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EMOTIONAL NEGLECT & COMPLEX PTSD BY PETE WALKER

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This article highlights the prodigious role that emotional neglect plays in childhood trauma, and how it alone can create Complex PTSD. It begins by extensively examining the processes of denial and minimization that blunt our awareness about childhood trauma. Denial is first explored in relationship to abuse, especially verbal and emotional abuse, which then sets the stage for a more complete explication of the trauma of emotional neglect. Denial about the deleterious effects of childhood abandonment seriously delimits our ability to recover. Continuous emotional neglect turns the child’s psyche into a quagmire of emptiness, fear and shame - a quagmire that she will, as an adult, frequently flashback into until she understands and works through the wretchedness of her childhood. Without such understanding, her crucial, unmet needs for safe and comforting, human connection will continue to cause her an enormous amount of unnecessary suffering.

 

Denial and minimization. Recovery from ptsd correlates with an individual’s ability to understand on deep impactful levels how derelict her parents’ were in their duty to nurture and protect her. The individual needs to get that emotional flashbacks are direct messages from her child-self about how seriously her parents hurt and injured her. As denial is significantly deconstructed, the recoveree feels genuine compassion for the child she was. This in turn motivates her to engage the healing process of identifying and addressing the specific wounds of her childhood. Over time she becomes aware of her specific abandonment picture and the pattern of physical, spiritual, verbal and emotional abuse and/or neglect that she experienced. [Chapter 8 of my book, The Tao of Fully Feeling, provides guidelines for assessing your particular pattern]. Confronting denial is no small task. Children so need to believe that their parents love and care for them, that they will deny and minimize away evidence of the most egregious neglect and abuse.

 

De-minimization is a crucial aspect of confronting denial. It is the process by which the individual deconstructs the defense of making light of his childhood trauma. The lifelong process of deminimizing the impact of childhood trauma is like peeling a very slippery and caustic onion. The outer layer for some is the stark physical evidence of abuse, e.g., sexual abuse or excessive corporal punishment. In a perversely ironic way, my parents’ physical abuse of me as a child was a blessing for it was so blatant that my attempts to suppress, rationalize, make light of and laugh it off lost their power in adolescence, and I was able to see my father for the bully that he was. [Seeing my defensively idealized mother’s abusiveness came much later]. Identifying my father’s behavior as abusive eventually helped me become aware of less dramatic aspects of my parents’ oppression, and I subsequently discovered the verbal and emotional abuse layer of the onion of my childhood abandonment.

 

Verbal and Emotional Abuse. The fact that verbal and emotional abuse can be traumatic is lost on many childhood trauma victims. Many never learn to validate its crippling effects. They never accurately assign current time suffering to it. Attempts to acknowledge it are typically blindsided with thoughts that it was nothing compared to kids who were repeatedly beaten – who had it worse. Yet for me, and many of my clients, verbal and emotional abuse was much more injurious than our physical abuse. Being ongoingly assaulted with critical words systematically destroys innate self-esteem and replaces it with a prevailing consciousness of toxic self-criticism. Even worse, words that are emotionally poisoned with contempt [a deadly cocktail of intimidation and disgust] infuse the child with fear and toxic shame respectively. Fear and shame condition him to refrain from asking for attention, from expressing himself in ways that draw attention, and before long from seeking any kind of help or connection at all. Unrelenting criticism, especially when it is ground in with parental rage and scorn, is so injurious that it changes the structure of the child’s brain.

 

Here is a theoretical model of this. Repeated messages of disdain are internalized and adopted by the child, who repeats them over and over to himself. Incessant repetitions result in the construction of thick neural pathways of self-hate and self-disgust. Over time a self-hate response attaches to more and more of the child’s cognitions, feelings and behaviors. Eventually, any inclination toward authentic or vulnerable self-expression activates internal neural networks of self-loathing. The child is forced to exist in a crippling state of self-attack, which eventually becomes equivalent to a state of full-fledged self-abandonment. The ability to support or nurture himself or take his own side in anyway is decimated. With ongoing parental reinforcement, these neural pathways expand into a large complex network that becomes an Inner Critic that dominates mental activity. This critic elaborates myriad programs of self-rejecting perfectionism and paints the psyche with the endangerment scenarios that I describe in my articles on “Shrinking The Critic”. Until these programs are effectively deconstructed, the individual typically lives in varying degrees of emotional flashback much of the time.1

The verbal and emotional layer of the abuse onion has myriad sublayers of minimization which must be confronted in the long difficult disengagement of one’s identity from the toxic critic. I have heard clients jokingly repeat numerous versions of this over and over: “I know I’m hard on myself, but if I don’t constantly kick my own ass, I’ll be more of a loser than I already am.” A childhood rife with verbal and emotional abuse often creates an identification with the critic that is so pervasive, that it is as if the critic is the whole identity.

