Daniel Schechter
Daniel S. Schechter (born 1962 in
Career
Following studies in music and French literature (Oberlin Conservatory of Music, Columbia College (B.A.), and Columbia University Graduate School of Arts and Sciences (M.A.), Schechter then completed his medical training at the
Funding through the
In Geneva, his clinical research efforts
Schechter's work has received a number of awards including:
Helping traumatized parents "change their minds about their young children"
During his work as director of infant mental health services at the Columbia University Medical Center (1998–2008), Schechter found that the large majority of inner-city mothers who were requesting consultation for their infants and young children for reasons of behavioral difficulties had histories of childhood maltreatment and/or family violence victimization and exposure, often with related psychiatric sequelae (i.e.
Schechter and colleagues developed an experimental paradigm informed by attachment theory called the Clinician Assisted Videofeedback Exposure Sessions (CAVES) to test whether mothers could "change their mind" about their young children if helped to watch video-excerpts of play, separation and similarly stressful moments in the presence of a clinician who asks the mother to think about what she (and her child) might be thinking and feeling at the time of the excerpt and at the moment of videofeedback. Thus this technique applies principles of mentalization as an aide to emotional regulation with traumatized parents[33][34] This technique also involves elements of prolonged exposure treatment—in other words confronting avoidance of trauma-related negative emotions,[35] the video-based treatment Interaction Guidance,[36][37] and psychodynamically oriented child-parent psychotherapy [38] Schechter and colleagues showed a significant change in the way mothers perceived their own child and their relationship together.[39] Schechter, Rusconi Serpa, and colleagues have manualized a 16-session psychotherapy for violence-exposed mothers, their infants and young children that builds upon the CAVES technique. This treatment is called Clinician Assisted Videofeedback Exposure-Approach Therapy (CAVEAT) and currently is in a pilot phase.
Intergenerational communication of violent trauma
Schechter has studied how the distressed toddler can trigger a parent's posttraumatic stress marked by a) emotional unavailability or frank avoidance and b) how parents communicate— often unintentionally, memories of their own violent traumatic experiences. In relation to emotional unavailability, Schechter and colleagues' found that mothers with interpersonal-violence related PTSD, while not showing differences in their capacity to jointly attend to play with their toddlers before a stressor when compared to control-subjects, show significant limitation in their responsiveness to their toddlers upon reunion following separation stress. This is despite the finding that children of PTSD mothers show no greater distress during separation than those of controls.[40] And in relation to communication of traumatic experience, following from the work of Scheeringa and Zeanah, Schechter explored the implicit and explicit non-verbal and verbal ways parents communicate their traumatic experiences to their children who may or may not have been present during these violent events.[41] In particular, Schechter has shown how a parent can vicariously and unintentionally transmit her prior experiences of interpersonal violence to her child through her behavior and narrative associations by doing or saying something— or drawing connections between actions and/or language, that the child cannot place in any familiar context, but that is by its nature, frightening or even traumatizing. His work has demonstrated this both in routine daily interactions, laboratory observations, and in violent-media viewing practices by mothers and their toddlers in the home.[42][43][44][45] He has hypothesized that this inadvertent intergenerational transmission is often an effect of traumatized mothers' efforts to control their own psychophysiological dysregulation that is linked to their posttraumatic psychopathology. This was, for example, demonstrated with regards to the hypothalamic-pituitary-adrenal (HPA) axis in the first publication on maternal physiologic response to child separation, and in a parallel study subsequently, in relation to the autonomic nervous system response.[46][47]
Schechter and colleagues have in addition to maternal behavioral and physiological dysregulation, also found at the level of maternal brain activity, corticolimbic dysregulation on functional neuroimaging as associated with maternal PTSD and dissociative symptoms in response to child separation and adult male-female violence-related video-stimuli in both New York and Geneva samples[48][49][50] The same pattern of corticolimbic dysregulation has also been associated with increased parenting stress, HPA axis dysregulation as marked by decreased methylation of the glucocorticoid receptor gene, and observed child behavioral difficulty during mother-child play.[51]
An important motivation for traumatized parents, Schechter and colleagues have found is the conscious aim of the traumatized parent to interrupt intergenerational cycles of violence and trauma so that her child does not have to suffer the emotional and often physical pain that she had experienced as a child. As Schechter and Willheim describe, this can be a long and difficult process for families—and one that requires that the therapist be prepared to intervene thoughtfully (i.e. modeling and stimulating parental mentalization) as much in-the-moment in response to real-life events reported by the parents and professionals (i.e. pediatricians, daycare and preschool staff, child protective agencies, the courts) as during parent-child sessions.
