The Emotional Frontier - A New Diagnosis?

by Richard C. Raynard, Ph.D.
Licensed Clinical Psychologist

Developmental trauma disorder - A new DSM V diagnosis?

Van der Kolk and many others see the post-traumatic stress diagnosis (PTSD) as way too narrow for adult problems in identity, relationships, emotional regulation and even physical health.  Adults can be, at times, "clinging, needy, impulsive, enraged, depressed, despairing or suicidal".  Their childhood often features prolonged abuse, neglect, violence and incest. After presenting 130 research papers representing over 100,000 children - and resubmitting 300 more research articles - the trauma task force led by Van der Kolk was turned down by the DSM V committee. "Developmental Trauma Disorder" was seen as too broad, not researched, overlapping with other diagnoses and not useful .Still, the DTD trials go on, using newer treatments like TARGET and ARC. An uphill fight for the recognition of emotions.

The heart of DTD 



Shared emotions

The heart of DTD may be "extreme disregulation of emotional states" (Ford). Cloitre found that a failure of parental attachment and attunement to the child was worse than physical abuse in its consequences. Van der Kolk says that you need a parent who can mirror the child's emotions, so that he can "connect with his own felt inner experience" to develop a sense of his authentic self, or else the "capacity to feel your inner realness is impaired". Damage to your personal identity and coherent sense of self distinguishes DTD from PTSD. Such is the importance of emotions.

A catalogue of childhood emotional trauma.

Young (1999) has found and developed 18 maladaptive beliefs and feelings about relationships that begin very early in life, resulting from "ongoing patterns of everyday noxious experiences" with their parents or caregivers. These "schemas" fall into 5 groups: disconnection/rejection; impaired autonomy/performance; impaired limits; other-directed-ness; and overvigilence/inhibition. He has convincingly related several of these early abuse patterns to the development of resistant personality disorders appearing later in life. In a forthcoming book, I have identified the primary emotions that show up in each personality disorder.

Emotions give us energy and direction from our earliest days.  Why is it so hard to give them their due?

About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.