Ghosts and angels: Intergenerational patterns in the transmission and treatment of the traumatic sequelae of domestic violence

The article discusses the impact of exposure to domestic violence on infants, toddlers, and preschoolers; the manifestations of post-traumatic stress disorder in the first years of life; and the parameters of Child-Parent Psychotherapy as a relationship-based treatment that aims at enhancing the parent's effectiveness as a protector as a means of restoring the child's momentum towards healthy development. Obstacles to the child's mental health and to the success of treatment are discussed, with particular attention to the adverse effects of parental psychopathology and of environmental stressors such as poverty, cultural marginalization, and lack of access to resources. It is argued that the infant mental health clinician working with traumatized children and their families needs to adopt a therapeutic approach that actively incorporates collaboration with other service systems, including pediatric care, childcare, law enforcement, child protective services, and the courts, in order to provide ecologically sound and culturally competent treatment.