Tuesday, March 20, 2007
Monday, March 19, 2007
I had a "well-duh!" moment today while working. I received permission from this individual to use their ideas in my blog. We were discussing childhood development and the stages that were developed by such professionals as Piaget and Erickson. I personally am more apt to pay attention to Erickson's explanation of human development. If you are interested in reviewing it, Wikipedia has a helpful overview at http://en.wikipedia.org/wiki/Erikson's_stages_of_psychosocial_development
Check it out and it might help understand my psychobabble. The first stage occurs during the first year of a child's life and is "trust vs. mistrust." For anyone who has read my earlier blogs on safety, trust vs. mistrust is highly correlated with a sense of personal safety. A child must have the ability to feel safe in their environment which is created and maintained by their caretaker. If the caretaker provides for the basic emotional, mental, physical, and developmental needs the child will develop trust and move on to the next stages of development. While softly touching upon this stage, this individual indicated that she realized that a child usually knows where to go for comfort. If the child gets hurt he/she can run to their caregiver in pain and have the pain resolved and feel safe and peaceful once again. They learn how to develop the capacity to release the emotional or even physical burdens through trust and care by their parent/caregiver. If a child's caregiver does not give that reassurance, nurturing or love, the child's development will be stunted. For example, if the child runs to their parent/caregiver in tears complaining of an "owie" and the caregiver says something to the effect of, "stop bawling, or I'll give you a real reason to cry..." they are taught to suppress the pain and are put on a heightened state of alarm or fear when it comes to experiencing personal pain due to the negative reinforcement by their caretaker. Not only is this abuse, but it is also neglect. Abuse, to me is a type of negative reinforcer that is forced upon an individual against their will causing damage. Neglect is similar, however, it involves withholding a reinforcer that is necessary for the developmental survival of the individual. It is something that didn't happen that should have. Now, some cognitive behavioral theorists may say, "well, every individual has the ability to choose how to feel by thinking differently and addressing their cognitive distortions, changing their irrational belief system, or modifying their cognitive schema...then, the negative feelings will change." I agree with them, but it seems that there is a piece missing. If a client does not have the capacity to "reprocess" the abuse or neglect (the actual pain it caused) how can thinking about it differently cause it to go away? If in a situation where trust is required the client who has been trained in cognitive therapy can certainly think their way through the situation...but, what about the correlation that the current situation has with past abuse or neglect situations? What about the pain that is still present and surfaces during a trigger moment that doesn't seem to dissipate even when trying to rationalize through it? I am not supposing that cognitive behavioral therapies are not effective. There is sufficient research evidence that supports its efficacy. However, they are not effective alone in these types of situations (which are the situations in which I work every day). Other interventions are necessary that are non-traditional and focus on pain resolution, developmental restructuring, augmented by cognitive approaches. Not one approach, but all that are necessary to meet each client's specific needs.