Impact of the post-traumatic stress linked to domestic violence on parenting: Empirical data and clinical applications

Mothers with Interpersonal Violence-Related Post-Traumatic Stress Disorder (IPV-PTSD) may experience their toddler's routine expression of distress and/or helplessness as a trigger of post-traumatic stress. We review evidence in support of this hypothesis from two studies conducted in New York and Geneva. In both studies, mothers and toddlers (ages 12-42 months) were recruited from the community. They entered a protocol including filmed interviews, mother-child interactions and an experimental psychotherapeutic intervention session the Clinician Assisted Videofeedback Exposure Session (CAVES). For a sub-sample of mothers, a functional neuroimaging study was conducted prior to the CAVES, involving mothers watching video-clips of their own and unfamiliar toddlers during separation and play. Following the fMRI scan, mothers rated their own stress while watching the video-clips. Mothers with IPV-PTSD found seeing their own and unfamiliar children during separation as significantly more stressful than controls. Parenting stress was correlated with the severity of maternal PTSD as was decreased maternal availability to their toddlers for joint attention. fMRI revealed less neural activity in the medial prefrontal cortex in both studies. The paper shows how the CAVES technique targets IPV-PTSD mothers own emotional dysregulation upon exposure to child distress and helplessness and supports maternal reflective capacity. Clinical examples are discussed.