“Not Seen Not Heard” – Annual Report Article 2022-23

“Not Seen Not Heard”

Child sexual abuse is an abhorrent trauma to suffer and so it is understandable mental health treatment services concentrate efforts to distance and desensitize the traumatic events but what many Phoenix clients are reporting and backed by neurological research is that attachment wounds are the more determinant factor of dissociation and emotional dysregulation. Specifically, when a main care giver is neglectful of their child’s emotional needs, so they repeatedly fail to be attuned, give warm affection, encourage, or soothe their child. The child then feels and believes themselves to be worthless.

When a client is struggling to regulate their emotions and be in touch with their body, they first need help to learn to be able to be present and to trust that it is safe to feel. Paulsen has a technique of resetting a clients affect circuitry to ensure clients are in touch with and can regulate their emotions which is a requirement before safely moving further forward in therapy.

When a client can both feel and socially connect instead of being overwhelmed or dissociated, then the person is ready to process trauma, but which trauma to start with, Schmitt (2023) distinguishes between trauma wounds from unmet physical safety needs and attachment wounds from unmet emotional needs? Many of Phoenix clients have experienced both a repeated feeling of being physically unsafe and emotionally abandoned and find that it is not the physical wounds, but it is the broken attachment they find the most painful. Schmitt notes we know desensitization is an effective trauma treatment, but we can’t desensitize unmet needs, instead attachment wounds only heal when unmet emotional needs get seen and repaired.

When we ask our clients about their first memories of emotional abandonment/neglect many of them say ‘I don’t remember’ and this is because of two main factors:

  1. They are trying to recall explicit memory of who, when, where and what happened to them, but this is usually only recalled from age of 3years upwards.
  2. When trauma occurs the brain goes into survival mode and puts its efforts into flight, flight, freeze, fawn, or flop responses and so shuts off non-essential survival modes such as language/narrative of events but what does stay switched on is the bodily felt experience so the child is on alert to the threat happening again.

This bodily emotional felt sense is part of implicit memory and can be remembered from preverbal time in life. Katie O’Shea and Sandra Paulsen (2009) developed an Eye Movement Desensitsation Reprocessing (EMDR) Early Trauma Protocol (ETP) for when there are no words and goes back to the first trimester as some researchers (Shore 2009) are formulating that this can be the start of lifelong psychopathology.

As there is no explicit memory from the womb the ETP targets blocks of three-month time frames and asks the client to imagine what it may have been like for the foetus. Working with clients I have found they do not struggle to imagine this time but do worry about blaming their mother saying ‘I know my mum was going through a tough time of… domestic violence…or drugs…. or had her own trauma to deal with.’  Paulsen teaches us to tell clients that the ETP is not about you the adult, but this is the time for your inner baby self to be seen and heard, giving her/him what s/he never had back in the womb. With this explanation clients seem to give themselves the permission to do this work.

In processing each 3-month time frame the client is asked to review what comes up for them and often they access painful emotional trauma which is given time to be released and then they are asked to imagine what they think baby needed and did not get at the time. Usually, it is a need to be seen and heard and very often they can bring their adult selves in to give their baby selves the loving attachment they have so longed for and needed.

It is important not to rush processing each time frame so that all the emotionally held memory is released and attachment needs are fully met. I have been privileged to witness clients experiencing their inner baby selves become integrated into their adult selves and have a body felt sense they are now seen, heard and safe and a healthy adaptive belief of self-worth begins to develop. To build on this loving adult/baby connection a poignant question Philip Mansfield asks of clients is ‘what did baby do to deserve the love?’ ‘nothing’ comes back the reply, and so clients start to have an assimilation of an embodied experience and belief that they are worthy regardless of what they do or don’t do.



O’Shea K. and Paulsen S. (2009) When There Are No Words EMDR for Early Trauma Neglect Held in Implicit Memory.

Mansfield P. (2010) Dyadic Resourcing: Creating a Foundation for Processing Trauma.

Schmitt S. J. (2023) Preparing Dysregulated Dissociative Attachment Wounded Clients for EMDR -Presented at EMDRAA Conference Melbourne Australia.

Shore, A.N. (2009) Right brain regulation: An essential mechanism of development, trauma, dissociation, and psychotherapy. Paper presented at the annual meeting of the EMDR International Association August Atlanta, GA.

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