 

Disidentification from the critic is the fight of a lifetime, and for a long time there is a great pull to collapse back into the old habit of self-blame. Ironically this selfhate can constellate around the self-judgment that one is especially defective because she cannot simply banish the critic. [Typical toxic, all-or-none thinking from the critic]. Sadly, many survivors give up before recognizing the myriad subtle ways the critic tortures them. Yet, there is no more noble recovery battle than that which gradually frees the psyche from critic dominance. Until this happens to a significant degree, there is minimal development of the healthy, user-friendly ego. Let us look now at how emotional neglect alone creates a psychedominating Critic.

 

Emotional Neglect: The Core Wound in Complex PTSD

Minimization about the debilitating consequences of a childhood rife with emotional neglect is at the core of the PTSD denial onion. Our recovery efforts are impeded until we understand how much of our suffering constellates around early emotional abandonment – around the great emptiness that springs from the dearth of parental loving interest and engagement, and around the harrowing experience of being small and powerless while growing up in a world where there is no-one who’s got your back. Many survivors never get to discover and work through the wounds that correlate with this level, because they over-assign their suffering to overt abuse and never get to the core issue of emotional abandonment. As stated above, this is especially true when they dismissively compare their trauma to those who were abused more noticeably and more dramatically. [This is particularly ironic in light of the fact that some individuals can suffer a modicum of active abuse without developing PTSD, if there is one caretaker who does not emotionally neglect them].

 

Traumatic emotional neglect occurs when a child does not have a single parent or caretaker to whom she can turn in times of need or danger, and when she does not have anyone for an extended period of time who is a relatively consistent source of comfort and protection. Growing up emotionally neglected is like nearly dying of thirst just outside the fenced off fountain of a parent’s kindness and interest. Emotional neglect makes children feel worthless, unlovable and excruciatingly empty, with a hunger that gnaws deeply at the center of their being, leaving them starving for human warmth and comfort - a hunger that often morphs over time into an insatiable appetite for substances and/or addictive processes. [I find it noteworthy that denial processes about early abandonment often morph later in life to the minimizing operations that some survivors use to rationalize their substance and process addictions. While addictions are often understandable, misplaced attempts to regulate painful emotional flashbacks, they become increasingly self-destructive when an individual is old enough to learn a healthier flashback management regimen. Accordingly, excessive eating, spending, drinking, drugging, sexing, working or dissociating, are not only desperate attempts to distract from inner pain, but also counterproductive efforts to attain an ersatz form of human comfort and soothing. And while many recoverees eventually come to see their substance or process addictions as problematic, many also minimize their deleterious effects and jokingly dismiss their need to end or reduce their reliance on them.]

 

 

The Evolutionary Basis of Attachment Needs

The human brain evolved during the Hunter-Gatherer era that represents 99.8% of our time on this planet. Children’s vulnerability to predators caused them to evolve an intense, instinctual fear response to being left alone without protection. Fear hard-wired in the child as a healthy response to separation from a protective adult, and linked automatically to the fight response so that the infant and toddler would automatically cry angrily for attention, help, cessation of abandonment - even at the briefest loss of contact with parental figures. Beasts of prey only needed seconds to snatch away the unprotected child. In present time dysfunctional families, many parents disdain children for needing their attention. Even the most well-intentioned can seriously neglect the child by subscribing to the egregious 20th century ‘wisdom’: “Kids need quality time …not quantity”. When children experience long periods of being powerless to obtain needed connection with a parent, they become increasingly anxious, upset and depressed. Over time their dominant experience of self is so replete with emotional pain and so unmanageable that that they have to dissociate, act out [aggression against others] or act in [aggression against the self] to distract from it. The situation of the abandoned child further deteriorates as an extended absence of warmth and protection gives rise to the cancerous growth of the inner critic as described above. The child projects his hope for being accepted onto inner demands of self-perfection. By the time the child is becoming self-reflective, cognitions start to arise that sound like this: “I’m so despicable, worthless, unlovable, ugly; maybe my parents would love me if I could make myself like those perfect kids I see on TV.”

