Differentiation of Core, Developmental and Situational Trauma:A Depth Psychological perspective

Kenneth R Lakritz, Ph.D.

2022

Trauma, as a clinical concept and psychic event, is clearly in the forefront of all

current psychological and psychiatric thinking. We have slowly been making strides in

unraveling the mysterious processes that underlie each individual’s experience and

response to so called traumatic events. In this discussion, I will explore current thinking

regarding fundamental psychological dynamics in an attempt to elucidate the distinct

challenges of both deep, early developmental and more circumscribed, situational

traumatic events- occurring during or after the formative years.

Defining Trauma

First, I’d like to define trauma, not by it’s symptomatology, but by how it acts to

create internal emotional ruptures and intra-psychic dismemberment when external,

mediating and containing functions of the psyche break down. Second, I’d like to

clarify how certain circumstances and events disrupt the natural unfolding of Self and

Ego when they occur during peri and post-natal formation. I also want to distinguish

these early developmental (and sometimes prolonged and pervasive) conditions from

circumscribed events that occur further along the developmental continuum.

Understanding these distinctions has profound implications for the types and

effectiveness of treatments used to help individuals with severe symptomatology

stemming from these life altering experiences.

Events or circumstances that create ruptures at the deepest level of psyche

fracture the healthy link between the Soul/ Self and the conscious Ego. I am using the

term Soul/ Self here, as it is often thought of in alchemical and hermetic terms as the

meeting place between the spirit and the physical body (the embodied spirit). When

the True Self/ Soul becomes dissociated or dis-membered by events that overwhelm

the ego’s usual coping defenses, attempts to re-integrate these split-off parts of the

psyche have sometimes been referred to as “soul retrieval.”

Severe stresses generated by splitting or fractures within the psyche produce an

array of known symptoms, some of which follow standard definitions (such as anxiety,

insomnia, hyperarousal, depression, depersonalization), while others reflect a variety of

physical conditions emerging from associated chronic stress and ineffective coping

(e.g., gastrointestinal issues, autoimmune, cancer, skin, etc). The Self clearly does not

function well in isolation or alienation from the Ego, and these very distressing

symptoms represent a deep calling for re-linking or re-integration.

The Self-Care System

Throughout the lifespan each of us experiences events big and small at various

points along the developmental continuum. Not all these events create ruptures in the

psyche that are fundamental to personality organization/ development, or cause the

soul secede from the ego in order to cloister within the guardianship of what Jungian

analyst, Donald Kalsched, refers to as the “self-care system”. Referring to the seminal

writings of psychoanalyst D.W. Winnicott, Kalsched (Trauma And The Soul, 2013/ The

Inner World of Trauma, 1996) writes:

Winnicott suggests that the ‘true self’ is an individual’s ‘inherited potential’ which

must incarnate and become actualized in a ‘personal body scheme’. Winnicott

describes this as a process of ‘indwelling’ or ‘personalization’. As the mother

continually introduces and re-introduces the baby’s mind and body to each other,

the child’s true self ‘personalizes’ and actualizes in the body. A ‘spirit’ or ‘entity’ of

some ethereal kind, existing ‘somewhere’ descends into the body through the

mother’s mediation of the reality/fantasy interface. Winnicott never says what this

indwelling ‘spirit’ really is, but he does say that depersonalization is the inevitable

result of its failure to incarnate. We might speculate that if indwelling fails, then the

disincarnate ‘spirit’ remains a ghost (Kalsched, JOAP, vol 48, issue 2).

The ghost that Kalsched is referring to here is the imperishable Soul untethered to

the body and life. Seminal questions in this discussion involve the distinctions

between the context and nature of 1) an environment between infant and caregiver that

cannot nurture the actualization of the incarnation process, and 2) specific events that

cause emotional dissociation due to an overwhelm of the Ego’s usual coping defenses.

When these earthquakes within the psyche occur, the Self-care system provides an

unconscious, archetypal holding environment for Soul in the absence of caregivers or

an ego structure that can protect the Self from the onslaught of potential emotional

annihilation. I would, however, like to differentiate, here, between protective functionsthat arise from A) primitive, unconscious archetypal defensive processes and B) ones

that arise from within a mature, cohesive ego structure whose defensive capacities are

overwhelmed by the threat of annihilation. I would propose a spectrum from a more

primitive to more sophisticated self-care process based on the continuum of

development of a functioning relationship between the Self and Ego.