Infant and early childhood mental health advocacy
Schechter served as a key member of the New York City Early Childhood Mental Health Strategic Work Group, an advisory group to the New York City Department of Health and Mental Hygiene under the direction of Evelyn Blanck from 2004 to 2008. In 2005, the Workgroup published a White Paper,“Promoting the Mental Health and Healthy Development of New York’s Infants, Toddlers and Preschoolers, A Call to Action,” that has been used to effectively advocate for mental health services for children from birth to age 5 across all child-serving systems in
References
- ^ Mayer, KM. (December 10, 2001). Der Terror bleibt in den Menschen (The terror lingers...). Focus, Germany
- ^ "Der 11. September: Die leise Stimme der Vernunft". 2004-05-10.
- ^ Davaris, S. (March 18, 2011). Mon enfant peut-il me rendre fou (Can my child drive me crazy?). Tribune de Genève, Switzerland. [1][permanent dead link]
- ^ Coates SW, Rosenthal J, Schechter DS — Eds. (2003). September 11: Trauma and Human Bonds. New York: Taylor and Francis, Inc.
- ^ Schechter DS, Coates SW, First E (2002). Observations of acute reactions of young children and their families to the World Trade Center attacks. Journal of ZERO-TO-THREE: National Center for Infants, Toddlers, and Families, 22(3), 9-13.
- ^ Schechter DS, Coates SW, First F (2003). Beobachtungen von akuten Reaktionen kleiner Kinder und ihrer Familien auf die Anschläge auf das World Trade Center. In T. Auchter, C. Buettner, U. Schultz-Venrath, H.-J. Wirth (Eds.): Der 11. September. Psychoanalytische, psychosoziale und psychohistorische Analysen von Terror und Trauma. Giessen, Germany: Psychosozial-Verlag. pp. 268-280
- ^ Coates, Susan W.; Schechter, Daniel S.; First, Elsa; Anzieu-Premmereur, Christine; Steinberg, Zina (2002). "Summary". Psychotherapies. 22 (3): 142–152.
- ^ "Messages from those lost on Sept. 11". Stamfordadvocate. 2010-09-13.
- ^ Schechter DS, Zygmunt A, Coates SW, Davies M, Trabka KA, McCaw J, Kolodji A., Robinson JL (2007). Caregiver traumatization adversely impacts young children’s mental representations of self and others. Attachment & Human Development, 9(3), 187-20.
- ^ Schechter DS, Coates, SW, Kaminer T, Coots T, Zeanah CH, Davies M, Schonfield IS, Marshall RD, Liebowitz MR Trabka KA, McCaw J, Myers MM (2008). Distorted maternal mental representations and atypical behavior in a clinical sample of violence-exposed mothers and their toddlers. Journal of Trauma & Dissociation , 9(2), 123-149.
- ^ Schechter DS, Willheim E (2009). Disturbances of attachment and parental psychopathology in early childhood. Infant and Early Childhood Mental Health Issue. Child and Adolescent Psychiatry Clinics of North America, 18(3), 665-687.
- ^ Fonagy P, Gergely G, Target M (2007). The parent-infant dyad and the construction of the subjective self. Journal of Child Psychology, 3, 288-328.
- ^ van IJzendoorn M, Bakermans MJ (2008). DRD4 7-repeat polymorphism moderates the association between maternal unresolved loss or trauma and infant disorganization. Attachment and Human Development, 8(4), 291-307.
- ^ Charuvastra A, Cloitre M (2008). Social bonds and posttraumatic stress disorder. Annual Review of Psychology, 59, 301-328.
- ^ Mills-Koonce WR, Propper C, Gariepy JL, Barnett M, Moore GA, Calkins S, Cox MJ (2009). Psychophysiological correlates of parenting behavior in mothers of young children. Developmental Psychobiology, 51(8),650-61.
- ^ Hibel LC, Granger DA, Blair C, Cox MJ (2009). Intimate partner violence moderates the association between mother–infant adrenocortical activity across an emotional challenge. Journal of Family Psychology, 23(5), 615-625.
- ^ Swain JE, Konrath S, Dayton CJ, Finegood ED, Ho SS. (2013. Toward a neuroscience of interactive parent-infant dyad empathy. Behav Brain Sci. 2013 Aug;36(4):438-9.
- ^ Schechter DS, Brunelli SA, Cunningham N, Brown J, Baca P (2002). Mother-daughter relationships and child sexual abuse: A pilot study of 35 mothers and daughters (ages 1-9 years). Bulletin of the Menninger Clinic, 66(1), 39-60.
