Holistic psychology views the individual as a whole, indivisible entity who is more than the sum total of his constituent parts and must therefore be treated in ways that not only address mind and behavior but also other factors such as relationships, social and physical environment, lifestyle, and physical health.

Lewis, 2009, in a literature review, emphasizes the importance of a holistic approach in relation to childhood trauma in relation to:

  • assessment
  • diagnosis 
  • intervention

 

He further states that such a holistic approach should mean that a broad variety of individuals are involved in the healing of childhood trauma including:

  1. parents
  2. teachers
  3. medical professionals 
  4. communities

 

Lewis quotes Visser (2007) who said:  mental health is not situated within the individual, but [the} interaction between people over time and [the] social and physical environment…’

He further cites research conducted by Van der Kolk suggesting a link between childhood trauma and adult ill-health (e.g. cancer, anxiety, and heart disease) which, in turn, Lewis asserts, ’emphasizes the adverse effect the traumatized child can have on others around him/her.

He also cites Bronfenbrerrer (1977, 2005), in order to reiterate this researcher’s view that childhood development takes place within the context of several ‘nested’ systems which are as follows:

  • microsystems – immediate social setting e.g. family, friends, school
  • mesosystems – microsystems (see above) interact directly and indirectly within the mesosystem
  • exosystems – these are systems within which the individual is not directly involved but, nevertheless, affect him/her e.g. public policy, the media, and the education system
  • macrosystems – these are broad ideologies relating to, for example,  society, culture, and the legal system that underpin the individual’s life and family structure
  • chronosystems – changes that occur to the individual and his/her environment over time.

 

The Holistic Development Of The Child

When assessing childhood trauma it is also necessary to consider the child’s (defined as primary school age) stage of development in a holistic fashion that takes into account many interacting components that, according to Lewis, should include:

  • physical development: influenced by, for example, genes, diet, healthcare, and exercise. Children of primary school age are prone to accidents due to adventurousness and lack of experience and judgment. Physical symptoms of trauma may include tiredness and headaches.
  • emotional development includes the child’s level of control over his/her emotions, degree of independence, degree of emotional flexibility. Emotional symptoms of trauma may include numbing, anger, depression, aloneness, denial, depression, guilt, hopelessness, grief, irritability, temper tantrums, destructiveness, fear, and anxiety.
  • cognitive development: includes the ability to think, conceptualize, reason, interpret, understand, acquire knowledge, insight, remembering, problem-solving, and analyzing (Mwamwenda 1995, cited in Lewis). Cognitive symptoms of trauma may include impaired ability to concentrate, magical thinking, shattered assumptions, misperceptions, time distortion, confusion about good and bad, bargaining, sense of a foreshortened future, reenactment, insomnia, nightmares, separation anxiety, regression, somatization (Van der Merwe 1999:192-223; Perrin, Smith & Yule 2000:278-279, cited in Lewis)
  • conative development: this relates to the child’s ‘driving forces’ that lead to his/her behavior including needs, impulses, tendencies, motives, aspirations, goals, and will to succeed (Van den Aardweg & Van den Aardweg 1988, cited in Lewis). It also relates to the child’s craving for recognition, approval, autonomy, group acceptance, love, safety, challenge, and adventure.
  • moral development: this refers to the child’s ability to distinguish between right and wrong within society, what is allowed and what is not, and the degree to which the child is honest and friendly.
  • social development: this refers to how the child gets on with others and, Lewis asserts, this is strongly influenced by the child’s family, school and upon the relationship, the child has with him/herself, The child’s stage of development in relation to each of the above is important because certain behaviors may be normal at one age but abnormal at another so, in the case of the former, the behavior would be age-appropriate whereas, in the case of the latter, it would NOT be age-appropriate and may, therefore, be a symptom of trauma. In relation to this, you may wish to read my article on arrested development.

 

Developmental Trauma Disorder:

Lewis also draws our attention to the view of Van der Kolk, a leading expert on trauma, that a PTSD diagnosis for children who have experienced significant trauma inadequately expresses the adverse effect trauma has on the developing child and that, therefore, a better diagnosis for those children who have been affected by severe, protracted, interpersonal and repetitive trauma would be Developmental Trauma Disorder (DTD), a diagnosis based on the idea that such trauma has ‘consistent and predictable consequences that affect many performance areas of the child’.

David Hosier BSc Hons; MSc; PGDE(FAHE)