………………...2

Chapter 2: Implicit memory………………………………………………….6

Chapter 3: Dissociation………………………………………………………10

Chapter 4: Trauma treatment…………………………………………………14

Conclusion……………………………………………………………………19

References…………………………………………………………………….20
Abstract

Developmental trauma occurs at a stage of development when the self is most vulnerable and

hence leaves a lasting legacy on the personality. The symptoms associated with

developmental trauma are ‘nonverbal iterations’ in which there is no coherent narrative. The

memory of early trauma is stored implicitly in the body and it is these implicit memories that

manifest as somatosensory fragments, such as distressing body sensations and images. In

developmental trauma, the emerging self protects itself by splitting off overwhelming

experiences, in the process of dissociation, with the result that the personality becomes split

and fragmented. In order to resolve this kind of trauma, this early protective process must be

reversed – the dissociated must become associated again. The split off and dissociated parts

of the personality must be linked together through integration which can be understood as

something that lies at the heart of health and healing. The ‘parts paradigm’ is an effective

model for working with this kind of presentation. In this process, the client is facilitated to

have an internal dialogue to link different parts together. The non-traumatised, healthy part of

the self, offers empathy and compassion to the traumatised ‘child-parts’ and in this process

creates internal secure attachments by providing reparative experiences that serve as an

antidote to the traumatic past.

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INTRODUCTION

This paper will explore developmental trauma and how it can best be treated in a

psychotherapeutic context.

The way in which developmental trauma occurs and what the implications are on the

development and functioning of the self will be examined in the first chapter. The paper will

look at how early trauma leaves a lasting effect on the personality, particularly in its ability to

regulate affect. In the second chapter the paper will focus on how developmental trauma is

stored in the form of implicit memory. The third chapter will explore the concept of

dissociation, examining the key role it plays in the organisation of the personality after early

trauma. This will lay the foundation for, in the final section, looking at how the integration of

implicit memories and different parts of the personality can lead to the healing and

transformation of developmental trauma. The paper will conclude with a critical evaluation of

using a ‘parts’ approach to working with trauma in psychotherapeutic practice.

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CHAPTER 1: DEVELOPMENTAL TRAUMA

People with trauma often present with symptoms rather than verbal narratives (Ogden et al,

2006). Traumatic memory often takes the form of reactivated nonverbal memories with

incomplete narratives. These symptoms are split off from conscious awareness as sensory

perceptions, obsessive thoughts and behavioural re-enactments. People ‘remember events’

through ‘nonverbal iterations’ of traumatic events or through mysterious physical symptoms

that have no organic basis. These memories are self-contained and do not necessarily interact

with autobiographical knowledge. As they are inaccessible to verbal recall they remain

unintegrated and unaltered over time. It is this lack of integration that allows reminders of the

trauma to trigger ‘somatosensory fragments’ which impede the client’s ability to modulate

arousal and function effectively. They remain unintegrated and clients then become phobic to

their contents.

There is a need to expand the idea of trauma from catastrophic events in adulthood to

everyday interactions in childhood that we depend upon for survival (Cozolino, 2017). For

primates, attachment equals survival and abandonment equals death. Early trauma has an

overwhelming, disorganising and painful effect on the developing organism (Heller and

LaPierre, 2012). Developmental trauma can take the form of shock trauma at an early age;

on-going misattunements leading to attachment trauma; or abuse and neglect. Relational

trauma can be more impactful than other types of trauma as it overrides every capacity of the

infant to cope, leading to visceral dysregulation. The infant is completely dependent on the

care-giver so when that care-giver is experienced as a source of threat or when they cannot

provide safety, the infant has no refuge to go to. The world is experienced as unsafe which

becomes a lifelong experience. The earlier the trauma the more global the impact on

psychology and physiology. The nervous system is locked in high arousal and defensive
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responses which effects all the systems of the body. The source of threat (no longer in the

environment) is in the nervous system, memory and the cells of the body.

