Sidelined Youth

While taking a class on trauma in children, my professor said more than once, “there is no hierarchy for trauma.” This accepted truth applies to both physical and psychological abuse. This research paper will focus more on an unexpected form of psychological abuse-the emotional neglect of children among the privileged.

One morning while walking my five-year-old daughter to school, I marveled at the nice houses, trimmed yards, and tall palm trees in California suburbia. Every other vehicle that drove by was a Tesla, announcing to the public that we were rich techies and proud of it. I really enjoyed observing nature and cherishing the time before school to teach my six-year old daughter about her five senses and the world around her. We arrived at school fifteen minutes early and sat down on the cement curb where the children ran around playing and waiting for the gates to open. I sat down and checked my phone and began to scroll through countless emails while my daughter jumped up and down on the cement curb. Surprisingly, a curious girl maybe six or seven years old walked up to me and said, “Why are you on your phone? My dad is always on his phone and computer?” I quickly put my phone down and replied, “Really, doesn’t sound fun to me. Playing sounds better.” The girl said, “I ask him to play but he just works all day and night. That’s not fun.” I paused for a second and thought about what would get her father’s attention. “Why don’t you draw a picture of you and your Dad at the park playing and give it to him today or tomorrow. You can choose to draw it during arts and crafts time. Sometimes mommy’s and daddy’s have a hard time listening!” The girl smiled and went off to school. I hugged my kiddo tighter than normal and realized how important playing is to children. Since the viral (COVID-19) shutdown and at-home schooling, I still wonder if she ever drew that picture and give it to her dad.

Ironically, one would think that wealthy parents with deep pockets and plentiful resources would be capable of providing emotional support and quality child raising, but studies show many well-to-do families hide issues of child neglect through their use of power privilege. For the purposes of this paper let’s consider wealthy to be those household who make $250,000 or more per year here in the US and can afford a nanny to care for their children. Emotional trauma in this case can be defined as moderate to severe neglect. Obviously, many children in the wealthy category can still have healthy attachments to their caregivers whether parental or hired help but there is still a certain category that feel extremely neglected if their own parents choose not to raise them. Age 11-15 appears to be a critical time of development where problems due to emotional neglect may begin to express themselves and can later morph into disorders like anxiety, depression, substance use, social dysregulation, attachment disorders, and even borderline personality disorder (BPD).

In many of these middle-upper class families, kids in suburbia reported significantly higher use of cigarettes, alcohol, marijuana, and hard drugs than their inner-city counterparts (Luthar & Latendresse, 2005). With huge amounts of pressure to get straight A’s in school and low parental involvement, it should be no surprise that this same cohort reported higher amounts of anxiety and depression than their inner-city comparisons. These observations suggest the maladaptive tendency to self-medicate, especially in boys. The girls in suburbia are likely to have three times higher levels of depression than the normative sample. Interestingly, girls in the upper-class (ages 11-15) also experienced intense social pressure to be attractive and popular vs. their counterparts in the inner cities (Luthar & Latendresse, 2005). How can being from a privileged family cause trouble with the youth? It appears that a toxic cocktail of achievement pressure, isolation from parents who work too much, and social influence from peers create a perfect storm for mental illness in teens who grow up with these dooming factors. Is this trauma in a classic sense? Maybe not, but the long-term effects of emotional neglect add-up in privileged children whose parents are absent.

Some of the negative effects of extreme neglect include anxiety, depression, attachment disorders, and even BPD. One such study makes a connection with adverse childhood emotional trauma and recollections of adults who needed psychotherapy later in life. A clinical group of 80 psychotherapy patients diagnosed with depression where compared to a group of 111 non-depressed patients from acute care somatic facilities. In this self-report study, emotional abuse and neglect as children significantly increased the probability of being in the depressed group of patients vs. the non-depressed individuals as adults (Neumann, 2017). Consequently, the depressed group of adults self-reported a connection between having experienced childhood neglect and the need for psychotherapy later in life.

Along with needing special attention as adults, emotional neglect in childhood also proves to shape social dysfunction in future relationships from weak attachments. Another study on emotional neglect and social anxiety was performed analyzing the oxytocin levels of population-based subjects who self-reported neglect on a Childhood Trauma Questionnaire. Blood samples were drawn from 121 men and women which resulted in lower than average oxytocin levels indicating insecure attachments in their relationships (Mueller, 2019). This bio-behavioral synchronicity model indicates that oxytocin and secure attachments play an important role in developing social relationships. The bi-directional relationship of healthy oxytocin blood levels and strong relationships are shown to correlate with social adjustment and the results of this study support the assumption that strong attachments are critical to guiding the development of youths through the lifespan.

Even though the source I am about to mention is older than fifteen years, I believe it provided more depth and understanding to the complexity of extreme parental neglect. Because Borderline Personality Disorder is considered by most clinicians as challenging to treat and difficult to understand, I included this source to shed more light on how psychopathology has the potential to develop in children. Two groups of patients entering a general hospital for psychiatric care were given the Parental Bonding Instrument measure. This examination measures recollections of parenting on dimensions of care and protection. One group was the 62 patients who had previously been diagnosed with BPD and the other group of 99 patients were the non-BPD group. The BPD group remembered both parents as less caring and more controlling than the non-BPD group (Zweig-Frank, 1991). This sets the stage of conflict and polarization inside the development of the child’s personality. The child can’t find the trust and security that parents can care for them and when they appear to care it is with heavy restrictions. How does this apply to the affluent? Well, many wealthy parents are busy working and managing their money which takes most of their mindshare leaving very little for their offspring. Ironically, they may pressure their children to perform on a high level of intensity as they did, enforcing controlling parameters on their children, and not allowing much free time for play and natural development. The bonding for children occurs during play with parents and allowing for free expression.

