A case study of traumatic stress disorder in a 5‐month‐old infant following surgery

Abstract

This case study of a 5-month-old infant describes the symptoms of trauma following a surgical procedure (cranial remodeling) with short-term hospital stay. The infant showed a symptomatology similar to that found in other studies of hospitalization during the preverbal period, and fit the diagnosis of traumatic stress disorder according to the DC:0-3. The therapy was implemented by the parents in consultation with the author. The approach was based on an exposure therapy model (flooding) using a somatic trauma trigger that occurred spontaneously in the context of a normal caretaking routine. The infant was allowed to have a full-blown emotional response during several treatment sessions. The outcome was positive, with the disappearance of some symptoms of traumatic stress disorder after the first week, and no remaining symptoms after two months. Periodic follow-up evaluations for one year revealed normal development with no return of symptoms. The symptoms, treatment, and outcomes are discussed in the context of behavioral learning theory and emotional processing theory. The role of crying during flooding therapy is discussed, and an emotional release theory emphasizing the therapeutic value of crying is proposed. Six cautionary guidelines are offered for the use of intense exposure therapy with infants.

Psychological impact of esophageal atresia: review of the research and clinical evidence

“…There is growing awareness of the potentially traumatizing effects of surgery and medical interventions on infants . Several studies of premature infants have shown an association between chronic medical trauma experienced in the NICU and increased risk for psychiatric disorders during childhood .…”

A 2‐year‐old child's memory of hospitalization during early infancy

“…The outcome was positive, with disappearance of some symptoms of TSD after the first week, and no remaining symptoms after 2 months. His posttraumatic symptoms and treatment are described in a previous paper by the author (Solter, 2007). At the time of this memory study, Michael had no physical or emotional problems and was not in therapy.…”

Ways of Seeing: An Early Childhood Integrated Therapeutic Approach for Parents and Babies

“…Perhaps the quality of affectively matched mutual engagements with her Mom and Dad were compromised as well. Following traumatic reenactment treatment principles (Solter 2007), the improvisationalbased activities of the session enable Jessica to have new explorations that are bodily and experientially based. The goal of these experiences is to enable Jessica to create new experiences that can replace, rewrite and resolve her difficult felt-sense memories, creating a revised edition of her early childhood story.…”

“…Activities are multisensory-based and include: music, song, movement/dance, play, breath awareness, and relaxation methods (Tortora 2004(Tortora , 2006. When the presenting symptoms include traumatic or painful experiences, trauma techniques such as systematic desensitization (Solter 2007) are also used. When trauma techniques are used, the individual is carefully exposed to fear-evoking stimulus that is paired with a supportive emotional state (Solter 2007).…”

“…When the presenting symptoms include traumatic or painful experiences, trauma techniques such as systematic desensitization (Solter 2007) are also used. When trauma techniques are used, the individual is carefully exposed to fear-evoking stimulus that is paired with a supportive emotional state (Solter 2007). For children reworking traumatic or stressful experiences, these techniques strive to improve emotional self-expression and stability.…”