- ^ Schechter DS, Marshall RD, Salman E, Goetz D, Davies SO, Liebowitz MR (2000). Ataque de nervios and childhood trauma history: An association? Journal of Traumatic Stress, 13:3, 529-534.
- ^ Schechter DS, Zeanah CH, Myers MM, Brunelli SA, Liebowitz MR, Marshall RD, Coates SW, Trabka KT, Baca P, Hofer MA (2004). Psychobiological dysregulation in violence-exposed mothers: Salivary cortisol of mothers with very young children pre- and post-separation stress. Bulletin of the Menninger Clinic,68(4), 319-337.
- ^ Schechter DS, Willheim E (2009). The Effects of Violent Experience and Maltreatment on Infants and Young Children. In CH Zeanah (Ed.). Handbook of Infant Mental Health—3rd Edition. New York: Guilford Press, Inc., pp. 197-213.
- ^ "HUG - Service de Psychiatrie de l'Enfant et de l'Adolescent". Archived from the original on 2009-11-30. Retrieved 2018-11-08.
- ^ "University of Geneva - Geneva Neuroscience Center". Archived from the original on 2011-07-07. Retrieved 2010-12-14.
- ^ "Axis 2 : Environment and the brain | NCCR-Synapsy". 17 March 2019.
- ^ "| myScience.ch - Swiss Portal for Research and Innovation". 15 April 2010.
- ^ Schechter, D., Rusconi Serpa, S (2011). Applying clinically-relevant developmental neuroscience towards interventions that better target intergenerational transmission of violent trauma. The Signal: Newsletter of the World Association of Infant Mental Health, 19(3), 9-16.
- ^ Moser DA, Aue T, Wang Z, Rusconi-Serpa S, Favez N., Peterson BS, Schechter DS (2014). Comorbid dissociation dampens limbic activation in violence-exposed mothers with PTSD who are exposed to video-clips of their child during separation. Stress. 16(5):493-502.
- ^ Schechter DS, Coots T, Zeanah CH, Davies, M, Coates SW, Trabka KA, Marshall RD, Liebowitz MR, Myers MM (2005). Maternal mental representations of the child in an inner-city clinical sample: Violence-related posttraumatic stress and reflective functioning. Attachment and Human Development, 7(3), 313-331
- ^ Schechter DS, Kaminer, T, Grienenberger JF, Amat J (2003). Fits and starts: A mother-infant case study involving pseudoseizures across three generations in the context of violent trauma history (with Commentaries by RD Marshall, CH Zeanah, T Gaensbauer). Infant Mental Health Journal. 24(5), 510-28.
- ^ Schechter DS, Zygmunt A, Coates SW, Davies M, Trabka KA, McCaw J, Kolodji A., Robinson JL (2007). Caregiver traumatization adversely impacts young children’s mental representations of self and others. Attachment & Human Development, 9(3), 187-20.
- ^ Schechter DS, Willheim E, McCaw J, Turner JB, Myers MM, Zeanah CH (2011). The relationship of violent fathers, posttraumatically stressed mothers, and symptomatic children in a preschool-age inner-city pediatrics clinic sample. Journal of Interpersonal Violence, 26(18), 3699-3719.
- ^ Schechter DS, Willheim E (2009). Disturbances of attachment and parental psychopathology in early childhood. Infant and Early Childhood Mental Health Issue. Child and Adolescent Psychiatry Clinics of North America, 18(3), 665-687.
- ^ Fonagy, P., Gergely, G., Jurist, E.L., Target, M. (2002). Affect Regulation, Mentalization, and the Development of the Self. London: Other Press, Inc.
- ^ Slade, A. (2005). Parental reflective functioning: An introduction. Attachment and Human Development 7(3), 269-283.
- ^ Foa, E.B., Dancu, C.V., Hembree, E.A., Jaycox, L.H., Meadows, E.A., Street, G.P. (1999). A comparison of exposure therapy, stress inoculation training and their combination for reducing PTSD in female assault victims. Journal of Consulting and Clinical Psychology, 67(2), 194-200.
- ^ McDonough,S.C. (1995). Promoting positive early parent-infant relationships through interaction guidance. Child and Adolescent Clinics of North America, 4, 661-672.
- ^ Rusconi-Serpa S, Sancho Rossignol A, McDonough SC (2009). Video feedback in parent-infant treatments. Child Adolesc Psychiatr Clin N Am. 2009 Jul;18(3):735-51.
- ^ Lieberman, A.F., Van Horn, P., Ippen, C.G. (2005). Towards evidence-based treatment: Child-parent psychotherapy with preschoolers exposed to marital violence. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 1241-1248.
