The Incorporation of Emotion Regulation Struggles in Highly Complex Developmental Traumatized Individuals

Abstract

This systematic review aim is to investigate the effects of child maltreatment and developmental complex trauma on emotion regulation. For this aim; articles published in PubMed, Web Of Science and Elsevier databases between 2009-2016 were scanned. In this review, 11 empirical articles in English were analyzed based on inclusion/exclusion criteria. These studies highlight that, children and adolescents who are exposed to maltreatment during childhood exhibit deficits in regulating their emotions. As studies show, the reason behind Complex Developmental Trauma is a repetitive and ongoing form of neglectful or abusive parenting. If parents lack of ability to provide enough and necessary attention to their child, he/she will not be able to control themselves or their actions. In brief, if children do not find a secure place for themselves during infancy, they will be more prone to experience some difficulties in regulating their moods and emotional responses when they become adults. Infants with traumatic history tend to be aggressive, isolated and disengaged and unfortunately, they may develop many psychiatric illnesses such as; depression, anxiety disorders, eating disorders, dissociation etc...in the future. Secure attachment pattern helps us create our inner maps that affect our relationships throughout life. Emotion Regulation Children who experience complex developmental trauma have difficulties in identifying and expressing their emotions compared to non-maltreated children. Maltreated children are more likely to suffer from significant depression, anxiety, frustration or anger in their adulthood. They usually respond to various situations in an unpredictable and fierce way. Even unthreatening situations make maltreated children tremble, angry, sad and isolated. These children so often experience flashbacks of traumatic events from their environment. If flashbacks of trauma occur repeatedly, stress hormones impress those memories profoundly in the mind making it harder for them to enjoy and feel satisfied by an ordinary life because they are imprisoned in the past. Children who have intense and negative feelings will have difficulty calming themselves down. Childhood trauma experiences are so disruptive that they are internalized by the child and they change their physiology. Complex Developmental Trauma suppresses the prefrontal cortex, which has a vital importance regarding impulse control, decision making and regulating social behaviors. The executive capacities of the prefrontal cortex enable people to observe what is going on around them, predict what will happen if they take a certain action, help them make conscious choices, act calmly and control their obsessive thoughts, feelings and emotions. This capacity is crucial for human beings to continue their relationships with each other. As long as the frontal lobes are functioning properly, individuals are unlikely to lose their temper in inappropriate situations. FMRI studies show that there are measurable differences in brain activations of the amygdalas and prefrontal cortexes of non-maltreated and maltreated children [1]. Traumatized people generally escape from their emotions. Although their neglectful or abusing caregivers are no longer existing in their present, they still react in a way as if those people are influencing their lives. Even their physical responses are due to their traumatic history and they react to things around them as threats. Even though the trauma is not a current issue, the emotional brain continues producing sensations that makes the trauma survivor feel scared and lost all the time. It is predicted that so many trauma survivors turn into binge eaters, alcoholics or drug addicts. They tend to avoid building romantic relations and prefer not to socialize. They unfortunately carry the risk of developing personality disorders in the future [2]. As Leahy, Tirch & Napolitano et al. [3] stated, an individual is uncapable of regulating emotions, this means that a person cannot process emotions and filter experiences as dangerous or safe. Emotion regulation is a very important element of individual development and is also an effective part of interpersonal relationships. Emotion regulation is an important skill in managing an individuals problems in stressful Biomedical Journal of Scientific & Technical Research (BJSTR) Open Access Biomedical Journal of Scientific & Technical Research Volume 6Issue 3: 2018 Cite this article: Eda Ylmazer. The Incorporation of Emotion Regulation Struggles in Highly Complex Developmental Traumatized Individuals. Biomed J Sci&Tech Res 6(3)2018. BJSTR. MS.ID.001341. DOI: 10.26717/ BJSTR.2018.06.001341. 