ABSTRACT There is a small cohort of traumatised adopted children whose fear of separation from parents, and fear of hostility and rejection from the therapist, prevent them from being able to make use of the therapist’s thoughts and words. Some children are in such heightened states of alarm and dissociation that they are unable to play. This personal account of clinical development recounts growing awareness of the extent to which some highly traumatised children’s mentalizing capacity in therapy is dependent on their neurophysiological regulation. Therapy with such children must therefore begin by attending to the alarmed body, triggered by the anticipation of what is termed ‘relational trauma’. Moving beyond psychoanalytic and attachment theory to draw on ethological studies, relational trauma behaviour can be understood as a symptom of humans in agonic mode; this is a group behaviour mode observed in higher primate troops when they are experiencing compromised resource acquisition and stress. Such troops organise themselves in relations of dominance and appeasement that are aggressively enforced and resemble disorganised attachment behaviours. Fear-infused relationships are designed to reduce uncertainty and increase intra-group predictability. Parent-child homeostasis therefore needs to be understood within its familial, historical, geo-political and socio-economic context. Helping traumatised families move from agonic to benign hedonic mode arguably requires the double task of reducing environmental stressors and transforming fear-fuelled hostile-helpless relations into those of mutuality, reciprocity and understanding. This paper argues that such support involves a form of social activism on the one hand, and recognition and acceptance that the subject of therapy is primarily the parent(s)-child dyad, on the other. Any effective therapy must address trauma triggers in all subjects. Finally, some novel ways of transforming hostile-helpless behaviours into safe nurturing reciprocal interactions are suggested, with clinical illustrations.

中文翻译：

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对受创伤的收养儿童进行儿童心理治疗的“其他事情”

摘要 有一小群受创伤的收养儿童害怕与父母分离，害怕治疗师的敌意和拒绝，使他们无法利用治疗师的想法和话语。有些孩子处于高度的警觉和分离状态，以至于他们无法玩耍。这种对临床发展的个人描述讲述了人们越来越意识到一些受到高度创伤的儿童在治疗中的心理化能力取决于他们的神经生理调节的程度。因此，对此类儿童的治疗必须从关注被称为“关系创伤”的预期触发的惊慌失措的身体开始。超越精神分析和依恋理论，利用行为学研究，关系创伤行为可以理解为人类处于痛苦模式中的一种症状；这是在高等灵长类动物遇到资源获取和压力受损时观察到的群体行为模式。这些部队以支配和绥靖的关系组织起来，这些关系被积极地强制执行，类似于无组织的依恋行为。充满恐惧的关系旨在减少不确定性并提高组内可预测性。因此，需要在家庭、历史、地缘政治和社会经济背景下理解亲子稳态。帮助受创伤的家庭从痛苦的模式转变为良性的享乐模式可以说需要双重任务，即减少环境压力源并将恐惧助长的敌对无助关系转变为相互关系，互惠和理解。本文认为，这种支持一方面涉及一种社会激进主义形式，另一方面涉及承认和接受治疗的主题主要是父母-子女二人组。任何有效的治疗都必须解决所有受试者的创伤触发因素。最后，提出了一些将敌对无助行为转化为安全的互惠互动的新方法，并附有临床插图。