"Unseen Wounds: Understanding the Silent Traumas of Childhood Neglect"

"Exploring the Impact of Emotional Neglect on Adult Well-being"

Ronan (pseudonym, all names are used at the patients' request) shifts uncomfortably when I broach the topic of his childhood trauma. Together, we are attempting to ascertain if his childhood experiences are connected to his tendency to maintain minimal contact with his wife and three children while traveling abroad for work. The COVID-19 pandemic temporarily reduced Ronan's travel, leading to fewer tensions in his marriage. However, recently, Ronan resumed traveling for work, despite his lack of enthusiasm for these trips, particularly to a dreary city in Germany. Despite having free evenings during these trips, he rarely calls home.

"What was it like when you returned home from school?" I inquire.

Ronan looks at me quizzically, as if to say, "What's the significance?"

"Who was waiting for you?" I delve deeper. "What questions were asked? What was lunchtime like? Who helped you with your homework?"

Ronen's expression remains distant. After a brief pause, he awakens and mentions that most mornings, he would wake up to an empty living room devoid of adults. His mother worked in a government office and left the house early to commute to Jerusalem. His father often worked night shifts at a hospital and attempted to catch up on sleep in the mornings. Ronan and his older sister would wake up independently with the aid of an alarm clock, prepare their own breakfast, and head to their respective schools. Ronan rode his bicycle, while his sister took the bus to a more distant school.

The atmosphere upon returning home wasn't any more cheerful. Ronan would arrive to find an empty house and prepare his own lunch. His sister often studied until later, attending ballet classes after school. Their parents insisted that Ronan rest between two and four in the afternoon, preventing him from immediately playing with friends. During these hours, he was expected to complete his homework.

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No notes awaited him from his parents, and there was no special phone line for conversing with them. A note on the fridge contained only emergency contact numbers, and Ronan recalls using it when their upstairs neighbor required medical attention. However, there was no answer from his mother's office even then, and he doesn't recall his father's whereabouts.

In the afternoon, Ronan played with friends. Shy but well-liked, he was a competent athlete and seldom faced difficulties fitting in during sports activities. He appreciated the independence and privacy his family's lifestyle afforded him, but his childhood years were marked by crises, including bullying by peers and occasional trouble with teachers. When these issues arose, Ronan didn't know how to handle them, and his shyness entrapped him in silence and embarrassment.

None of his family members were aware of these challenges. He typically returned home around seven in the evening, briefly encountering his mother. She would return from Jerusalem around six, rest for half an hour, then tend to her elderly mother in another neighborhood. She often returned home after Ronan had already gone to bed. His father was usually home by seven, having completed various tasks, while his sister joined them around eight. The three of them would share a simple dinner, prepared by his father before he left for his night shift. Ronan couldn't recall the conversations held around the dinner table when asked.

"To whom would you turn if you faced difficulties or achieved something at school?" I inquired.

Ronan appeared baffled.

"And if you needed assistance with something?" I pressed.

He shrugged.

"So," I attempted to clarify, "on most days of your childhood, you didn't anticipate any acknowledgment from your family regarding your day, did you?"

Ronan concurred, indicating that he understood. As a child, he comprehended that his parents were working tirelessly to provide him and his sister with better opportunities than they had, expecting him not to burden or trouble them. In hindsight, it is apparent that their struggle for survival drained them physically, mentally, and emotionally, leaving them with insufficient energy to engage with their child's inner world and attend to needs beyond the physical. Therefore, when Ronan travels for business in Germany, he finds it challenging to envision that his wife and children in Israel would eagerly await his calls, share details of their day, and desire to connect.

Parents are frequently separated from their children due to various reasons, but this doesn't imply they are mentally distant. Numerous methods exist to demonstrate interest in the child's world, reside together at home in a non-utilitarian manner, pose open-ended inquiries, nurture the child's inner world, and address more than just material requirements. Consequently, parents can be in close physical proximity to their children while remaining emotionally detached. Therefore, it is worth examining whether the absence from home, throughout various stages of the child's development, is truly dictated by necessity within the "rat race."

But why term it "trauma"?

"Alright," Ronan interjected, displaying a modicum of self-compassion for his younger self, "but why use the term 'trauma'? They didn't physically harm me, insult me, or yell at me. They were merely doing their best."

"Indeed," I concurred, acknowledging his perspective. Nevertheless, I maintained that the events that repeated daily and yearly throughout Ronan's childhood were traumatic. To grasp this, it is necessary to distinguish between at least two types of trauma: those that add unwanted experiences to a child's development and those that subtract desired experiences from it.

When parents frequently subject a child to physical harm, insults, or yelling, they introduce adverse experiences into the child's cognitive repertoire, making it relatively simple to comprehend why it qualifies as trauma. Ronan's case, in my opinion, illustrates why it is appropriate to describe it as trauma, even when parents fail to fulfill roles essential for a child's normal development. Gabor Maté, a renowned addiction specialist, refers to this form of trauma as "trauma by omission." He emphasizes that trauma can arise both from negative occurrences and from the absence of positive ones.

Although physical punishment and violence undoubtedly leave indelible scars on children, it is essential to recognize that traumas by omission create distinct and particularly challenging problems for children, primarily due to their nebulous nature. A child who endures direct harm typically comprehends that something adverse is transpiring. Even if they grow accustomed to vulnerability during childhood, they may recognize the issue if they later find themselves in a healthy relationship. Conversely, children who experience trauma through the neglect and absence of vital parental functions may be left with a vague sense of the source of their emotional distress, persisting into adulthood, much like Ronan.

This becomes especially intricate when we acknowledge that many parents inadvertently subject their children to such traumas, despite not exhibiting violent tendencies or personality disorders that are easily identifiable. These parents, like Ronan's, are genuinely doing their best to survive while grappling with their own historical traumas. Yet, within this struggle, children often fall through the cracks, bearing silent traumas.