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Core Developmental Trauma

Early, evolving relationship between the Self and Ego is fostered and contained

within what D.W. Winnicott referred to as a “holding environment”between the infant

and primary caregivers. The stability and quality of this holding environment determines

the degree to which an open link can be nurtured between the Soul and “personal

body schema” or Ego. Instability or the absence of this early bond can be so

emotionally overwhelming for the infant that anxiety regarding potential annihilation

may arrest natural emotional development. This precognitive, existential threat to the

Soul undermines the conditions necessary for the continued “indwelling” and

incarnation of the Self. The rupture between of Self and Ego, consequently, activates

deep dissociative processes/ archetypal defenses that provide containment/ protection

for the inner world of the nascent Self that does not exist in the outer one. This

dynamic seizes the development of personality in a manner that both interrupts healthy

unfolding and normalizes for the individual the severing or alienation of Ego from Self.

Ego Syntonic Traits

Early normalization of this “un-integrated” state creates predictable symptoms

and behavior (e.g., emotional splitting, pervasive feeling of emptiness, instability of

relationships, primitive coping) that is reflective of a personality divided to protect the

Soul at all costs. In other words, the psyche adapts to its fractured state, and, to its

own detriment, becomes highly resistant and threatened by the possibility of opening

again to a healthy incarnational process. Alienation from Self and life clearly generates

incredible suffering, and, yet, attempts to reestablish a healthy link between the Self

and Ego after a lifetime of cloistered separation, would likely face a person with the

very annihilation anxiety that fostered dissociation in the first place.

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Situational Trauma

I’d, now, like to distinguish situational from core, developmental trauma both in its

timing and quality. Trauma expert Bessel van der Kolk once stated (live conference)

that the greatest trauma one can have is the experience of “never having been loved”.

The experience of the love’s absence can manifest from a variety of differing dynamics

within the primary caregiving relationship (e.g., a parent conflicted about parenting a

newborn, grief from previous losses, illness, depression, exhaustion, substance abuse,

etc.) I would argue that the pattern of behaviors manifesting from these early

conditions develop into enduring qualities of character, better known as “traits”.Conversely, psychic earthquakes or ruptures that occur within the individual who has

had a stable and adequate holding environment are more likely, I believe, to experience

signs and symptoms (e.g., hyperarousal, exaggerated startle, re-experiencing of

traumatic event, insomnia, etc.) that are alien to the Ego, and more reflective of

“states” (I.e., a temporary mental condition) than enduring “traits”.

Ego Dystonic States

While situational “traumatic” events can and do challenge usual coping

capacities, and can prolong beyond the acute to a more chronic presentation, I would

argue that the the effect on the relationship between the Self and Ego takes on a very

different intra-psychic character. The defensive response from these so-called “small

t“ traumas create a dissociative environment that is more Ego-alien to the individual

than early, core “large T” trauma that becomes intrinsic to the organization of

personality, and adaptive to the absence of an adequate early holding environment.

The Ego-alien nature of situational trauma is distressing to the individual in a different

way. The core difference appears to be one where individuals with large T trauma have

never felt safe. Whereas, individuals with small t traumas have had an adequately

functioning “psychic skin” that has become breached in such a way as to break down

a generally experienced inner foundation of safety. I believe that these distinctions have

profound implications for treatment, which I will address in the following discussion.

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Four Integral Categories of Treatment

Drawing from the discussion above, I would like to a outline a multi-layered

treatment approach that addresses differing degrees of symptom management and re-

integration. When working with the stresses intrinsic to both core, developmental and

situational trauma, there are four general, integral levels of intervention

that can provide:

1) Alleviation, stabilization, and coping support of presenting symptoms

2) Desensitization and Reprocessing for integration of dissociated emotional

awareness

3) Soul retrieval and re-linking of Self and Ego

4) Re-membering who we are are at the deepest level of being, fostering individuation

and conscious re-unification

1. DILUTION of Symptoms and Coping Support/ Strategies

The standard of care for many conditions presenting with symptoms of anxiety

and acute stress involve approaches whose primary objective is to stabilize and

attenuate the impact of traumatic symptomatology. I would assert that standard

approaches, such as Cognitive Behavioral Therapy/ Dialectical Behavior Therapy/

Mindfulness Based Meditation/ Yoga utilize cognitive and self regulatory strategies to

dilute the intensity of symptoms, and help to create emotional tolerance and effective

coping behaviors. Psychiatric interventions similarly focus on symptom management and attenuation. These forms of supportive intervention are part and parcel of any

integrative treatment approach.

