Childhood trauma is a public health problem worldwide. Constituting adversities such as abuse and neglect, they give rise to multiple adverse social, behavioral and health outcomes, not just in the immediate aftermath of such stressors but throughout the lifespan. Referred to as the umbrella term Adverse Childhood Experiences (ACEs), the term ‘compounding’ in the title of this presentation is used both as a verb and a descriptor. Using Child Sexual Abuse as an example, there is the trauma experienced by one child abused once by one person, either known or unknown. This abuse itself may range in from non-contact/contact to non-genital/genital to non-penetrative/penetrative to non-assaultive/assaultive. Each of these carries with it unique dynamics that determine the nature and severity of resultant psychopathology. In comparison, there is the experience of multiple children in a child care institution, abused by multiple perpetrators (known and unknown), multiple times over a long duration. This is a context where there is serious compounding of ACEs. Many, indeed most, of such children come from vulnerable backgrounds characterized by chronic neglect and other forms of abuse. The compounding effect of such experiences constitute complex trauma.
This complexity if further evident in situations of trafficking. The trauma of child trafficking for sex work goes beyond conventional impact mentioned in traditional models of trauma. As with trafficking of children for other forms of abusive labor, trafficking for prostitution gives the child feelings of “dislocation, deprivation and the absence of nurturance and trust” that is normally provided by the family. The sexualization process that is a result of prostitution has particular effects on the child, affecting her/his sense of selfhood, distorting her/his sense of affirmative sexuality, and giving the child a feeling of loss of control over her/his life. The trafficking situation also disturbs the child’s confidence in relationships and affiliations, bringing about a sense of alienation and suspicion of others. The natural life processes of child – the simple acts of sleeping, waking, eating and playing – are distorted in the brothel situation. The feelings of continuity, regularity and coherence which are so important for the young are also lost.
Such circumstances are significant triggers for dissociation and the development of complex PTSD. Matters are not helped by the often frightening experiences of socio-legal processes. The recognition and addressing of ‘compounding’ factors is critical in planning help and assistance.
Learning Objectives:
At the conclusion of this session participants will be able to:
Participants will be able to factor the significance of multiple ( compounded) Adverse Childhood Experiences in their therapeutic practice
Participants will be able to assess elements of complex trauma in individual and institutional settings
Participants will be able to use Child Sexual Abuse and Trafficking as exemplars of experiences that determine dissociation and complex PTSD processes
Participants will be able to plan interventions in instances involving compounded trauma processes
Participants will be able to include transdisciplinary approaches in their practice