Furthermore, another study (Young, 2011) analyzed a sample size of 1,700 children ages 11-15 and discovered that youths as young as age 11who perceived their parents as providing less than optimal parenting, showed an increase in the odds of developing a psychiatric disorder. A small percentage (3%) of children in this study even reported their parents as being very unloving and controlling at the same time, a combination of parenting dysfunction known as “affectionless control.” These children were measured using the Parental Bonding Index at age 11 and were later observed at age 15 with twice the likelihood of having depression and/or anxiety (Young, 2011). While this study didn’t look at parental socioeconomic levels like the previous ones I discussed, it gave some reference to critical age ranges in the emotional development of adolescents.

As reviewed throughout the various domains (social, biological, development), the common thread in these study samples is emotional childhood neglect. The most difficult scenario, however, for me, is the one where parents have the affluence and resources to be good parents but fail miserably at providing the emotional support necessary to raise a healthy child. This irony doesn’t sit well with me. While I was doing this research, my family and I sat down to watch a movie, and to my amusement, The Willoughby’s (Bron Studios, Netflix animation, 2020) appeared on the screen. The setting opens with wealthy prestigious parents who are too busy loving each other to pay attention to their children. In a sick selfish spin, they pretty much completely ignore their four children and hire a nanny who supports them and shows them the world. The children luckily later end up wanting to be adopted by her and her husband because they finally feel emotionally supported by these new caretakers. While this is not clinically based or sound, it portrays the surreal and outlandish social ideas prevalent about lavish lifestyles, raising children, and the ignorance beneath the surface. In contrast to the popular cinematic views, the harsh reality of childhood emotional neglect is proven in these evidence-based research papers.

What types of interventions are effective in treating severe childhood emotional neglect? Trauma based Cognitive Behavioral Therapy is the most used along with Emotion-focused therapy for complex trauma (EFTT). EFTT works in four steps to help the client facilitate an “emotional transformation.” Phase1 is building the therapeutic alliance. Phase 2 is reducing fear, avoidance, and shame. Phase 3 is resolving issues with perpetrators and those who neglected the client. Phase 4 is termination. The emotional change for the client happens during the in-session processes utilizing emotional expressiveness, experiencing, and therapist expressed-empathy (Mlotek & Paivio, 2017). One example of a technique used in EFTT is the Gestalt use of a chair role-play where the therapist acts as the perpetrator/neglector and the client resolves the issue in a live acting session. Client: “How could you leave me alone at home for days like you did?” Therapist: “I sorry. I didn’t realize how it made you feel.” Client: “I felt so sad and alone” Therapist: “I wish I wouldn’t have done that and now realize how it hurt you.” Emotional catharsis is released from these Gestalt type techniques and are highly effective.

To conclude, the pursuit of the American dream today lives on, but its demands are increasing relentlessly at the cost of emotional stability for the children victimized by its golden lure. Many well-to-do parents are so single mindedly focused that they minimize the importance of spending quality time with their children to develop healthy attachments. Hiring a nanny and shuttling kids around after school from activity to activity is not always the virtue and privilege dreamt up by society. There are major consequences for those parents who don’t carve time out of their productive workday or weekend to play with their kids. Nannies, psychotherapy, and medication, and devices are no substitutes for spending quality time with children. Our children should be the focus of our energy and effort in life. To sideline our children is to cast them out into the dark where anxiety can cripple them, allowing the claws of addiction to constantly pull at their well-being. Living in “the land of opportunity” is most certainly a privilege but be aware of the potential side effects of the pursuit of riches here in America today.

References

Aust, S. et al. (2013). The role of early emotional neglect in alexithymia. Psychological Trauma: Theory, Research, and Policy, 5(3). p. 225-232. http://dx.doi.org.lib.pepperdine.edu/10.1037/a0027314

Bernard, C. (2018). Recognizing and addressing child neglect in affluent families. Child & Family Social Work Dec 26, 2018. http://dx.doi.org.lib.pepperdine.edu/10.1111/cfs.12619

Luthar, S. & Latendresse, S. (2005). Children of the Affluent: Challenges to Well-Being. Current Directory of Psychological Sciences, 14(1), pp. 49-53

Mlotek, A. & Paivio, S. (2017). Emotion-focused therapy for complex trauma. Person-Centered and Experiential Psychotherapies, 16(3), pp. 198-214.

Muller, L. et al. (2019). Emotional neglect in. childhood shapes social dysfunctioning in adults by influencing the oxytocin and attachment system: Results from a population-based study. International Journal of Psychophysiology, 136, Feb. p. 73-80.

Neumann, E. (2017). Recollections of emotional abuse and neglect in childhood as risk factors for depressive disorders and the need for psychotherapy in adult life. Journal of Nervous and Mental Disease, 205(11), p. 873-878.

The Willoughbys. (2020). Bron Studios, Netflix animation.

Young, R. et. Al. (2011). Children’s perceptions of parental emotional neglect and control and psychopathology. Journal of Child Psychology and Psychiatry, 52(8) pp. 889-897.

Zweig-Frank, H. (1991). Parents’ emotional neglect and overprotection according to the recollections of patients with borderline personality disorder. The American Journal of Psychiatry, 148(5), pp. 648-651.