The Sense of Self Feeling Stuck in Therapy
When a kid gets 'stuck' in therapy it is usually about the struggle with how their experience with Developmental Trauma has influenced the sense of self. The sense of self is our perception of who we believe we truly are, what we like/dislike, values and beliefs; our confidence of knowing who we are is constant despite our changing environment. We learn about ourselves through our relationships with family and it is tested by our relationships with friends and interactions with the community. The kids I work with have had the sense of self significantly tested by Developmental Trauma. In the DSM, one of the requirements of trauma is to fear that the integrity of the body will be compromised. In essence, that the body or self will be damaged. While the integrity of the body is physical and tangible, the sense of self is more abstract. The kids that I see have learned their sense of self with their relationship with Developmental Trauma. To expand upon Developmental Trauma, remember that this trauma caused by the hands of the primary caregiver.
We always talk about the sense of self in treatment. We have to; it is integral in recovering. Most of the kids I work with are convinced that the trauma they have experienced is the self. Think about that. Think about genuinely believing your experiences with being sexually abused or neglected actually is your sense of self. Kids tell me all the time: "I'm no good. Stay away from me because I'll hurt you." They feel like they are the hurt that they feel. Or that they are cursed and that there is no use in trying. They have been forgotten. Some kids try to take on their abuser's persona as their core identity to avoid getting hurt again. They can get irritated or frightened by our good intentions of help (i.e., therapy, neurofeedback, medication). Lump school performance into this too. And do not forget positive relationships at home. And all of this is normal for a child who has been Developmentally Traumatized.
"One of the greatest tragedies in life is to lose your own sense of self and accept
the version of you that is expected by everyone else." -Unknown (How to Build a
Strong Sense of Self. Psychology Today. August 01, 2019).
This quote is important. It does not matter if that sense of self is negative or positive. Solid or diffuse. It is felt as a tragedy to lose that sense of self and can imply a sort of death. The victim has to change its version of the self in order to survive the trauma. A survivor has to change what worked in the trauma to survive the recovery. What if being a bully in the home of your abuser kept you from being hurt? Or stealing food and binge eating kept you from starving? Where is the justification for change when it can mean death? Forget about the life part because we are just trying to survive here.
When kids get stuck because of the sense of self struggle, it is because they feel like we are chopping away at who they are piece by piece. They feel that our interventions are wrong because that survival sense of self kept them alive. Again, adapting to survive the recovery is scary and painful. Sometimes I catch kids fawning during a session to be the perfect version of what they think I want when all we need to talk about is their truth. That kid is trying to survive the session. I also watch them try to sabotage a session perfectly. I believe they are showing me how scared they really are in a different type of communication. That kid is also trying to survive the session. Trauma tricks its victims into believing they are monsters. Trauma trains its victims into learned helplessness. Trauma tries to be the one and only version of the self only for survival purposes. And these false truths feel so intensely real that kids do not believe what any of us tell them. It all feels like to them that we are trying to carve them into the perfect versions of what we want, not who they are or want to be. That it is safer to be what worked for them in the past.
What I have found to be successful in helping a traumatized child in developing a healthier sense of self is to help them to understand their story first. I praise them for doing what they needed to do to survive their trauma. That very hurt part of the self deserves mad respect. Self awareness about how they feel about their coping during those hard times is very important. Then we work on cultivating other aspects of the self, such as, interests, what are they good at, to whom are they kind? I love when kids are in drama because they can have the experience of "trying on" characters; this helps them to broaden their perception of identity. Group activities like dance, band, or sports can help them to build another part of the self through a group identity. You see, the splinters from the trauma will always be there. We cannot extract them or tell kids to just 'move on.' But we can help them to build other parts of themselves that they can trust just as much as their survival self.