 

In this way, the child becomes hyperaware of imperfections and strives to become flawless. Eventually she roots out the ultimate flaw – the mortal sin of wanting or asking for her parents’ time or energy. Intrinsic to this process is noticing – more and more hypervigilantly - how parents turn their back or become angry or disgusted whenever she needs anything, whether it be attention, listening, interest, or affection.

 

Emotional neglect, alone, causes children to abandon themselves, and to give up on the formation of a self. They do so to preserve an illusion of connection with the parent and to protect themselves from the danger of losing that tenuous connection. This typically requires a great deal of self-abdication, i.e., the forfeiture of selfesteem, self-confidence, self-care, self-interest, self-protection. Moreover, ever-developing endangerment programs proliferate in the critic as the child learns that he cannot ask the dangerous parent to protect him from outside world dangers and injustices. His only recourse is to become hyperaware and on constant look out for things that may go wrong, and the list of such possibilities becomes endless, especially when they are graphically illustrated and overemphasized on the television. Consciousness eventually becomes overwhelmed with the processes of drasticizing and catastrophizing– the processes by which the child constantly rehearses dreaded and dreadful scenarios in a vain attempt to prepare himself for the worst. This is the process by which Complex PTSD with its overdeveloped stress and toxic shame programs sets in and becomes triggerable by a plethora of normally innocuous stimuli. Most notable of these stimuli are other people, especially unknown people or people even vaguely reminiscent of the parents. Over time, the critic comes to assume that other people are dangerous and automatically triggers the fight/flight/freeze/fawn response [ See my article: “ The Four F’s: A Trauma Typology”] whenever a stranger or unproven other comes into view. This process becomes the social phobia that is frequently a symptom of complex ptsd.

 

 

Abandonment Stultifies Emotional and Relational Intelligence

Emotional intelligence and its cohort, relational intelligence, never get to develop, and children never learn that a relationship with a healthy person can become an irreplaceable source of comfort and enrichment. Moreover, the appropriate management of the normal emotions that recurrently arise in significant relationships is never modeled for them. Emotional intelligence about the healthy and functional aspects of anger, sadness, and fear lies fallow. Moreover the receptor sites for receiving love and caring from others often lay dormant and undeveloped. Emotionally abandoned children often devolve into experiencing all people as dangerous, no matter how benign or generous they may in fact be. Anyone can automatically trigger the grown-up child into the deeply grooved patterns of perfectionism and endangerment engendered by their parents. Love coming their way reverberates threateningly on a subliminal level. If, from their perspective, they momentarily “trick” someone into seeing them as loveable, they fear that this forbidden prize will surely be taken away the minute their social perfectionism fails and unmasks some normal flaw or foible.

 

As with physical abuse, effective work on the wounds of verbal and emotional abuse can sometimes open the door to deminimizing the awful impact of emotional neglect. I sometimes feel the most for my clients who were “only” neglected, because without the hard core evidence – the remembering and deminimizing of the impact of abuse – they find it extremely difficult to connect their non-existent self-esteem, their frequent flashbacks, and their recurring reenactments of impoverished relationships, to their childhood emotional abandonment. I repeatedly regret that I did not know what I know now about this kind of neglect when I wrote my book and over-focused on the role of abuse in childhood trauma. It is so hard to convey this to a client whose critic minimizes and shames them for their plight by comparing them unfavorably to me: “ I didn’t have it anywhere near as bad as you. My mother never hit me!”

 

How ironic that this typically invokes a feeling-sense in me that by far the worst thing that happened to me, by far, was growing up so emotionally abandoned. In fact, it was not until I learned to assign the pain of numerous current time emotional flashbacks to the abject loneliness of my childhood, that I was able to work effectively on the repetition compulsion that kept me vacillating between long periods of isolation and relationships that were never safe enough to reveal my whole self. It is important to emphasize here that real intimacy, and the healing comfort it alone can bestow, depends on showing up in times of vulnerability – and eventually, and most especially, in the flashbacked-times of feeling trapped in the fear, shame and depression of the abandonment melange.

