The Boy Who Was Hit in the Face: Somatic Regulation and Processing of Preverbal Complex Trauma

Abstract

Examination of novel treatment for complexly traumatized youth, in particular, those exposed to preverbal trauma, is necessary given challenges associated with effective intervention for this population. Therapies that facilitate somatic regulation have demonstrated benefit for some trauma survivors. The current article briefly reviews the emerging literature on symptoms of and treatments for complex and preverbal child trauma and describes Sensory Motor Arousal Regulation Therapy (SMART), an intervention for child and adolescent trauma with preliminary empirical support. SMART aims to enhance sensory motor engagement and promote affective, behavioral and physiological regulation using somatic regulation and sensory integration techniques. Utilizing case study methodology, the article illustrates application of SMART in treatment of a latency-aged child with history of exposure to complex and preverbal traumatic experiences. Case analysis suggests the potential contribution of enhanced somatic regulation in traumatized children toward increased relational engagement, behavioral and emotional regulation, and trauma processing.

The brain-body disconnect: A somatic sensory basis for trauma-related disorders

“…Grounded in concepts of experience-dependent neuroplasticity and Hebbian learning ( Hebb, 1949 ; Rao and Sejnowski, 2001 ), these approaches are posited to repeatedly evoke an organizing response conducive to environmental and self-mastery, or the consistent and satisfying ability to produce meaningful goal-directed action ( Ayres, 1972 ). Small-scale clinical trials of SP-informed group therapy ( Langmuir et al, 2012 ; Gene-Cos et al, 2016 ; Classen et al, 2021 ) and case-studies of SMART ( Warner et al, 2014 ; Finn et al, 2018 ) and SE ( Payne et al, 2015 ) have shown promising results in arousal regulation and reductions in PTSD symptoms. Deep brain re-orienting (DBR) is an approach that similarly targets the multisensory integrative brainstem and midbrain regions by specifically focusing on orienting and postural responses.…”

The Impact of Childhood Trauma on Sensory Processing and Connected Motor Planning and Skills: A Scoping Review

“… Pre-verbal trauma primarily. Finn et al, ( 2017 ) USA Out-patient clinic. Evaluation of SMART 1 programme intervention and observed difficulties N = 1 7-year-old boy Single case study.…”

“…The remaining study by Elbrecht and Antcliff ( 2015 ) provided a practice review in relation to a specific approach of clay therapy however was included within the review as it provided helpful consideration of areas of difficulty frequently seen within the setting in the context of therapy as well as clinical analysis of the potential reasons for this. All four of these studies had a primary focus on interventions including clay therapy (Elbrecht & Antcliff, 2015 ), SMART programme (Finn et al, 2017 ), hippotherapy (Guerino et al, 2015 ), the Circle Pre-school Programme (Ryan et al, 2017 ). However, each contained reflections on the rationale for treatment approach, observations, or assessment data that was useful in considering the impact of trauma therefore were included.…”

“…A number of areas of motor difficulty were identified within the studies in relation to gross and fine motor skills, balance, coordination, spatial awareness, motor planning, postural control and visuo-motor integration suggesting a broad range of motor impacts resulting from trauma. Three of the studies identified impairments in motor coordination (Guerino et al, 2015 ; Finn et al, 2017 ; Elbrecht & Antcliff, 2015 ) which was connected with reduced body scheme impacting on their ability to use their body effectively within the environment. Elbrecht and Antcliff ( 2015 ) discussed specific examples in relation to bilateral coordination with a common area of difficulty seen being children only using one hand within an activity as if unaware of their ability to use the other hand.…”

Definition and attributes of the emotional memory images underlying psychophysiological dis-ease

“…Therefore, the EMI is created via the transference of the parent/caregiver’s terror (fear) to the child who creates an EMI which negatively associates with the spider. Both experiences can be seen as preverbal traumas (for more insight to infant traumas see Coates, 2016 and Spiel et al, 2019 ), which receive a poor prognosis for young children in community based mental health ( Finn et al, 2017 ). The Split-second Unlearning process, however, requires no verbal recollection of the original traumatic experience, seeking only to locate and clear the EMI ( Hudson and Johnson, 2021 ).…”