- ^ Schechter DS, Myers MM, Brunelli SA, Coates SW, Zeanah CH, Davies M, Grienenberger JF, Marshall RD, McCaw JE, Trabka KA, Liebowitz MR (2006). Traumatized mothers can change their minds about their toddlers: Understanding how a novel use of videofeedback supports positive change of maternal attributions. Infant Mental Health Journal, 27(5), 429-448.
- ^ Schechter DS, Willheim E, Hinojosa C, Scholfield-Kleinman K, Turner JB, McCaw J, Zeanah CH, Myers MM. (2010). Subjective and objective measures of parent-child relationship dysfunction, child separation distress, and joint attention. Psychiatry;73(2):130-44.
- ^ Scheeringa, M.S., Zeanah, C.H. (2001). A relational perspective on PTSD in early childhood. Journal of Traumatic Stress, 14(4), 799-815
- ^ Schechter DS, Coots T, Zeanah CH, Davies, M, Coates SW, Trabka KA, Marshall RD, Liebowitz MR, Myers MM (2005). Maternal mental representations of the child in an inner-city clinical sample: Violence-related posttraumatic stress and reflective functioning. Attachment and Human Development, 7(3), 313-331.
- ^ Schechter DS (2003). Intergenerational communication of maternal violent trauma: Understanding the interplay of reflective functioning and posttraumatic psychopathology. In S.W. Coates, J.L. Rosenthal and D.S. Schechter (eds.) September 11: Trauma and Human Bonds. New York: Taylor & Francis, Inc., pp. 115-142.
- ^ Schechter DS, Kaminer, T, Grienenberger JF, Amat J (2003). Fits and starts: A mother-infant case study involving pseudoseizures across three generations in the context of violent trauma history.
- ^ Schechter DS, Gross A, Willheim E, McCaw J, Turner JB, Myers MM, Zeanah CH, Gleason MM (2009). Is maternal PTSD associated with greater exposure of very young children to violent media? Journal of Traumatic Stress. 22(6), 658-662.
- ^ Schechter DS, Zeanah CH, Myers MM, Brunelli SA, Liebowitz MR, Marshall RD, Coates SW, Trabka KT, Baca P, Hofer MA (2004). Psychobiological dysregulation in violence-exposed mothers: Salivary cortisol of mothers with very young children pre- and post-separation stress. Bulletin of the Menninger Clinic, 68(4), 319-337.
- ^ Schechter DS, Moser DA, McCaw JE, Myers MM (in press; epub 11.06.2013). Autonomic functioning in mothers with interpersonal violence-exposure related posttraumatic stress disorder in response to the stressor of separation-reunion. Developmental Psychobiology.56(4):748-60.
- PMID 22021653.
- S2CID 34731243.
- PMID 25062841.
- PMID 26074844.
- PMID 19242290.
- ^ Almeida A, Merminod G, Schechter DS (2009). Mothers with severe psychiatric illness and their newborns: a hospital-based model of perinatal consultation. Journal of ZERO-TO-THREE: National Center for Infants, Toddlers, and Families, 29(5), 40-46.
- PMID 24553738.
- PMID 18007960.
- PMID 15325488.
- ^ http://www.docsfortots.org/documents/NYCMentalHCalltoAction.doc[full citation needed][permanent dead link]
- ^ http://www.omh.ny.gov/omhweb/clinicplus/[full citation needed][permanent dead link]
External links
- http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=dss11&DepAffil=Psychiatry
- http://www.columbia.edu/cu/news/media/03/danielSchechter/index.html
- https://web.archive.org/web/20110707004513/http://neurocenter.unige.ch/groups/schechter.php
- https://web.archive.org/web/20120426200125/http://www.nccr-synapsy.ch/cp4
- http://ssbb2011.epfl.ch/index.php?page=speakers
- http://dana.org/news/cerebrum/detail.aspx?id=30762
- http://www.cambridge.org/us/catalogue/catalogue.asp?isbn=9780521895033
- http://www.rts.ch/video/info/journal-12h45/?page=3754#/video/info/journal-12h45/5848799-le-rendez-vous-sante-cyril-jost-presente-son-nouveau-livre-sur-les-enfants.html
- http://sherwood-istss.informz.net/admin31/content/template.asp?sid=40923&brandid=4463&uid=1028099949&mi=4449102&mfqid=17980717&ptid=0&ps=40923
- http://www.frontiersin.org/Journal/Abstract.aspx?s=944&name=psychology_for_clinical_settings&ART_DOI=10.3389/fpsyg.2015.00690&field=&journalName=Frontiers_in_Psychology&id=139466[permanent dead link]