The cumulative impact of repetitive stress, fear, and shame in childhood wreaks havoc on the developing brain, resulting in a life-long vulnerability to anxiety, despair, and dissociative moments that are often described as developmental trauma. Adverse childhood experiences are often overlooked by therapists. This book focuses specifically on the profound suffering of high-functioning private-practice patients who manifest developmental trauma from chronic shock, shame, and neglect. Adams offers a synthesis of diverse theoretical worlds in her study of adaptations to cumulative trauma, namely, relational psychoanalysis, the British school of object relations, trauma theory, neuroscience and interpersonal neurobiology, developmental psychopathology, and attachment theory.

Using richly detailed clinical material, this book provides invaluably clear examples to illustrate the effects of disorganized states in infancy, making it essential reading for psychoanalysts, psychotherapists and clinical psychologists working with traumatized patients.