Relational trauma can be defined as exposure to chronic misattunement and prolonged

periods of dysregulation in the early attachment relationship (Hill, 2015). When the infant

seeks affect regulation from the caregiver, they receive responses that worsen rather than

modulate arousal. The attachment figure lacks the emotional ability to regulate the infant and

the relationship itself becomes the stressor. Relational trauma, as referred to by Allan Schore,

is less about abuse and extreme neglect as it is the “unobvious, invisible trauma” that happens

in the early attachment relationship (Hill, 2015, p.136). According to Schore, chronic

misattunement in affect regulation transactions leads to defects in the primary affect

regulation system and negatively impacts the limbic-autonomic structures. In these

transactions the primary affect regulation system of the caregiver is imprinted onto the infant.

For developmental trauma to occur the child need not be abused, only to experience

themselves as abandoned (Fisher, 2014). When the mother is experienced as absent, an

attachment trauma forms leading to the flooding of primary limbic emotions like fear, shame

and anger. Attachment rupture is the central disorganising core of developmental trauma

manifesting in severe affect dysregulation. In the absence of the mother the child does not

develop around the being of another, but alone, amidst the eruptions of powerful emotions,

which, when not regulated, deform the development of the child. In the perception of being

motherless, the infant experiences profound helplessness, left in fear for their survival. Even

in the face of other early traumas, the core and most impactful trauma may be the absence of

the mother who could prevent, address and repair the effects of trauma.

Being held in the mind of the mother is the original holding environment for the infant

(Fisher, 2014). Not receiving this the child feels lost and forgotten and can later describe the
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experiences as ‘falling backward through a black hole’. ‘Motherlessness’ develops into a

background ambient fear which becomes the person’s universe. The central nervous system

becomes frozen in fear. In ‘motherlessness’ there is no mother there, which means no one to

remember ‘me’ (the infant), ‘no mother inside me’. There is no sense of containment; the

person feels unmoored and wild, without any sense of being held. The child relies on the

survival responses of fight/ flight but since they cannot discharge this energy they collapse

into freeze. Levine (2012) describes this as arousal coupled with the overwhelm of being

immobilised by fear.

According to Bessel Van Der Kolk, developmental trauma leads to a lack of affect regulation

due to the lack of synchronicity between the care-giver and infant resulting in abnormal

rhythms of brain, body and mind (hyperarousal or shut down) (Fisher, 2014). Infants are

supposed to learn affect regulation during the first few years of life. If this capacity is not

wired in during this time it is not likely to develop later, writes Van Der Kolk. The mother’s

inability to regulate herself comes at a high cost to the right hemisphere of the developing

child’s brain - the area responsible for affect regulation. When this area is underdeveloped, it

leads to difficulty modulating the intensity and expression of emotion. According to Allan

Schore, the development of affect regulation is the basis for developing a coherent self.

Without the felt sense of a self-regulated mother the baby is overtaken by a fear of survival.

Without this experience the development of the brain structures that can inhibit subcortical

responses of fear and rage are compromised.

Fear is the emotion at the core of developmental trauma (Fisher, 2014). It is the primary

dysrhythmia that overtakes the brain. In order for treatment to be effective it must target the

fear circuits in the brain. Neglect, abuse, abandonment, maternal mental illness and addiction

are all examples of what Sebern Fisher calls the ‘catastrophe’ of the child whose mother has

‘turned away’. The child is left without the felt sense of the ‘organising other’. As a result,
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the baby suffers on-going primary dysregulation impacting the development of body and

brain, resulting in unrelenting terror that disfigures the mind.

The infant feels no separation between themselves and the environment. Therefore,

environmental failures are internalised as something being wrong with them (Heller and

LaPierre, 2012). Deficient holding is an environmental failure but is experienced in the infant

as a deficiency within themselves. As a result, people carrying early trauma experience a

lifelong sense of shame.

In this chapter we have explored the nature of developmental trauma. Developmental trauma

is nearly always relational in nature as it stems from either a lack of protection from

caregivers in relation to external threats, or situations where the caregiver themselves are the

threat, or their absence is perceived as a threat to survival. From the literature it is clear that

the legacy of early trauma is chronic emotional dysregulation. The primary task of the first

three years of life is developing the capacity for affect regulation which occurs through the

co-regulation provided by the caregiver. This environmental failure leaves infants

overwhelmed and flooded by powerful emotions – an experience that is carried into

adulthood and eventually brings people to therapy.

