1st Edition

Attuned Treatment of Developmental Trauma Non-abused, High-functioning People Living Outside of Time

By Kathleen Adams Copyright 2023
    328 Pages
    by Routledge

    328 Pages
    by Routledge

    This book takes a painstaking look at developmental trauma as it manifests in group, individual, and combined psychotherapies, tracking the growth of non-abused individuals who have courageously addressed overwhelming childhood experiences to make sense of the chaos in their lives.

    The cumulative impact of repetitive stress, fear, and shame in childhood wreaks havoc on the developing brain, resulting in a life-long vulnerability to anxiety, despair, and dissociative moments that are often described as developmental trauma. Adverse childhood experiences are often overlooked by therapists. This book focuses specifically on the profound suffering of high-functioning private-practice patients who manifest developmental trauma from chronic shock, shame, and neglect. Adams offers a synthesis of diverse theoretical worlds in her study of adaptations to cumulative trauma, namely, relational psychoanalysis, the British school of object relations, trauma theory, neuroscience and interpersonal neurobiology, developmental psychopathology, and attachment theory.

    Using richly detailed clinical material, this book provides invaluably clear examples to illustrate the effects of disorganized states in infancy, making it essential reading for psychoanalysts, psychotherapists and clinical psychologists working with traumatized patients.

    Part 1: Emerging from the Fog: Navigating the Wilderness of Developmental Trauma, 1. Our Pain Knows No Time, 2. Our Pain is the Crack in the Shell that Encloses our Understanding (following Gibran), 3. Retreat from the Body: Birth and Beyond, 4. No Safe Harbour: Children of Perdition, 5. Sometimes it Takes a Village: Treating Developmental Trauma in Combined Therapy, Part 2: Group Therapy with Developmental Stress and Trauma, 6. Failling Forever: The Price of Chronic Shock, 7. The Abject Self: Self States of Relentless Despair


    Kathleen Adams has specialized in primitive states, dissociation, and developmental trauma since 1977. Extensive experience in inpatient settings complements her long-term outpatient psychotherapy practice with children, adolescents, and adults.

    'Kate Adams has been quietly crafting an elegant language for the wordlessness of traumatic experience. Her intuitive and hard-won grasp of the workings of wounded minds and bodies is extraordinary. Adams has a unique, fresh approach that is indeed attuned to how hurt gets so big that it can neither be consciously felt nor known, for example her exploration of 'dead thoughts'. It's not too often that I read chapter after chapter with anticipation of learning something new. She has been incubating the work of many skilled clinicians, and the child who has emerged is playful, astute, broad-minded, self-effacing, and compassionate. Her language is highly accessible, and she puts on no airs, quite the contrary in a totally down-to-earth cultivated garden of organizing themes. I'm delighted with her gifts and you will be, too. When I encouraged her to write a book, I knew she had much to say, but honestly I had no idea how much my patients and I would benefit from her effort. Get a copy of her book, and say hello to the brilliance and humanity of Kate Adams.'

    Richard A. Chefetz is the author of Intensive Psychotherapy for Persistent Dissociative Processes: The Fear of Feeling Real (W.W. Norton, 2015)

    'Kathleen Adams has given us a remarkable compendium, integrating neurobiology, attachment theory, contemporary psychoanalysis and theories of group psychotherapy. The staggering breadth and depth of theoretical integration is impressive and necessary to grasp the subtle and profoundly complex ideas and patients Dr. Adams addresses. This book should be read widely and outlines important paradigm shifts in the way we think about trauma and shock.'

    Paul LePhuoc is a Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine

    'Dr. Adams has an impressive art of weaving the early effects of trauma from the incubator to day-to-day life. She reviews case examples of the many clients/patients who seem to fall through the cracks of normal psychology and brings them to life through treatment and expressive story. I only wish that I would have had this resource available to me when I began my career of focus on Developmental Trauma. I not only see this as an excellent resource for post-graduates but also as a required text in both psychology and counseling programs. Dr. Adams' work again reinforces that we should not base our patient/client evaluations on first appearances.'

    Stephen J. Terrell is the founder of the Austin Attachment and Counseling Center and co-author of Nurturing Resilience (North Atlantic Books, 2018).

    'In this groundbreaking text, Dr. Adams describes the all-too-often unrecognized and unexplored internal experiences of individuals who struggle with developmental trauma. With clarity and sensitivity, she offers us a deeper understanding of the numerous and complex ways these clients suffer, despite appearing to function quite well in the world. Dr. Adams thoroughly synthesizes and illuminates concepts of neurobiology, trauma research, attachment theory, dissociation, and shame with many rich and moving case histories. She brings the theoretical to life on the page and leaves us hopeful for richer, more courageous conversations with our clients. She shows us what our clients need from us if they are to begin living more authentic and gratifying lives. This book is now on my list of must-reads for new clinicians—graduate students and supervisees—and study group participants.'

    Allyson Jervey is an LCSW-supervisor and former Adjunct Professor at the Steve Hicks School of Social Work, University of Texas. She is also the Director of Jervey and Associates Psychotherapy in Georgetown, Texas.