Book Review

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Stauffer, K. A. (2021). Emotional neglect and the adult in therapy: Lifelong consequences to a lack of early attunement. W. W. Norton & Company

I believe it was during a conference in 2015 when I first heard Martin Teicher talk about the impact of neglect in young children; how there was growing evidence that in comparing the “neglect trajectory” and “abuse trajectory” for the deleterious impact on the developing brain, neglect may be more harmful than abuse. Since then, we have been watching the accumulation of further evidence to support this bold claim, coming out of various labs. As research in this area became more nuanced over the years, we started to see that “neglect” means something different than emotionally ignoring infants and young children. For a lot of trauma clinicians, this created a persistent question about what exactly this may mean in terms of what happens in the therapy room: How do these different experiences present differently in adulthood, and how may the various trauma-focused approaches and interventions result in different outcomes based on the nuances of the impacts of the experiences? Dr. Kathrin Stauffer’s Emotional Neglect and the Adult in Therapy: Lifelong Consequences to a Lack of Early Attunement (2021) provides a cohesive response to these questions by pulling together experience-informed effective theories, principles, and specific interventions for the treatment of adults who were emotionally neglected as infants and young children.

In the first part of the book, Dr. Stauffer wisely and helpfully presents the overlaps and nuances between emotional neglect and trauma experiences. She emphasizes that predictably, there is significant overlap between the world of trauma and emotional neglect, both in terms of situational and interpersonal risk factors and clinical presentations. On the other hand, in describing the emotional neglect cases, she emphasizes shame as the most prominent tell-tale sign of emotional neglect. To demonstrate both the clinical presentations and the suggested interventions, four different cases are used. The definitions, descriptions, theories, and interventions come to life in these case excerpts that Dr. Stauffer turns to regularly throughout the book. Using a developmental framework, emotional neglect is defined as the experience of not having a primary caregiver who is able to interpret and/or appropriately respond to the needs of the infant/young child. She uses the term “ignored children” throughout the book to describe individuals who have suffered emotional neglect. From this perspective, shame has two fundamental prongs: the shame of having needs (e.g. the need to be close to others) and the shame of being someone who deserves all the painful experiences of the past. “Deserving the painful experiences” comes from the common understanding that for the ignored children (and for those who have suffered early and chronic interpersonal traumas), it is safer to assume responsibility to preserve the “goodness” of others, to avoid the biggest threat of all: isolation.

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