Developmental trauma occurs at a time when the human being is most vulnerable and when

they are in the process of developing a self. Therefore, trauma at this stage can become the

shaky foundations on which the developing personality is built. It is as if trauma is built into

the core of the person’s being, coming as it does at such a seminal point. Developmental

trauma leaves a legacy of intrapersonal and interpersonal difficulties but how is trauma stored

or remembered? If past experience impacts present functioning how does this occur? In the

next section we will look at the idea of implicit memory and explore how early trauma is

carried forward and ‘remembered’ throughout life.

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CHAPTER 2: IMPLICIT MEMORY

In the early years of life, the establishment of new interconnections between activating

neurons creates what is known as implicit memory (Siegel, 2012). There are a number of

elements involved in implicit memory including perceptual, emotional, behavioural, and most

likely, bodily sensory memory. Mental models are also part of implicit memory, which can

be understood as generalisations made based on repeated experience.

Early implicit memories lay down the foundation for who we are and encode core relational

patterns that form the implicit truth of how relationships work (Badenoch, 2017). This is

‘relational encoding’. These implicit memories create the perceptual lens through which we

experience life. Our system knows that the implicit sensations and emotions associated with

trauma would be overwhelming and so shield our awareness from them until the resources

needed for integration are present. The lost remnants of early painful and frightening

experiences that did not receive the support needed to integrate are hidden away in

subcortical regions and bodily pathways, waiting to be healed. Accessing these implicit

memories is the key to altering the felt sense of how we experience ourselves and the traumas

held within us. Implicit memories remain below conscious awareness but when we attend to

activation, sensation and behavioural impulses they become conscious. As traumas embed in

the form of implicit memory, time stops for those parts of us. Implicit memory might be

referred to as ‘the eternally present past’.

Developmental trauma occurs before our verbal skills have developed (Kain, 2018). In early

trauma we are in a developmentally pre-verbal stage therefore our ability to create narrative is

limited. Our earliest experiences are primarily somatic. Our brains have not yet developed to

the point that we have the capacity for cognition or higher-order reasoning. Instead, at this

early stage, we are having ‘somatic conversations’ with ourselves through our interoceptive
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and sensory experiences. Most of our sense of safety comes from the direct experience of

somatic touch. This means that the narrative of developmental trauma is primarily a somatic

narrative. These narratives are diffuse with the quality of having a ‘sense of’. The felt sense

describes this somatic narrative (for example the felt sense of safety, or lack thereof).

Traumatic experiences leave behind a neurological footprint, almost like bread crumbs that

provide a larger map of how we navigated our earliest experiences. They also show how we

integrated those survival strategies into our sense of self, other and environment. This map

becomes the territory in which we function, the reference point for all new experiences. We

all create these maps or narratives but when developmental trauma has occurred the map or

narrative may be organised around the trauma.

Developmental trauma can occur at different stages: Prenatal trauma, prenatal attachment

trauma; birth trauma; perinatal trauma; attachment and relational trauma (Heller and

LaPierre, 2012). Traumatic symbiosis can occur where the infant takes on the trauma of the

mother. Inadequate attachment, particularly in the first six months, can create a traumatic

legacy. Insufficient holding, nourishment, attachment, and touch are experienced as a

profound but indefinable threat, held in implicit memory. When needs are not met initially

the infant protests but if there is still no response, they go into shut-down, disconnect from

the body and enter freeze and immobility. This unresolved high arousal creates a nameless

dread and an impending sense of doom. There is a general fear that something bad is about to

happen. In reality, something bad has happened and they are carrying it forward

unconsciously. This nameless dread latches on to named dreads – like phobias, OCD, and

pathological fear of death. Going into freeze at an early stage mean these infants have a

lessened capacity for self-regulation; they also feel awkward in themselves and shy away

from social contact.

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In developmental trauma people remember their experiences through the body (Fisher, 2014).

They suffer somatic problems and are often dismissed as hypochondriacs. Sue Gerhardt

(2004) writes that the most stressful experience of all for a baby or infant is separation from

the mother or caregiver, the person who is supposed to keep them alive. Even short

separations from the source of food or protection is very frightening for all mammals (Fisher,

2014).

