In advance of our one day online CPD event: Emotional Neglect and the Adult in Therapy with Dr Kathrin Stauffer on Saturday 22nd April 2023, we’ve put together an article exploring the impact of early emotional neglect on development and how this might present in the therapy room. She draws on the work of Kathrin Stauffer, and also includes an overview of Kathrin’s latest book: Emotional Neglect and the Adult in Therapy: Lifelong Consequences to a Lack of Early Attunement .
Childhood Abuse v Childhood Emotional Neglect
“One of the hallmarks of neglect is that it’s invisible. It’s very hard to put your finger on it.” p. 6.*
The impact of abuse on mental health has long been recognised as a serious issue, and it has been the focus of much research and public discussion. However, emotional neglect in childhood has often been overlooked, despite its potential to be just as damaging to mental health.
This is changing thanks to the work of experts such as Sue Gerhart, Gabor Mate, and those working on trauma and attachment theory. Sue Gerhart’s book, Why Love Matters, explores the importance of a secure attachment to a primary caregiver in early childhood (especially in the first 1000 days from conception) for long-term good mental health. Gabor Mate’s book, The Myth of Normal, challenges our understanding of what is “normal” in our society, and the impact of widespread, but still negatively impacting, early childhood experiences and practices (such as medicalised childbirth, limited childcare support, mothers having to return to work within a few months of birth etc) on mental health. Trauma and attachment theory, which is gaining increasing attention in the field of psychology, is also shedding light on the long-term effects of emotional neglect in childhood. This blog post will explore the impact of emotional neglect in childhood and how it appears in the therapy room.
Emotional Neglect and The Ignored Child
“Neglect is about an absence of something. It’s really about an absence of responsiveness, of emotional mirroring, and attunement.” p. 16*.
Emotional neglect is a pervasive issue that affects millions of people worldwide. It occurs when a child’s emotional needs are consistently unmet by their caregivers, resulting in feelings of emptiness, disconnection, and shame. These feelings can then persist into adulthood and impact the person’s relationships, self-esteem, and mental health.
Kathrin Stauffer is a well-established psychotherapist, clinical supervisor, and author who has dedicated her career to understanding the impact of emotional neglect on individuals and how it can be addressed through therapy. She calls them “ignored children”. She writes in the introduction to her book, Emotional Neglect and the Adult in Therapy: Lifelong Consequences to a Lack of Early Attunement:
“They may not have been rejected or abused early in their lives; but they were not made to feel welcome, loved, and safe in the world either, and they didn’t have their needs met or even seen. Instead they were taken for granted, overlooked, treated like adults from a very young age, or used by their caregivers to help, without receiving any positive attention in return.”
While it is common to see the impact of childhood abuse on mental health, the impact of neglect is only more recently being acknowledged, along with the corresponding developmental deficits. This can result in a sense of bewilderment of how to “do” life, with a distrust or inability to play and be spontaneous.
How Early Emotional Neglect manifests in Adulthood
Early emotional neglect can have a significant impact on an individual’s emotional, social, and cognitive development. When a child’s emotional needs are consistently unmet and neglected by their caregivers, they may experience a range of negative emotions, such as loneliness, sadness, and shame. These emotions can then persist into adulthood and manifest in various ways, including:
- Difficulty forming and maintaining relationships: Adults may find it hard to trust others, fear rejection, and feel disconnected from those around them.
- Low self-esteem and negative self-image: Individuals may struggle with feelings of worthlessness, self-doubt, and shame.
- Emotional dysregulation: They may have difficulty identifying, expressing, and managing their emotions in a healthy way, leading to mood swings, anger outbursts, and emotional numbness.
- Anxiety and depression: Individuals may struggle with feelings of sadness, hopelessness, and worry.
- Addictions: Some individuals may turn to substances or behaviours to cope with their emotions, leading to addiction and other unhealthy coping mechanisms.
- Physical health problems: Studies have shown that individuals who experienced emotional neglect in childhood are more likely to develop chronic health conditions, such as obesity, diabetes, and cardiovascular disease.
How these clients appear in the therapy room
“It’s important to bear in mind that people who have suffered neglect are often invisible. They’re not necessarily the person who is sobbing on your couch. They may be the person who’s very contained, very controlled, and very logical.” p. 19*.
Clients with a history of early emotional neglect may present differently in the therapy room compared to those who have not experienced such neglect. Here are some ways a client with early emotional neglect might appear in therapy:
- Difficulty expressing emotions: They may appear emotionally guarded or may have difficulty connecting to their feelings, leading to a sense of emotional numbness.
- Attachment avoidant: Individuals may avoid forming attachments with others, including their therapist. They may come across as disengaged, distant, or aloof, creating a sense of emotional distance in the therapy room.
- Fear of vulnerability: They may be hesitant to trust their therapist, fearing rejection or abandonment.
- Negative self-image: Clients may view themselves as unworthy, unlovable, or flawed. This may manifest in feelings of shame, low self-esteem, and self-criticism.
- Difficulty with intimacy: They may struggle to form close relationships with others and may experience discomfort when it comes to intimacy.
- Perfectionism: They may have a tendency towards perfectionism as a way of coping with feelings of inadequacy. This may lead to a sense of pressure to perform or succeed in the therapy room, leading to additional feelings of stress or anxiety.
