Preverbal Trauma – Therapy Problems
A. R. Quintiliani, Ph.D., LADC
Preverbal trauma (hereafter PVT) is one of the most pervasively troubling human conditions. PVT occurs when a preverbal child is exposed to parental, caretaker, or other forms of abuse. This abuse 
may be sexual, physical, or emotional. This form of abuse is so destructive because the child has no cognitive/executive/verbal ways to understand and respond to the experience. The long-term bio-psycho-social-spiritual effects of PVT are quite difficult to treat effectively. One reason for this is that some therapist are determined to utilize their favorite approaches (mainly forms of pure talk-therapy and psychodynamic holding) despite the limited effectiveness that these forms of therapy results in. Still worse for the client is generic talk therapy, often a mixture of various talk-therapy components but no actual evidence-based method of helping. Remember it is our obligation to Do No Harm and to use therapeutic interventions beyond alliance that are effective. There may be moral if not ethical implications here.
It is best to keep in mind that both The American Psychological Association and The Agency of Healthcare Research and Quality found recently that correctly applied CBT is the therapy of choice for most forms of trauma. These investigations were thorough and completed in an independent manner. The APA is a professional guild group representing the interests of psychologists, but the AHRQ is a semi-governmental research arm looking into how we spend healthcare dollars. Their main concern is that we spend healthcare funds doing evidence-based interventions with good 
outcomes. In the interest of research, of course other therapies have been found to be effective with trauma. To mention a few, these are EMDR, DBT, PET, and, Briere’s self-trauma therapy with slow, complete exposure work. MBSR and ACT may be helpful regarding emotional dysregulation in traumatic re-experiencing and self-empowerment. Of course effective attachment therapy with very specific object relations correctives is also helpful.
The following list contains many conditions that make PVT difficult to treat. These suggest that therapy modifications may be needed. The effects of PVT may include:
- The non-verbal experience itself;
- Somatics of ACEs;
- Unexplained body sensations and feelings;
- Unexplained bodily awareness;
- Problems with long-term memory formation about the event/s;
- Visual observation without clear cognitive understanding;
- Painful and uncomfortable sensory experiences without apparent causation;
- Possible increased limbic fear reactions without clear rationale;
- Emotion dysregulation without grounding about specific stimuli and variables;
- Parts-of-body reactions without clear causes;
- Classically conditioned emotional responses without clear conscious cause and effects; and
- Brain sensitivity to future traumatic experiences.
Hopefully this list will encourage you to re-examine the form of therapy you may be using for PVT. Hopefully, this list of intense suffering of a child due to PVT will motivate you to use an evidence-based approach.
Anthony R. Quintiliani, PhD., LADC
From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton Sangha
Author of Mindful Happiness
especially when impulse control and emotion regulations issues are included. Buddhist Psychology offers clear explanations why this intervention may be helpful for so many suffering people. The four most common clinical conditions of depression, anxiety, trauma, and addictions are strongly and positively influenced by regular practice of this form of meditation. Below I have noted in a very basic manner how Vipassana’s effects may be explained via Buddhist Psychology and the dharma.
simply pay undivided attention to the feelings/sensations as we breathe in and out. Moment-to-moment bare attention is practiced for at least 30 minutes. To be successful, you must practice letting go of thoughts, emotions, and memories of past suffering. When they arise simply note that it/they have come up, and pay no attention to it/them – hold a non-evlautaive stance and stay with your breath. It will require significant practice before you can do this well. Awareness may then be expanded to the throat and chest areas – just feeling sensations of awareness as you breathe in and out. Second move into about 30 minutes of loving kindness meditation. Third, complete a body scan with attention only from head to toes and back again for about 30 minutes. Just pay attention to the awareness of sensations and feelings as you are guided slowly down and up the body. When distractions come, simply return attention back to the part of your body you are working with now.
In line with the thousands of studies now available supporting the use of mindfulness-based interventions in depression, anxiety, chronic pain and addictions (via emotion regulation and interoception), this post will review recommended mindfulness interventions for trauma and PTSD. The post will note information from two recent books on this topic. Also recognize that meta-analytic research in 2004, 2010, and 2014 have found that mindfulness-based interventions improve depression, anxiety, chronic pain, and emotion regulation. These are common conditions co-occurring with addictions and trauma. Such interventions may be carried out as part of various Western therapies: cognitive, behavioral, cognitive-behavioral, dialectical-behavioral, and even psychodynamic.
the best of object relations therapy, mindfulness therapy (MBSR, ACT), and cognitive-behavioral therapy. Here is the listing of therapeutic functions and interventions.
state, empty mind, thinking, striving, nor is it only applied to meditation or yoga. Mindfulness is awareness in the present moment of experiencing – it is awareness of whatever comes into consciousness without trying to change it or judge it. Choiceness awareness changes over time; this is not a concentrative effort to narrow down what you pay attention to (that is concentration practice). You simply notice matter-of-factly what you are experiencing here, now. Given the dominance of various clinical conditions (depression, anxiety, trauma, substance misuse – self medicating behaviors),
one that brings the provider’s experience and expertise to the recipient’s level of willingness and experience in practice. Basic breathing skills, awareness skills, basic meditation, yoga, walking meditation awareness, etc. are all helpful practices.
taught and practiced in the relationship with the educator or therapist. In the final