According to Joseph LeDoux there are two fear circuits in the brain (Cozolino, 2017). The

fast or taxon fear system has the amygdala at its core and makes rapid, reflexive, unconscious

decisions. It develops first and organises learning related to attachment and affect regulation.

This brain circuit involves sensory, motor and affective memories related to early life. Most

scientists now agree that early experiences shape neurobiological and neurochemical

structures in the brain by the transcription of sections of genetic code. In people with early

developmental trauma real or imagined abandonment triggers states of terror. There is no safe

inner world that people can return to when trauma occurs. Somatization disorders, in which

emotions are turned into physical symptoms, are adaptations to early deprivation and trauma.

The literature on implicit memory suggests that this is how early trauma is stored and kept

active within the organism. There seems to be some confusion around whether implicit

memory equates with unconscious or non-conscious memory. The implicit, in its ‘stored’

form, rests outside of conscious awareness but when triggered or activated comes into

awareness but often in subtle ways that make it hard to notice as it is experienced simply as

‘who we are’. Implicit memory, it is suggested in the literature, covers everything from

emotional responses, somatic sensations, images, motor and autonomic activity. This raises

the question: What is the boundary or the limits of the implicit? It is our felt sense experience

of the world based on previous experience so does that mean that everything we experience

in life is an implicit memory?

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In relation to early trauma the bodily held sensations and emotions that constitute implicit

memory ‘tell the story’ of events for which we have no verbal recall. Autonomic activations

of hyperarousal and hypoarousal are understood to be activations of implicit memory. But is

this really memory? In the sense that these activations are based on patterns of prior

activations which make future activations more likely to occur it would seem so. But if this is

the case how do we ‘step outside’ of implicit memory? In order to change the traumatic

imprints of the past it would seem necessary to find a vantage point free of the past but how

is this possible if the very basis for all our experience and our sense of self is implicit

remembering?
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CHAPTER 3: DISSOCIATION

The essence of trauma is structural dissociation of the personality (Van Der Hart et al, 2006).

This involves an organisation of the personality in which certain psychobiological systems of

the personality are unnecessarily rigid and closed off to each other. As a result, there is a lack

of cohesion and co-ordination in the personality. Trauma survivors have an impaired

integrative capacity and lack of skill in regulating their internal world and relationships.

Dissociation is the key concept in understanding trauma, a term which originally meant the

division of the personality or consciousness. Pierre Janet described dissociation as division

among the systems of ideas and functions that make up the personality. The personality is a

structure made of systems. A system can be understood as an assembly of related elements

that together make up a whole. Each element is part of that whole and relates to the other

parts in the system or to the system as a whole.

Trauma related dissociation is a deficiency in cohesiveness and flexibility of the personality

(Van Der Hart, 2006). There is not a complete split but a lack of cohesiveness and co-

ordination across the systems of the personality. Dissociative parts of the personality

constitute a whole, are self-conscious, have some sense of self and are more complex that one

psychobiological state. They are mediated by action systems. The child has immature

integrative brain structure and function and structural dissociation acts as an impairment of

the natural move towards integration in the personality.

Dissociation is a key variable in understanding disorders that have roots in early relational

trauma (Schimmenti and Caretti, 2014). Dissociation links the overwhelming with the

unbearable. It binds the experiences of neglect and disrupted communication with attachment

figures in childhood with the development of unbearable self-experiences that cannot be

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integrated into consciousness and therefore continue to disturb the person throughout their

life.

In infancy the drive to attach is stronger than the fight or flight response (Fisher, 2017). All

early trauma happens in the vacuum of ‘motherlessness’ where the baby is alone in the world

(Fisher, 2014). Developmental trauma happens in the ‘motherless void’; the self falls apart

under the weightlessness of neglect. In order to avoid feeling overwhelmed humans seek to

create psychological distance from traumatic events or ‘deep memory’ (Fisher, 2017). People

adapt to early trauma by psychically splitting off the memory of it. Survivors of trauma must

keep some part of the self separate from the memory of horrifying events in order to keep

going with normal life. They must disown the horror and the fear, ‘the other’ inside. By

disowning traumatised ‘parts’ of the personality, or ‘not me’ self-states, we disconnect

emotionally and lose consciousness in dissociation. In so doing we preserve ourselves and

hold hope for a better future.