5211 and difficult situations. (Dempsey, 1996; akt. Onat ve Otrar, 2010). Emotion regulation consists of internal and external processes that are responsible for changing the emotional response to achieve goals and to control and evaluate situations rationally. Intense negative emotions may cause terror, trauma, fear, impatience, uneasiness, anxiousness or a sense of urgency. On the other hand, apathy may cause dissociation such as: amnesia, identity alteration, depersonalization, identity confusion, fugue or derealization. It is very challenging for many traumatized children to describe their feelings because they are un capable of identifying even their physical sensations. Not being able to explain what is happening in their bodies and minds, makes them out of touch with their needs. Parents or first caregivers should guide their children to satisfy and establish control over their needs [4]. Emotion regulation is an essential part of auto regulation and self-esteem. On the other hand, neglectful, abusive caregivers block the development of healthy emotion regulation skills of their children. Children who experience complex developmental trauma during their infancy develop ADHD and are known to become problematic and maladaptive in their adolescence and adulthood. If a child is exposed to sexual, physical or emotional abuse during childhood, it is very probable that they will develop mental illnesses, sexual problems or unhappy romantic or social relationships in the future. In the light of previous studies, it is clear that there is a positive correlation between child abuse and psychological illnesses such as; attention deficits, hyperactivity disorder, depression, anxiety disorders, posttraumatic stress symptoms, eating disorders, alexithymia, dissociation, substance abuse, oppositional defiant disorder, personality disorders and lack of self-respect [5]. Effects of Complex Trauma on Emotion Regulation Children who are abused and neglected are often more alert than other children. It is obvious due to their increased heart rate, blood pressure rates and high levels of stress hormones (adrenaline, cortisol, norepinephrine) present in their immune system and their sympathetic nervous system. As a result, these children have compromised immune systems and they are more susceptible to illness. It is not possible to gain emotional equilibrium in adulthood if children are exposed to repetitive chronic stressors in an insecure environment with ongoing pain and suffer. Unfortunately, they are confined to live with chronic anxiety and terror throughout their lives. Securely attached children are aware of others emotions and thoughts. They establish empathy towards others and acquire a sense of security. Bowlbys and Winnicotts theory focuses mainly on securely attached children and this theory is influential in child development. Overwhelming complex developmental trauma destroys the self-regulatory system and as a result, trauma survivors never find a chance of maintaining emotional security throughout their lives. Securely attached children usually become good-natured and coherent playmates. They build good relationships with their peers. They can easily notice changes in voices and faces of others and adjust their behaviors according to needs arising in diffferent situations. Abused kids are often responsive to physical stimuli such as, changes in tone of voice and facial expressions. They often react to them as threats. When those relationships with others are unstable or unpredictable, children learn that they cannot rely on and trust other people. When primary caregivers abuse and mistreat their child, they identify themselves unfavourable, invaluable and inadequate and as a result they develop a negative perception about the World in their minds [6]. Children with unhealthy attachments have difficulty in coping with stress. Concerned first caregivers or parents have a positive impact on their childrens healthy development, mainly the brain, body and emotional systems. Children who are survivors of developmental complex trauma are more likely to develop unhealthy relations with their romantic partners, friends and authority figures (teachers, police officers...) in the future. They cannot establish a healthy connection between their childhood memories and their current lives. They feel alive and alert only when they revisit their traumatic past or if something makes them remember their past traumas. Trauma leaves an imprint in the mind, body and brain. This imprint causes so many consequences about how people manage to live and survive in the present and in the future [7]. Blaustein and Kinniburgh [5] suggested that if children exposed to chronic stress with abuse and if it has a repeated and ongoing pattern by their first caregivers or parents, it is called complex developmental trauma. These children are generally exposed to disorderly and uncertain environments, and they do not have any caregivers to protect and contain them because unfortunately, these caregivers are the main reason behind those traumas. If children do not have the opportunity to learn how to soothe themselves when they feel stressed, worried, frustrated or angry, these children will develop impulsive reaction