Child-Parent Psychotherapy and Traumatic Exposure to Violence.

This article illustrates the multidimensional impact of violence during infancy and the effectiveness of a relationship-focused treatment, child–parent psychotherapy (CPP), in addressing the traumatic consequences of exposure to violence. The authors describe the treatment of a 3-year-old boy and his mother and highlight three key points: (a) Infants have the capacity to remember traumatic events and encode preverbal memories into images that can be narrated once language is acquired; (b) a therapeutic working relationship with the parent provides a framework for trauma-focused treatment; and (c) speaking about and using toys to re-enact what happened, and practicing ways of feeling safe and protected, provide a vehicle to regulate emotions and create trust in the parent’s capacity to protect. his peers, was defiant at home and at school, and had nightmares, nocturnal enuresis (bedwetting), sadness, psychosomatic complaints (physical manifestations of psychological distress), anxiety, and developmental delays. during the initial assessment, the clinician asked Carola about her own state of mind, and she described symptoms of hypervigilance (heightened arousal), depression, dissociative episodes (periods of spacing out), flashbacks (intrusive recollections of the traumatic events), and psychosomatic complaints. When asked about any traumatic events in her life, Carola revealed that she had been a victim of severe verbal, physical, and sexual abuse by Juan’s father, beginning in pregnancy and lasting until Juan was 2 years, 8 months old. The violence ended when Juan was arrested, after a neighbor who saw Carola lying unconscious in front of the house called the police. Carola initially minimized the link between violence exposure and Juan’s presenting symptoms and dismissed the impact of his father’s absence on Juan. When asked how she had explained the separation, T he early experience of violence has a profound impact on every aspect of the child’s development. Contrary to the widespread belief that infants and toddlers are too young to remember and understand violent episodes, children who were abused or witnessed domestic violence remember and respond to these events with physiological, emotional, and cognitive disturbances. They may re-enact their experiences long after the event through play and through their interactions with parents, teachers, and peers. she answered, “I told him that his dad went to buy milk. I don’t think he remembers anything because he doesn’t ask about it.” The therapist provided developmental guidance about how young children like Juan respond to violent episodes and to their father’s departure from the home and explained the CPP focus on helping her and Juan verbalize, process, and cocreate Copyright 2012 ZERO TO THREE. All rights reserved. For permission requests, visit www.zerotothree.org/permissions