 

In this vein, I had to painstakingly practice for years showing up in my pain and abstaining from my childhood default positions of running or hiding or camouflaging with substances whenever I was in the grips of the fear, shame or depression of the abandonment melange. How else would I ever have learned that I was loveable and acceptable in all aspects of my experience, not just in the social perfectionism of my people-pleasing codependence? And of course, like most survivors, I was ignorant at first that I was experiencing the emotional pain of the abandonment melange; how could I help but conceal it? Yet, even after considerable deminimization of my childhood abuse/neglect picture, I still remained convinced for a long time that everyone but my therapist [who in deep flashbacks, I also recurrently distrusted] would find me abhorrent if I presented myself authentically in such condition. Gratefully, sufficient positive experiences with my therapist eventually emboldened me to bring my authentic vulnerability to other select and gradually proven relationships, where I found the acceptance, safety and support that, previously, I would not have even known to wish for.

 

It is important to note the limitations of the analogy of the onion. Effective recovery does typically involve working at various levels at the same time. De-minimization is a lifetime process, and remembering a crucial instance of being abused or neglected may occasionally impact us even more deeply on subsequent remembering as we more fully apprehend the hurt of particularly destructive parental betrayals. One such occasion left me reeling with the certain knowledge that getting hit felt preferable to being abandoned for long hours outside my depressed mother’s locked bedroom door. I have known about the latter for quite some time now, and yet writing about it brings up some new bitter-sweet tears. For me, my ongoing work with the layers of the denial onion still sometimes has a bitter-sweet quality to it – bitter because abandonment was the worst thing that happened to me, especially as it happened over and over again at such a young and normally needy age - and sweet because these tears validate the truth of this recollection - and sweet, in gratitude, because I do now regularly experience good enough love and safety in relationship – and now bitter again because I can still emotionally flashback to that bereft state of feeling stranded from the comfort of others, even occasionally from my wife and son and inner circle-friends – and then sweet again because, ongoingly, the frequency, duration and intensity of these flashbacks decreases as I increasingly master the use of the tools I describe in my article, “Emotional Flashback Management.” I am also blessed to see this same progress in various of my long term clients who work with this model.

 

The Neuroplasticity of the Brain

I am so heartened to know about all the new neuroscience research that proves the neuroplasticity of the brain, i.e., that the brain can grow and change throughout our life: old self-destructive neural pathways can be diminished and new healthier ones grown. [A General Theory of Love by Thomas Lewis inspiringly explicates this fact]. The critic can indeed literally be shrunk via long-term, frequent and dedicated use of the thought-stopping, thoughtsubstitution and thought-correction practices I describe in my articles on the critic. This is especially true when these techniques are empowered by the grieving processes I describe in my book, The Tao of Fully Feeling, and in an article, “Grieving and Complex PTSD”, that I will post on my website around the end of 2010.

 

There is also growing evidence that recovery from Complex PTSD is reflected in the narrative a person tells about her life. The degree of recovery matches the degree to which a survivor’s story is complete, coherent , emotionally congruent and told from a selfsympathetic perspective. In my experience, deep level recovery is often reflected in a narrative that places emotional neglect at the core of the understanding of what one has suffered and what one continues to deal with. It is a very empowering accomplishment to really get the profound significance of childhood emotional neglect - to realize in the moment how a flashback into bewilderment, panic, toxic shame, helplessness, and hopelessness is an emotional reliving of the dominant emotional tone of one’s childhood reality. Like nothing else, this can generate self-compassion for one’s child-self and one’s present-time self, kick-starting the process of resolving any given flashback. This also assuages emotional neglect by providing the self with the essential missed childhood experience of receiving empathy in painful emotional states instead of contempt or abandonment. This, in turn, proves that there has been significant deconstruction of the learned, unconscious habit of pervasive self-abandonment. 1 [In viewing Richard Davidson’s research along side that of Susan Vaughan’s, I have come to believe that the Critic forms in the right prefrontal cortex of the brain. Davidson’s research {“What does the prefrontal cortex do in affect”, Biological Psychology 67, 2004, pp219-233} shows that people with a predominant negative outlook have greater prefrontal right brain activation than those with a positive outlook whose left prefrontal cortex activation dominates; moreover Vaughan’s MRIs with people in flashback [The Talking Cure] shows intense right hemisphere stimulation during flashbacks with a dearth of left hemisphere activation.]