This distancing of trauma in childhood allows us to keep developing (Fisher, 2017). The

‘going on with normal life self’ is only dimly aware of what is happening in the rest of the

self. The worse the trauma and the less the safety experienced, the more distance will be

needed from that part. We disown feelings and needs in order to avoid disappointment or

punishment. One way to do this is to split the desperate need for attachment between two

parts; one part clingy and needy, the other avoidant and distant. Alienation from parts of the

self may be necessary to adapt to the environment. The child must ‘wall off’ parts of the self

that threaten the caregiver or are punished by the environment. However, segregating intense

feelings leads to affect intolerance resulting in acting out and acting in as the only way to

regulate arousal.
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Splitting and fragmentation must become more complex and creative as time goes on (Fisher,

2017). Some parts become more autonomous or ‘emancipate’ from cortical control. They are

split off from other parts that there is no intrapersonal awareness between them. The brain is

designed to split if things get too much or too overwhelming. The right hemisphere and the

left are separate from each other to begin with. When trauma occurs the left ‘verbal

linguistic’ self assumes the role of the ‘going on with normal life part’, while the right brain

‘corporeal and emotional’ self mobilises the physical survival responses to prepare for threat;

this is the trauma-related part. Each sub-part within the ‘self-system’ has a different lens, a

different job and employs a different animal defence (fight, flight, freeze, submit, cry for

help) for survival. Clients come to therapy not knowing that the symptoms they are

describing are ‘parts’ and implicit memories that once were adaptive but now are maladaptive

and out-dated.

In early trauma the organism gives up its unity in order to save itself (Heller and LaPierre,

2012). Numbing, splitting and fragmenting create disorganisation on all levels of experience.

When the organism experiences overwhelm it manages this by first numbing, then splitting

and finally fragmenting. Numbing can act like a dimmer where all experiences are just dimly

felt, or more dramatically it can be a full ‘brake’ where in a moment of shock all emotion and

sensation is shut off. Fragmentation is the coping mechanism of last resort. Fragmentation

creates a lack of coherency in the biological systems of the organism. It manifests as a lack of

consistency and organisation in all areas of life. There is a lack of a coherent narrative in the

person’s life.

Traumatised ‘parts’ of the self-system acutely feel emotions and sensations of pain, terror,

despair, and abandonment (Schwartz, 1995). It is as if their circuits overload and they

become frozen in time at the point when the trauma happened. These parts live on as if they
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are still stuck in this situation with all the feelings and sensations. When the system is

traumatised before it has fully developed it will become constrained and accumulate burdens.

The literature suggests that dissociation is an adaptive strategy used to defend against

traumatic experience that is too overwhelming to be processed and integrated by the self-

system. Dissociation, understood as the division of the personality, is a way to create distance

with traumatised parts of the personality, thus allowing some part of the person to develop

normally and carry on with day to day living. Traumatised parts are ‘exiled’ and in this

splitting and fragmentation the natural drive towards integration is thwarted.

The legacy of dissociation is disorganisation and a lack of coherence in the person. What

implications does this have for therapeutic treatment? If trauma creates a state of

disintegration then the treatment of trauma must involve the facilitation of integration. Van

Der Kolk (2014) supports the thesis that the essence of trauma is dissociation so, he argues,

the solution, or resolution of trauma, must involve association. Dan Siegel (1999) argues that

the essence of health is integration which is the linkage of differentiated parts of a system

together. On the level of memory, dissociation might be understood as the burying of implicit

traumatic memory in subcortical parts of the brain and body. These memories are banished

from awareness but are liable to be triggered in somatic flashbacks which flood and

overwhelm the person’s ability to regulate such strong affect. The heart of trauma treatment

would seem therefore to revolve around widening the window of tolerance through

developing skills and capacities to regulate affect and the ‘association’ and integration of

dissociated parts that hold the implicit memories of trauma, by linking them up with the

wider memory networks within the brain (Shapiro, 2013).

