Working with the pre-verbal client**

A blogger states:

“Ok, another interesting thing came up - how do you treat pre-verbal trauma? I think most of the stuff I actually remember, I dealt with well both at the time and later in life when reflecting back, but a lot of my general unsettled-ness comes from really early abuse...what can be done about that?”(end quote)

Some suggest that pre-verbal issues are more difficult to treat than a client who has problems from that stage of development where the child has gained mastery of language. (ie verbal issues). My personal view is that this is not the case. It is easier to do psychotherapy with someone who has problems from an age where they did not have language. One could say it is more primitive but those therapists who do not like it may perhaps feel insecure because they cannot do the interpretation of language. To my mind that makes things easier because you are dealing with more obvious and basic communications. It is non-fancy therapy and non sophisticated therapy and that requires the therapist to be non-fancy and sophisticated.

For a therapist working with pre-verbal issues is not hard in the

technical sense but can be hard in the emotional sense

Pre-verbal psychological maladaption means the person has suffered significant disruption to the parent/child relationship before the child has gained substantial mastery of language. Let’s say that is from birth to 18 months of age. This corresponds to what Freud defined as the oral stage of development: 0 - 18 months of age.

This disruption can occur because of obvious neglect or physical abuse of a child. Or it can occur because the child is physically looked after but there is a significant disruption to the attachment between the child and the main parenting figure. This can occur because there is some problem in the child or for some reason the parent is not available to the child. That can be because the parent is significantly effected by drugs or alcohol, is consumed with anxiety or depression, is physically ill and cannot see the child much or for what ever reason is emotionally unavailable to the child.

A minority of adults can just feel this age. It is a natural thing for them.

In attachment theory, for a successful attachment to occur the mother’s Free Child must be involved. In other words she can’t fake it. The newborn is so sensitive it will pick up that mother does not want to (or can’t) attach. If this is the case then the attachment will not happen in a successful way and pre-verbal difficulties will result.

This stage of development is actually divided into two separate stages. The oral sucking stage (0 - 8 months) and the oral biting stage (6 - 18 months).

Oral sucking stage - this is all about the mouth, lips and tongue, sucking, swallowing, passivity and dependency. In adulthood this is typified by cigarette addiction which involves sucking and taking in. The person who smokes cigarettes for these reasons will find it particularly hard to break the addicition. The dependent personality can result from this as can the narcissist and the schizoid personalities. The pleasure principle dominates as does autoeroticism.

Oral biting stage - relevant to teeth gritting and grinding and is about the teeth and jaws as any breast feeding mother will tell you. Biting, eating, destroying, sadism and aggression. Conduct disorders in children and the antisocial personality in adults may manifest from a fixation at this stage of development. This person is not so much into sucking on cigarettes but more into biting as with chewing gum or chewing pencils, finger nails and so forth.

If a client presents with such problems what does one do. The first thing one does is assess the level of regression that the client is capable of. If the client is able to regress significantly then preverbal fixation is a possibility. That is they can regress into their Child ego state to a degree more than the average person can not. They have that ability to be very child like although this can at times be well hidden in their day to day presentation.

The client will have that ability to naturally regress whereas others simply will not. As a result one often ends up working on a mat on the floor with the client. Some clients will naturally gravitate to this and others will not. They will feel a natural need or repulsion to be held and others will not. When doing two chair work they will say thing like. “I have no words or nothing to say”. When working they will naturally put their feet up in the chair or request to sit on the floor. They need of get off the chair and get onto the floor and curl up or lash out in a temper tantrum.

With preverbal clients one has to deal with strong emotions and thus one does things like rage work on a mattress on the floor. Or the client curls up frozen with terror. If one has ever seen such a thing they will know what I am talking about.

Then of course there is rebirthing. Which one can see here.

Unfortunately what happens with many therapeutic techniques is they get commercialised. Rebirthing can be most useful with the client who has conflicts from the first year of life. The client is given the opportunity to simulate their birth. This can either be a wet rebirth in a hot tub or a dry rebirth on the floor.

Unfortunately tend people seize on such things and set up places like rebirthing clinics. On a Saturday morning one can wander down to the local rebirthing clinic and get a rebirth if they want. It’s like ordering a hamburger. Obviously the meaning of such a therapeutic process is lost. For the pre-verbal client a few rebirthing experiences can be most therapeutic if correctly placed within the context of the overall treatment of the client.

With pre-verbal clients one is working on a mat on the floor. More noises than words are expressed. One is suggesting to the client things like curling up at home in bed and sucking on their thumb or using dummies or pacifiers as they are known here. (Interesting term that - pacifier). One asks of the client do they tend to suck on their pacifier or bite it. Thus one can gain insight into if they are at the oral sucking or oral biting stage.

Clients can do such “homework” and some have requested that I record a CD (or audio tape as it used to be) reciting bed time stories that a parent would do to a child. I have done this. Of course it would be better if I could do this in real life but the professional organisations and press would immediately sexualise it and thus it can’t happen.

Clients can also use baby food where feeding issues are indicated. The eating of such foods and monitoring the reaction. And finally one of the more prominent methods of working with the pre-verbal client is the holding of them. As with rebirthing this is not done in a mechanical way but has its place in the overall therapeutic process.

In such holding of the client by the therapist the Child ego state of the client gets soothed in a somatic and non-verbal way. A decisive aspect of any such relationship and attachment. Whilst the Child ego state is being soothed the Parent ego state of the client also takes in the soother for future self soothing. In my view one of the more important ways by which the client can develop the ability to self soothe.

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