What is trauma?
“Trauma survivors have symptoms instead of memories” Harvey 1990
We are used to thinking about people who have survived trauma in a certain way – movies portray veterans who have PTSD and startle at loud noises, children who cry and rock themselves, people who talk to themselves in the street etc BUT some symptoms are less easily defined as trauma symptoms and are seen as mental health issues, lifestyle choices and even moral issues.
Instead over the years we have become accustomed to people being diagnosed with anxiety and depression, to seeing people with drug and alcohol problems, insomnia, difficulty concentrating – seeing the diagnosis as discrete ‘problem’ to be fixed and treated, DSM V has many diagnoses which are now being realised could be part of developmental trauma, defined as being exposed to early and chronic trauma (see the ACEs page for more discussion on what constitutes an early traumatic event)
DR Bessel van der Kolk is a pioneer in the treatment of trauma, and he campaigned vigorously to have developmental trauma recognised in the DSM V
Dr Katherin Frogley of the UK based Association for Child and Adolescent Mental Health writes:
The term Developmental Trauma was introduced and was intended to specify the impact of multiple childhood traumas, noting that the difficulties (and perhaps treatment required) differs from that following a single traumatic incident. Developmental Trauma Disorder was later put forward for inclusion in the latest Diagnostic Statistical Manual (DSM-V), following a definition and set of diagnostic criteria developed by Dr Bessel van der Kolk and his colleagues within the National Child Traumatic Stress Network in 2009. The criteria included the following: exposure to trauma, affective and physiological dysregulation, attentional and behavioural dysregulation, self and relational dysregulation and post traumatic spectrum symptoms. To gain a diagnosis, symptoms would have to be present for 6 months or more and be having a clinically significant impact on the Individuals level of functioning. Despite evidence presented from a number of DSM-V field trials, Developmental Trauma Disorder did not make it into the DSM-5