It is important for therapists and counsellors to be aware of the potential impact of early emotional neglect on their clients and to create a safe and supportive therapeutic environment that allows clients to explore their emotions in a non-judgmental way. Developing a strong client alliance and a trusting relationship will be essential for supporting these clients to start healing and to develop healthier coping strategies going forward.
Helping clients who suffer from emotional neglect
“The capacity to be present with another person, to offer empathic attunement, and to hold a space of acceptance and nonjudgmental curiosity is essential for all therapists. However, it is particularly important for therapists working with people who have experienced emotional neglect.” p. 60*
In the following video, Kathrin discusses her book: Emotional Neglect and the Adult in Therapy: Lifelong Consequences to a Lack of Early Attunement, focusing on undertaking psychotherapy with adults who have experienced emotional neglect in early childhood, typically in the first few months and years of life, up to the age of 6.
She believes that emotional neglect means that the person’s emotional development has been impacted, leading to gaps in their emotional development. As a result, they may struggle to manage stress, be vulnerable to stress, avoid big adventures or thrill-seeking, feel anxious or depressed, and see other people as a problem. Often, individuals who have experienced emotional neglect may not realize it and may say that nothing bad happened to them during their childhood and upbringing.
Kathrin explains that therapists need to try to understand the subjective experience of clients who have been ignored as children to better help them. Her book covers the theoretical ways of thinking about emotional neglect, emotional self-regulation that doesn’t work well for these individuals, and specific interventions she has found useful.
Two things she suggests looking out for are: that the client may appear to be very high functioning on the surface (concealing their vulnerability well); and that the therapeutic work can be and feel extremely slow.
“Emotional Neglect and the Adult in Therapy” Book Chapter Overview
“The goal of therapy is not to forget or obliterate the past, but to integrate it into the present in a way that allows the person to move forward with greater emotional freedom and agency.” p. 126*
Emotional Neglect and the Adult in Therapy: Lifelong Consequences to a Lack of Early Attunement by Kathrin Stauffer provides therapists with guidance on how to work with adults who have experienced emotional neglect in their early childhood. The book is organised into several chapters, each covering a specific aspect of emotional neglect and its impact on individuals:
Chapter 1: Introduction
In this chapter, Kathrin introduces the topic of emotional neglect and the purpose of the book. She defines emotional neglect and highlights its long-term effects on individuals.
Chapter 2: The Subjective Experience of Emotional Neglect
This chapter delves into the subjective experience of individuals who have experienced emotional neglect. Kathrin Stauffer uses specific case examples to illustrate how emotional neglect can manifest in different ways, such as anxiety, depression, and difficulty regulating emotions.
Chapter 3: Theoretical Considerations
In this chapter, Kathrin Stauffer discusses theoretical considerations related to emotional neglect. She explores how different psychotherapeutic theories can be applied to working with individuals who have experienced emotional neglect. Additionally, she discusses how neuroscientific research can provide insight into the impact of emotional neglect on the brain.
Chapter 4: Emotional Self-Regulation
This chapter focuses on emotional self-regulation, which is often compromised in individuals who have experienced emotional neglect. Kathrin provides examples of how emotional self-regulation difficulties can manifest and discusses strategies that can be used to improve emotional self-regulation.
Chapter 5: Relational Aspects of Working with the Emotionally Neglected Client
In this chapter, Kathrin explores the relational aspects of working with individuals who have experienced emotional neglect. She discusses how therapeutic relationships can be affected by emotional neglect and provides strategies for building a positive therapeutic relationship.
Chapter 6: Interventions
The final chapter of the book focuses on interventions that can be used when working with individuals who have experienced emotional neglect. Kathrin provides concrete examples of interventions that she has found to be useful in her own practice, such as mindfulness exercises and body-oriented interventions.
The book is aimed at therapists, but it may also be of interest to individuals who have experienced emotional neglect and want to learn more about its effects.
Interested in exploring working with the ignored child as an adult in therapy further? Join us for our one day online CPD event: Emotional Neglect and the Adult in Therapy on Saturday 22nd April 2023, with Dr Kathrin Stauffer.
Feedback from Kathrin Stauffer’s Previous BTP Training
“Kathrin has a great manner. She is respectful, affirming and empathic – thank you”
“This training was rich, rewarding and very enlightening”
“This training was excellent. So accessible and interesting. Kathrin had a breadth of experience and brought it back to actual practice”
You can view Kathrin’s Trailer for the upcoming workshop below:
* All quotes from Emotional NegleEmotional Neglect and the Adult in Therapy: Lifelong Consequences to a Lack of Early Attunement by Kathrin Stauffer.
Friday 1st March 2024. ONLINE via Zoom and CATCH-UP for 28 days. Event Times: 10.00am – 4.00pm GMT (London)/ 11.00am – 5.00pm CET (Paris)/ 5.00am – 11.00am EST (New York).…
Friday 22nd March 2024. ONLINE via Zoom and CATCH-UP for 28 days. Event Times: 10.00am – 4.00pm GMT (London)/ 11.00am – 5.00pm CET (Paris)/ 5.00am – 11.00am EST (New York).…
Friday 19th April 2024. ONLINE via Zoom and CATCH-UP for 28 days. Event Times: 10.00am – 4.00pm GMT (London)/ 11.00am – 5.00pm CET (Paris)/ 5.00am – 11.00am EST (New York).…
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