Background
The notion of a three-dimensional theory of soul originates in ancient Greek Philosophy with Plato`s Tripartite Theology.
Following this, Sigmund Freud the “Father of Modern Psychiatry”, described a triple-layered topography to the anatomy of the psyche, in which he conceptualizes the Id, ego, and super-ego.
Dr. Trappler`s tripartite theory of trauma is an object-relations theory of trauma-psychology, which proposes that there are always three components – a triad – involved in the psychology of abuse. The theory proposes that the dynamics in which trauma plays out should be broadened from that of victim and predator, to include the role of derelict caretaker-functioning; which completes the triad.
When a parent or other caretaker (including a government) fails to protect, or even colludes in some way with a predator, there is some profound dynamic that has gone terribly astray.
When attempting to understand the psychological trauma experienced by groups such as children and spouses, it is extremely important to focus on all of the victims’ closest relationships.
Dr. Trappler extends the concept of caretaker to include any individual (e.g., a parent), civilian organization (e.g., Child Protective Services), or even governmental bureau or authorized agencies.
To convey the importance of trauma-dynamics, disrupting this safe arrangement creates the recipe for a pathological outcome.
Parental Caretaking in the Tripartite Model
1. John Bowlby, the forefather of “Attachment Behavior”, focused on attachment as an intrinsic biologically-based behavior system, whereby the consistency of caregivers became essential in fostering subsequent secure and mature social functioning (“Attachment and Psychopathology” Edited by Leslie Atkins and Kenneth Zucker, Guilford Press, 1997, pages 23-28, ISBN 1-57230-191-0)
2. We now know that healthy bonding between mother and child is an ongoing process characterized by distress signals and empathic responses that begin early in life. Secure attachment increases the probability of integrated personality development (Belsky, J., & Isabella, R.A. Ibid; pg. 4-5).
3. Studies of bonding among primates that tested different feeding patterns (foraging) between mother-infant bonnet-macaques monkeys showed that puppies who received insufficient or erratic unpredictable foraging showed elevated stress hormones and then later, as parents bonded less favorably with their own kin, (Jeremy Coplan M.D. and colleagues , C.N.S. Spectrums, July, 2005).
4. A good caretaker is one whose emotions, voice-tone, tactility, and responses show a total congruence with the needs of her infant. Franz Kohut, the founder of the school of “Psychology of the Self,” referred to this function as “empathy”, which implies “being with.” This trait requires a certain dedication or “generosity of spirit” towards another (Franz Kohut Psychoanalytic Dialogues: The International Journal of Relational Perspectives, Volume 5, Issue 3, 1995).
5. A mother generally exhibits a variety of bonding behaviors that impact her child’s sense of self (which ranges from being more or less cohesive), emotional regulation (self-soothing function), and attention (mindfulness).
Throughout development a child learns to manage external threats by identifying with and modeling the responses of good caretakers.
Early in life, caretakers will function as an external regulator of the child`s stress responses. Individuals are at an advantage if their caretakers identified their stress signals and responded supportively. Over time, children internalize their parents’ coping skills.
Having received healthy early-attachment, trauma victims believe that things will turn out all right, confront problems, plan solutions, and seek support when needed; alternatively, they may be pessimistic, avoid problems, not plan solutions, and ignore support when needed. Internalization of coping skills has been found in various studies.
This plays out in domestic settings, when a parent abuses his or her child, and evidence emerges that the Caretaker colluded with the predator, was mysteriously absent, or (from the victim`s perspective), “should have known”.
Victim’s of interpersonal trauma were described by Judith Herman as being at risk for Complex Post-Traumatic Stress Disorder because of the “violation of human connection”. Dr. Herman described that “traumatic events shatter the sense of connection between the individual and community” (“Trauma and Recovery- The aftermath of violence- from domestic abuse to political terror”. Judith Herman, M.D. Basic BOOKS, 1992, ISBN- 9780465-087303).
Governmental Caretaking in the Tripartite Model
“Parenting”, at a governmental level requires that its citizens feel safe, free of persecution, freedom of information, travel, and religious and political expression, as well as protected from external threat. Such citizens should feel secure in their daily affairs, free to safely engage in work and pleasure with minimal governmental interference. It therefore becomes contingent on government to provide a variety of protective functions. These would include access to medical care, law-enforcement, and a fair judicial system.
At the level of government, when caretaker functioning becomes abusive, (as demonstrated by tyrannical regimes), it has deformed its caretaking role into a fear-dominated, restrictive, or punitive dynamic. This form of tyrannical leadership not only replaces an entire society’s sense of well-being with that of fear and intimidation, but can demoralize the hopes and aspirations of entire nations.
When governments perpetrate or collude in unlawful intimidation, isolation, deprivation, or punishment of their own (or neighboring) citizens, this is analogous¾on a collective level¾to the punitive patterns shown by child abusers.
In such instances, the caretaker has abolished its protective role and, replaced this with restrictions or threat, leaving a vacuum of caretaking by abusing its privilege, replacing the caretaker with the predator, leaving the citizen as the victim.
Democracies have therefore placed checks and balances on the powers of the Administrative Branch of Government, with courts, parliament or a congressional form of citizen representation.
Stalin’s doctrine of intimidation and conquest via massive purges beginning in the 1930`s are an example of such caretaker perversion and abuse carried out on a grand scale.
