What is Developmental Trauma Disorder (DTD)? - New Age Psychiatry

What is Developmental Trauma Disorder (DTD)?

          Developmental Trauma Disorder (DTD) has gained much research interest as a separate disorder from Post-Traumatic Stress Disorder (PTSD), with the primary differentiation of DTD resulting from chronic trauma involving long-term emotional neglect, emotional abuse, family violence, and/or community-based violence.  If you were exposed to multiple, sustained, and untreated adverse or traumatic events, you may meet the criteria for this recently-proposed diagnosis.  Adults with DID have often been misdiagnosed with ADHD, Bipolar Disorder, Generalized Anxiety Disorder, or Borderline Personality Disorder.  The diagnosis of DTD has been specifically applied to individuals who endured years of emotional distress and who may exhibit the following symptoms: self-destructive behaviors, extreme distrust within all relationships, a pattern of emotionally abusive adult romantic relationships, verbal aggression, physical aggression, anxiety, depression, attention focus difficulties, and a very unstable sense of self activating the part of the brain called the amygdala.  The diagnosis of DTD helps mental health clinicians to treat adults who have endured adolescent trauma and who experience more deeply engrained disruptions in their personality development which has not typically been addressed with the more common PTSD diagnosis. 

           Furthermore, a child or adolescent who has experienced or witnessed multiple or prolonged adverse events over a period of at least one year beginning in childhood or early adolescence, including direct experience or witnessing of repeated and severe episodes of interpersonal violence, significant disruptions of protective caregiving as the result of repeated changes in primary caregiver, repeated separation from one’s primary caregiver, and/or exposure to severe and persistent emotional abuse.  Children and adolescents with developmental trauma are at increased risk for developing mental health problems, including substance abuse, unstable moods, a fear of abandonment, trust issues, and the tendency to get involved in emotionally and/or physically abusive adult relationships. 

            Survivors of chronic trauma during childhood or adolescence tend to endure trauma in adulthood as well.  Chronic trauma can occur for months to years.  These childhood or adolescent emotional and cognitive wounds often create the foundation for deep-seated toxic shame and self-sabotage for the survivor.  Survivors of Developmental Trauma Disorder can struggle with feelings of depression, rage, panic, and suicidal ideation.  Survivors may also carry a sense of toxic shame, helplessness, a feeling of “separateness” from others, and a perception of being “defective” due to the trauma.  They also bear the burden of guilt and negative self-talk which was inflicted upon them and becomes a part of their identity.  They tend to emotionally “shut down” in all significant relationships and to also experience social anxiety and self-doubt on a daily basis.  They are also prone to lifelong behavioral difficulties, such as impulsivity, aggression, sexual acting-out, substance abuse, and other self-destructive behaviors.  Cognitive difficulties, such as uncontrollable dissociation and a very fragmented sense of identity, are also common among survivors of childhood and adolescent trauma.  Interpersonal difficulties and diverse and chronic somatic complaints may occur from childhood and adolescent trauma.  Childhood and adolescent trauma has been significantly corrrelated with specific effects on the brain motivation and pleasure pathways which involve serotonin, norepinephrine, and dopamine. 

adolescent trauma Developmental Trauma Disorder, amygdala

Treatments for Adults who Experienced Developmental Trauma

           If you were exposed to chronic childhood or adolescent trauma, you may require a multi-faceted therapeutic approach.  As a chronic trauma survivor, your brain functioning has undergone severe rewiring and is extremely resistant to change.  The first brain structure affected by traumatic events is the amygdala.  The amygdala triggers your natural alarm system.  When you experience a disturbing event, the amygdala sends a signal which causes a fear response.  Chronic trauma creates an overreactive fear response within the amygdala, and this damage can remain within your brain throughout your life if untreated.  Even with therapy, triggers will occur throughout your life.  These triggers affect the amygdala, causing overreactive fear and anxiety responses.  The second brain structure affected by traumatic events is the prefrontal cortex.  The prefrontal cortex regulates your emotional responses to external events, as well as your overall decision-making, coping, and goal-setting processes.  Chronic trauma causes your prefrontal cortex to have extreme difficulty in managing threats which are sent from the amygdala.  The third brain structure affected by traumatic events is your hippocampus, which is your brain’s memory structure and which receives the most severe damage from traumatic events, in that it loses the ability to store and process information correctly.  After experiencing a traumatic event or even ongoing emotional abuse, your hippocampus often cannot separate safe events from the dangerous or painful events which have been inflicted upon you. 

           The most significant treatment areas for survivors of Developmental Trauma Disorder are the pervasive sense of being disconnected from others during daily life, trust and abandonment issues in relationships, and severe difficulty with emotional regulation, and frequent mood instability.  When traumatic childhood or adolescent memories are wired into your brain, you CAN learn, through motivation and hard work, to surrender these painful visions and to replace them with new, empowering visions of who YOU are and CAN be.  You have the power to destroy old narratives.  If you are an adult who experienced developmental trauma, you may require at least 6 months of trauma therapy to learn the tools for processing and getting control of the trauma triggers and the associated effects upon your thought patterns and emotional states.  Effective trauma therapy focuses upon cognitive reprocessing, which can be frightening but which is integral to creating real change in your behaviors, thought patterns, and emotions. 

            A major goal of trauma therapy is establishing a sense of security and comfort within yourself and within your significant interpersonal relationships, rather than being in crisis mode stemming from the amygdala.  Another important goal of trauma therapy is learning self-regulation, self-reflection, and maintaining healthy relationships.  The 3 main types of trauma therapeutic treatments for adults who have met the criteria for Developmental Trauma Disorder as children or adolescents are Trauma Affect Regulation Therapy, Anxious Attachment Therapy, and Trauma-Focused Cognitive Behavioral Therapy.  You CAN move forward from chronic childhood or adolescent trauma by creating and utilizing new, healthier reactions to your trauma triggers.  Finally, there is a 6-step process for gaining control over childhood and adolescent trauma but is by no means an easy, fool-proof process.  These 6 steps are: (1) identifying past experiences as “traumatic,” (2) allowing yourself to revisit these experiences in the present and with the support of a therapist, (3) learning about the relationship between traumatic experiences and current triggers, (4) understanding and tapping into the wisdom which has been created by these experiences, (5) utilizing this wisdom as part of your current life narrative, and (6) letting go of your past narrative as a victim.  When you revise your perceptions about your childhood or adolescent trauma as something which happened TO you and NOT something which DEFINES you, you can begin to recreate your sense of self and to let go of your shame and insecurities associated with your traumatic experiences.

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Written By: Dr. Rebecca Wang-Harris. Offering Counseling Sessions Now.

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