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CHAPTER 4: TRAUMA TREATMENT

In order to heal from trauma, the different aspects of the self that have been split off or

dissociated during the traumatic event, need to be made conscious, accepted and integrated

(Fisher, 2017). The fragmented parts of the self that hold the trauma still experience

themselves in danger of annihilation or abandonment or both.

Healing occurs through being able to notice, name and differentiate the parts that hold

trauma; then the client must learn to emotionally connect with these parts and provide a

‘reparative experience’ for them that are antidotes to the past (Fisher, 2017). It is really

important to be able to offer a ‘loving presence’ to the parts – relating with an attitude of

warmth, acceptance and curiosity, looking for what is right with each part, rather than what is

wrong.

This approach contrasts sharply with Cognitive Behavioural therapy (CBT). CBT seeks to

change the beliefs and cognitions that create distress. The ‘parts’ approach is in keeping with

the humanistic tradition of Client-centred therapy with an emphasis on acceptance. The

question we might pose here is, if it is possible to change the thoughts and feelings that cause

suffering (the ‘parts’) why would we accept them? These differences are down to contrasting

theories of change. CBT approaches work on the assumption that thoughts and beliefs can be

directly changed through challenging, substituting etc. While the humanistic tradition

subscribes to the paradoxical theory of change: When I accept myself as I am, I change.

The ‘normal life self’ (non-traumatised part of the personality) must learn to relate to the

‘child parts’ (traumatised) and create emotional bonds by welcoming and attuning to these

parts so that they can be brought home from exile (Fisher, 2017). This is what it means to

process memory. The client can tolerate the memory when they see it as part of ‘what

happened’ (and now is over). Creating a new ending transforms the event as the child part
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ends up ‘in the arms’ of someone safe and caring. The therapist, in this case, is facilitating an

empathic connection between the adult client and their child parts; then guiding them to

notice how it feels somatically and emotionally to connect in this way. Staying with this

experience for thirty seconds or more means that the brain will start to encode these positive

experiences as new memories.

It is questionable to what extent this offers resolution of traumatic symptoms. Does

witnessing and being present with these memories really process them and hence reduce

symptoms? It might be argued that, without more directly altering the pattern held by each

part, we are simply reinforcing it if we are not making attempts to directly alter or disrupt it.

But, on the other hand, interacting and relating to parts in a different way (from a resourced,

compassionate part of the self) is creating a new dynamic, and hence altering the pattern.

The above process is the essence of integration, which, as Dan Siegel describes, happens by

first differentiating parts of a system and then linking them together (Fisher, 2017). By first

differentiating, we can study, befriend and ‘own’ these different parts. Then, when different

parts are linked together, it transforms the sense of the client’s experience, facilitating healing

and reconnection. New information about the present must be linked to old perceptions

coming from the past. To feel safe today a connection must be made between ‘the adult I am

today’ and ‘the child I was then’.

For linking to occur in the process of integration we need to be able to access two different

states at the same time (The ‘adult’ and ‘child’). Is this really possible? When I become

aware of the child part am I not immediately ‘in’ that part, having lost the ‘adult’ me? We can

move back and forth between two states but it is hard to see how we can hold two states in

mind simultaneously.
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Trauma related vulnerability feels less scary when it is related to a new bodily sense of

mastery or the somatic sense of ‘it’s over’ (Fisher, 2017). Trauma resolution comes with

attachment repair of each ‘part’. The dissociative fragmentation and splitting off of

unbearable emotion from memory leads to self-alienation. Coherence is the opposite of

having fragmented, polarised and conflicting parts. It is where the sum of the many views of

the many selves come together creating a ‘healing story’. Coherence is a reconstruction or

transformation of painful memories which supports the encoding of new, more positive

feelings. In attunement, there emerge feelings of safety, pleasure and relief as parts feel

‘gotten’. New experiences of security, nourishment and acceptance become encoded, the

missing experience that parts never received. These experiences of resonance and internal co-

regulation create secure internal attachments. It is a little unclear though how this process

happens. If parts have been fragmented and split off for so many years how do we bring them

together again and how do they remain linked and integrated once they recede out of

consciousness?