After the fall of Communism, the Free World rejoiced when countries such as Czechoslovakia and Hungary were finally able to reclaim their own national identity. Such epic moments that celebrate freedom over suppression occur whenever a victim is rescued.
Once a benevolent style of caretaking was re-introduced, healing (also known as “trauma-recovery”), could begin.
The theory brings clinical support by Savjak on the Balkan Wars, where the effects of civil chaos in the face of international apathy left 42 % of an entire society with symptoms of PTSD, as an example of caretaker failure in global terms (Savjak, N. 2003, ‘Multiple Traumatization as a risk factor of post-traumatic stress disorder. Psihologija, 36 91-2): 59-71.
Irwin Cotler, Professor of Human Rights and Constitutional law at McGill University, has addressed the failure of caretaking at an international level as “the crime of indifference and inaction,” and notes that, in spite of a lot of rhetoric on Darfur, 450,000 people died. He adds, “The killing fields have not abated.” Our generation has witnessed ethnic cleansing in the Balkans, and genocide in Rwanda.
According to the Tripartite Theory of Caretaking all of these social catastrophes could have been prevented by effective global caretaking.
About The Author
After graduating Medical School in 1974 at WITS University in Johannesburg, Dr Trappler spent three years as a House-Officer in Medicine, Surgery, Pediatrics, and Intensive Coronary Care.
Having completed a psychiatric residency at the University of British Columbia, Vancouver, he moved to Brooklyn, where he completed a two-year Fellowship in Psychosomatic Medicine.
Dr. Trappler was Assistant Professor in Biological Research at Columbia University from 1988 to 1994.
He then became Associate Clinical Professor in Psychiatry at the State University of New York at Brooklyn between 1994 and 2010.
During this time, he occupied the following positions:
- Associate Medical Director of the Anxiety Clinic at SUNY Downstate.
- Block Director in Psychopathology.
- Director of Psychiatric Inpatient Education.
- Psychotherapy supervisor for Psychiatric Residents, Psychiatric Fellows, and Psychology Doctoral Interns.
- Lecturer in Pharmacology.
- As Representative for Department of Psychiatry on the Neuroscience Curriculum Committee devised and implemented the Problem-Based-Model for teaching Integrated Neuroscience for 3rd year medical students .
In the area of trauma-recovery Dr Trappler`s clinical research has been published in various peer-reviewed journals, including the American Journal of Psychiatry and the American Journal of Geriatric Psychiatry.
His work in trauma-recovery has been presented at National Conventions of the American Psychiatric Association and the American Geriatric Psychiatric Association.
The following is a partial list of his trauma-related peer-reviewed articles.
- Trappler B, Friedman S. “Post-traumatic Stress Disorder in Survivors of the Brooklyn Bridge Shooting”. Am J Psychiatry; May 1996. 153: 705-707.
- Trappler B, Friedman S. “Death on a Psychiatric In-Patient Unit – Effect on a Subgroup of Schizophrenic Patients”. General Hospital Psychiatry 1996, 18, 261-265.
- Sublette E, Trappler B. “Cultural sensitivity training in mental health: Treatment of Orthodox Jewish psychiatric in-patients”. Int J Social Psychiatry 2000 Vol 46 No 2 122-134
- Trappler B, Backfield J “Clinical characteristics of older psychiatric in-patients with borderline personality disorder”. Psychiatric Quarterly, Vol 72 No 1 2001 pg 29-40
- Friedman S, Smith L, Fogel D, Paradis C, Viswanathan R, Ackerman R, Trappler B “The incidence and influence of early traumatic life events in patients with panic disorder: a comparison with other psychiatric outpatients”. Journal of Anxiety Disorders, 16 (2002) 259-272
- Trappler B. “Post Traumatic Stress Disorder”, Edited by David Nutt, Jonathan Davidson, Joseph Zohar. Published by Martin Dunitz, London, UK 2000. Book Review. Annals of Pharmacotherapy 2001 Sept. Vol 35 1145-1146
- Trappler B, Braunstein J, Friedman, S. “Holocaust survivors in a primary care setting – 50 years later”. Psychological Reports 2002, 91, 545-552
- Friedman S, Smith L, Halpern B, Levine C, Paradis C, Viswanathan R, Trappler B. “Obsessive-Compulsive Disorder in a Multi-Ethnic Urban Outpatient Clinic: Initial Presentation and Treatment Outcome With Exposure and Ritual Prevention” Behavior Therapy 34, 397-410, 2003
- Trappler B, Cohen CI, Tulloo R. “Impact of Early Lifetime Trauma in Later Life: Depression Among Holocaust Survivors 60 Years After the Liberation of Auschwitz”: Am J Geriatric Psychiatry. January 2007
- Trappler B, Newville H, “Trauma Healing via Cognitive Behavior Therapy in Chronically Hospitalized Patients” Psychiatric. Quarterly. 2007 Dec 78 (4): 317-325.
- Trappler B “Modern Terrorism and Psychological Trauma”, 2008, New England University Press, published by Richard Altschuler.
- Trappler B “Identifying and Recovering from Psychological Trauma” , New England University Press, published by Richard Altschuler, 2009.
He has served as a Journal Referee for the following journals:
- Journal of Clinical Psychology
- Journal of Traumatic Stress
- Annals of Pharmacotherapy
- Acta Scandinavia.
Credentials & Letters of Recommendation
Tags: attachment-theory, bonding, child-abuse, Communism, Complex PTSD, empathy, parenting, predator, purges., Stalin, trauma-victim, tyranny