Building Trust With Children Who Have Experienced Developmental Trauma by Candace Bobier

I recently came across the special issue in the Australian and New Zealand Journal of Family Therapy from 2017: Relational Trauma and Family Therapy. Linda MacKay’s descriptions of the articles contained therein had me so enticed [1] I couldn’t decide which article to read first. Having heard Jonathon Baylin speak in Christchurch a few years ago, I started with his brief article, Social Buffering and Compassionate Stories: The Neuroscience of Trust Building with Children in Care [2]. The article is presented in Dr Baylin’s easy to digest engaging style which makes one wish it was more than five and ½ pages long, but packs a lot into those pages. Fortunately, I also a copy of his excellent book The Neurobiology of Attachment-focused Therapy: Enhancing Connection & Trust in the Treatment of Children & Adolescents [3] co-written with Dan Hughes whose article in this special issue I will share next. But, back to Dr Baylin’s thoughts on social buffering and compassionate stories. The article describes very thoughtfully how it is that children in care come to develop blocked trust and how caregivers themselves are at risk of blocked care in parenting a child whose defences reject closeness and connection. It invites us to consider these mechanisms in relation to neurobiology, beginning with the ability of a trusting caregiver to soothe or buffer the stress response system or HPA (hypothalamic-pituitary-adrenal axis) and to use this knowledge to assist caregivers to accept and embrace even the defensive or aggressive parts of the child. The story used to illustrate this process is a heart-warming delight describing discovery, with the child, of acceptance of ‘the Hulk’. Through this acceptance trust develops. Baylin concludes with a conceptualisation of internal narratives and automatic storytelling. I found it really interesting to think about the difference between social stories constructed fast and low in lower regions of the brain vs those developed more slowly using higher regions of the brain and how this is a process we can all benefit by being conscious of in creating our own internal dialogues.

Dan Hughes article, Dyadic Developmental Psychotherapy (DDP): an attachment-focused family treatment for developmental trauma delves deeper into how a therapist might facilitate the building of trust between a child with blocked trust and a caregiver at risk of blocked care. I first became aware of DDP through my involvement in the research, evaluation and occasional co-facilitation of the Canterbury delivery of the Fostering Security© training programme for parents and caregivers of children with early traumas and attachment difficulties [4]. What I like about Dan Hughes’s writing is that there is always something new to discover. This article takes the reader through an exploration of DDP beginning with a very moving vignette of a child in care named Jenny and her life experiences. It then considers the interplay between these experiences, neurobiology and poly vagal theory, and culminates with a description the process of therapeutic sessions first with Jenny’s caregivers and later including Jenny. I particularly appreciated the description of how the therapist applied the principles of PACE, a stance of playfulness, acceptance, curiosity and empathy, central to DDP, in building a relationship with Jenny’s foster parents to resolve their possible own past traumas and blocked care. Only after resolution and trust was established between all parties was Jenny invited to join sessions demonstrating the very same PACE-ful approach. We utilise PACE extensively in our delivery of the Fostering Security© Programme. I am a believer. This article gives readers a taste of how PACE can build relationships and demonstrate that “you get it,” something that I think is useful for anyone parenting or working with children and adolescents.

Of course, other articles in this special issue also appear enticing, but I’ll have to leave reading those for another day.

 

References

MacKay, LM. Special Issue: Relational Trauma and Family Therapy. Australian and New Zealand Journal of Family Therapy 2017; 38: 557-560.
Baylin, J. Social Buffering and Compassionate Stories: The Neuroscience of Trust Building with Children in Care. Australian and New Zealand Journal of Family Therapy 2017; 38: 606-612.
Baylin, J. Hughes, DA. The Neurobiology of Attachment-focused Therapy: Enhancing Connection & Trust in the Treatment of Children & Adolescents (Norton Series on Interpersonal Neurobiology). 2016. New York: Norton.
Hughes, D. Dyadic Developmental Psychotherapy (DDP): An Attachment-focused Family Treatment for Developmental Trauma. Australian and New Zealand Journal of Family Therapy 2017; 38: 595-605.
Fostering Security. 2016. www.fosteringsecurity.com