2. DESENSITIZATION and Re-processing/ Integration

Eye Movement Desensitization and Reprocessing (EMDR), Emotional Freedom

Technique (EFT, Tapping), and Exposure therapies move beyond symptom

management to open channels for the desensitized re-processing of dissociated

emotions and memories. These approaches help facilitate an integration of traumatic

memories and body states that are often “implicit” (i.e., because trauma floods our brain with

cortisol, the stress hormone, which shuts down the part of our brain that encodes memories)

and makes memories not only “explicit” (Explicit Memory is the conscious, intentional

recollection of factual information, previous experiences, and concepts), but also available for

emotional integration of dissociative states.

3. DISSOLUTION and Re-Linking

As we go deeper in our approaches toward re-linking of Self and Ego, depth

(Transpersonal/ IFS/ hypnotherapy) and medicinal (psychedelic) therapies assist by

lowering the threshold of consciousness and dissolving the defensive barriers that

maintain a severed link between Ego and Self. By creating an “optimal arousal

window”, these therapies work to dilute both ego and archetypal (unconscious Self

Care System) defensive structures. Relaxing and opening this defensive window allows

for direct connection and recovery of the dissociated Self that has been functioning in

isolation from the Ego by intolerable early, developmental or situational emotional

states. Psychedelics, and other approaches inducing non-ordinary states, assist the

practitioner in operating below egoic defenses so that the unconscious, archetypal

defensive system can be worked with more directly and effectively. Historically, these

approaches toward healing have operated within the purview of shamanic practices,

but, more recently, have entered the treatment room within depth, transpersonal, and

psychedelic therapeutic paradigms.

4. RE-MEMBERING and Individuation

Re-Membering is not a therapeutic technique as much as it is a world view.

Remembering involves a number of components. Firstly, it involves a deeper frame of

reference than one which holds a view of reality as anchored within the impermanent,

biographical level of life Second, remembering who we are at the permanent, root level

of being provides a foundation that can endure even the most unthinkable of emotional

experiences. Third, remembering helps us to make contact with the deeper purpose

and meaning of our lives, that also may include tragedy and trauma as an essential

aspect of our life story. This provides a frame for the meaningful struggle with even the

deepest of psychic wounds. Fourth, Remembering involves both the integration and

re-integration of split-off unconscious components that seek unity and wholeness

within the psyche, not just as healing but as a path of individuated consciousness. I

believe that the Self continuously seeks unity, and calls to us to attend to these divided

states through the emergence of symptoms and suffering. I refer to this depth

psychological treatment paradigm as psychedelic or spiritually integrated psychotherapy. This level of individuated (undivided) consciousness is core to Jungian

psychology and most mystical traditions and shamanic practices.

The effectiveness of these integrated psychotherapeutic approaches depends on

the nature of the traumatic circumstances, as outlined above, and the depth and

longevity of the therapeutic relationship. Superficial interventions are unlikely to be no

more than palliative with both core, developmental and severe situational trauma.

Whereas, spiritual/ psychedelic integrated psychotherapies are showing greater

efficacy in addressing both symptomatology and restoration of the healthy links

between Self and Ego that were ruptured in early life.

References

Joel Blackstock, Existentialism vs materialism: what is the Ego- Self Axis?, 2022

Donald Kalsched, JOAP, Volume 48, Issue 2, Daimonic elements in early trauma,

p145-169, 2003.

Kalsched, D. The Inner World of Trauma: Archetypal Defenses of the Personal Spirit.

London & New York: Routledge, 1996.

Bessel van der Kolk, live conference 2003

D.W.Winnicott Winnicott, D. W.

‘Ego distortion In terms of true and false self’. In

Maturational Processes and the Facilitating Environment. Madison, CT: International

Universities Press, 140–152, 1960.