Parts may still experience anxiety, depression and destructive impulses but clients now have

an earned secure attachment which provides a stable base to deal with grief, loss and other

challenges; they can soothe and reassure themselves (Fisher, 2017). The healing process

consists of repeated reparative interventions. Each repair retrieves a part that was once left

behind, so it is no longer phobically avoided but embraced. The left-brain ‘normal life self’

needs to befriend the right-brain related parts. This increases collaboration and

communication between the two hemispheres, leading to integration, the opposite of splitting.

This idea of internal earned secure attachment might be questionable. There is a large body of

research supporting attachment dynamics between people but it is unclear whether this can be

applied to the intrapersonal world. Do we really ‘bond’ and attach to different parts of

ourselves? Are parts even real entities?

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In reflecting back on the genesis of developmental trauma, it appears to be something that

occurs because of a lack of the presence of a safe and protective ‘other’ that can offer refuge

in the face of threat. Developmental trauma is born in the experience of separation and

‘aloneness’ in early life. The child, at some level aware of their utter helplessness,

experiences this as a threat to their very existence. Given this, it makes sense that the way to

repair this traumatic experience is to offer the antidote of connection – the presence of a

warm, loving other that can soothe and heal parts of the personality that carry the existential

fear inherent to trauma. This presence can be provided for by the therapist, but in the model

above, outlined by Fisher (2017), the healthy part of the client’s self augments the loving

presence of the therapist, leading perhaps to a deeper form of healing.

In the case of developmental trauma, where the central defence mechanism is learning to split

off and dissociate parts of the personality that hold the traumatic memory, the ‘parts

paradigm’ (where the personality is understood as a multiplicity rather than a unity) seems

like quite an appropriate way to address this fragmentation. The aim, as the literature

outlines, in resolving trauma, is integration.

This work, while facilitated by the external presence of the therapist, has a strong inward

focus on the unfolding experience of body and mind. Clients with developmental trauma tend

to view their inner world as highly threatening due to the activation of implicit traumatic

memories which can be overwhelming. This model, therefore, would seem to be quite a

challenge for this population. The ability to attune to and dialogue with ‘parts’ requires quite

a bit of skill to execute. One wonders to what extent highly traumatised clients would be able

to engage with this process given the metaphorical landmines that exist in their inner world.

CBT uses a more ‘blunt force’ approach – analysing and challenging certain cognitions –

which may be more accessible and user-friendly. The free association of psychoanalysis and

the non-directive nature of the client-centred approach are also, arguably, ‘less technical’ and
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easier to engage with. The internal dialogue of the parts approach is nuanced and subtle and a

radically different way of communicating for most people, but it could be argued that by

intentionally directing the client’s attention towards the direct experience of traumatic

phenomena, it holds greater promise and potential to get to the root of the client’s suffering.

The multiplicity model makes intuitive sense when working with dissociation and the

fragmented personality structure that comes as a result of developmental trauma. These

different exiled parts are protectively split off because the implicit memories they hold are

experienced as unbearable. If the fundamental mechanism of early trauma is disintegration

and ‘dis-association’ then it makes sense that the resolution and healing of trauma comes

about through integrating and associating different parts of the personality together into a

more coherent whole. The parts and memories that were exiled after the experience of trauma

must be ‘brought home’, by being integrated back into the self.

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CONCLUSION

In this paper the concept of developmental trauma was explored. We looked at the early

relational dynamics that are at the core of this phenomenon. The paper went onto discuss the

central role played by implicit memory in the symptoms that manifest as a legacy of

developmental trauma. The other factor that some authors claim to be central to early trauma

is the notion of dissociation, understood as the splitting and fragmenting of the personality

into separate, often disconnected, parts. In the final chapter we explored a ‘parts’ model for

working with the legacy of developmental trauma, exploring how the client’s non-

traumatised ‘normal life self’ can help, through the facilitation of the therapist, to create

secure internal attachments with ‘child parts’ in the resolution of developmental trauma.

Finally, some questions were raised as to the relevance of this ‘parts paradigm’. It was

concluded that this approach offers a helpful working model of the psyche and is a modality

that makes a lot of sense in working with developmental trauma in psychotherapy.

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