A reading report of Bonneville-Baruchel, E. (2015). Les traumatismes relationnels précoces : Clinique de l’enfant placé. Toulouse, France: ERES.
This book contains essential contributions in a field that few clinicians and theorists explore: the psychic life of children who have been neglected and abused during the first years of their lives. Two hundred and seventy thousand children are currently under report for serious maltreatment, representing 1.7% of the population, a figure constantly increasing. In comparison, pervasive developmental disorders have a frequency of 0.7%. These figures show how much the action/research conducted by Emmanuelle Bonneville concerns many children and professionals.
Most children affected by the pathology of early relational trauma did not have a priori genetic pathology at birth. At the beginning of their life – which includes a certain period of life spent in utero – these children had the same potential for optimal development in physical, emotional, cognitive and relational registers as other children. What distinguishes them from other children is that they have all suffered from neglect or very significant psychological abuse during their infancy, whether continuously or intermittently but recurrently.
Emmanuelle Bonneville proposes the results of a research conducted for many years, first as a psychologist at the Child Protection services and then in an outpatient rehabilitation programs in child psychiatry. One of the strengths of this writing is its clinical reading of the “behavior” of these children, and a theorization based on many psychoanalytic concepts, but also on recent research about the impact of repeated early trauma on the central nervous system.
The first interest of this book is the description of the bodily signs of the child: agitation, explosion of violence, noise emission, experience of liquefaction, loss of boundaries, disarticulated body, etc. These exhausting behaviors can discourage any attempt to establish a prolonged relationship. But Emmanuelle Bonneville shows us that this is a “principle of non-relationship in the relationship”; these bodily signs are messages who protect them from the relationship with others that could rekindle deep anxieties.
The author also describes how these children oscillate between different levels of psychic functioning, from secondary autistic defenses, to moments of delusion of persecution. It is a succession of states rather than a structure, which also complicates the approach of these subjects.
Another clinical aspect is the need to keep the image of the wonderful parental object, a kind of almighty God, at once seductive and terrifying by the risk of abandonment and violence. The child will constantly devote a lot of energy to “soften” this object. Emmanuelle Bonneville point out that the child can put in such a place, any professional who proposes a stable relation to him, with the risk for the latter to be absorbed by a demand of permanent exclusivity. It is necessary to introduce a “third-party separator” between these children and these adults, in all possible forms, to protect the child from moments of rapprochement that he wants but are cause of anxiety, and also to protect him from the restorative or violent movements he causes. For example, a game equipment offered to the child may be a “third-party separator”.
The question of the future of these subjects is obvious. We know that they are likely to suffer various ruptures which will aggravate the situation. As the author indicates, the most important is the permanence of the adult facing a child by which he is likely to be manipulated, like an object. Emmanuelle Bonneville indicates several principles: to demonstrate a constant commitment, both strict and benevolent; lay down social rules that can be internalized; establish a very personalized protocol that allows the child to anticipate. An essential point is also stressed: “there is no possibility of psychic recovery if the child continues to live traumatic experiences”.
WORDS WE HAVE LEARNED:
Early relational trauma = Traumatisme relationnel précoce
A foster child = Un enfant placé
A foster care = Un dispositif d’accueil
The central nervous system = Le système nerveux central
A genetic pathology = Une pathologie génétique