February 12, 2025 Written by: Cassy Collins, LCSW For most of us, when we think of trauma our minds usually go to something horrific happening to someone, but did you know that something not happening to someone can result in trauma as well? As one of my all time favorites in the field identifies: trauma is caused by “bad things happening, but also by good things not happening”.-Gabor Mate', MD The trauma that is my main area of focus in my therapy practice is that of Childhood Emotional Neglect or "CEN" as Dr. Jonice Webb has coined it. She has done extensive work in the area of CEN. CEN is the trauma that arises from "what didn't happen" in childhood, as Dr. Webb puts it. So what is the good thing that didn't happen for those who experienced CEN you ask? Emotional Attunement, that   is the good thing that didn't happen for those with CEN. I'm going to take a detour to expand on the concept of "emotional attunement" a bit here, before going further into CEN, as even my spell check doesn't recognize attunement as a proper word. (Seriously though, I had to check myself several times to make sure it's not me that is in the wrong here.) I digress. So Emotional Attunement is the ability to connect with another byway of expressing understanding of what they may be feeling. It communicates to another that they are seen. This can be done both verbally and non-verbally. Non-verbally would be through mirroring and body language. Communicating byway of facial expressions that say you understand what they are feeling. While verbal communication would be using reflective listening skills and empathic communication.  If you want to see a breif example of attunement being demonstrated and the impact of removing it, I think the short video below by Dr. Ed Tronick, on the " Still Face Experiment" provides a great representation of what I'm talking about here... So, if a mother not attuning to a child’s emotions for less than a minute can create such distress for a baby, most of us could see how an ongoing lack of emotional attunement from a caregiver can create lasting impacts on us. Why is emotional attunement so important in childhood? I'll give you two basic reasons here: Survival. From the beginning our basic human survival relies on emotional connection/attunement from others. It is how we communicated our most basic needs during infancy. Now, you may be wondering how emotional neglect happened, especially if all of your basic needs were met. After all, you’re reading this, so your caregivers must have made sure at minimum your physical needs were met. Connection. We are social beings so when our emotions are attuned to by another, we feel seen and significant. We are made to feel that our experience is valid , which can result in an overall feeling that we are valid! It's important to our overall development. So w hen this "good thing" doesn't happen, we are left feeling invisible or unimportant to others, especially those closest to us. This creates lasting effects that spills over into our adult relationships. How do I know if I’ve experienced childhood emotional neglect? Feeling emotionally disconnected, neglected or misunderstood are feelings we have all experienced at one time or another in our relationships. It's not realistic that our emotions have been attuned to 100 percent of the time. Have you ever been part of a conversation and something you say gets misconstrued, or something you contribute goes unheard? For the person who has not experienced CEN and has a solid sense of self, you can probably pretty easily brush this off; however, for the individual that experienced CEN, you will likely (unknowingly) chalk this up as evidence that what you have to say is unimportant, or that others just don't care. Childhood Emotional Neglect is kind of like that, only more consistent, and takes place with the ones that are 'expected' to be closest to you or know you best. No matter how much you try to clarify your experience, or how loud the cries, they go unheard.. This results in no longer trying to be heard or seen and instead the emotional attunement gets demonstrated by the child to the parent. This is not an all inclusive list, but some of the common feelings stemming from CEN include feeling overlooked, dismissed, ignored, anxious, and alone. While the common behaviors are people pleasing , difficulty saying "no", being guarded and isolating, yet longing for connection. Individuals who experienced CEN may find it difficult to accept the good things that come their way now. They may feel undeserving or that it won't last, fear of losing that 'good thing'. They may struggle to identify their own feelings as they are busy attuning to everyone else's. What can I do if I think I may have CEN? While we can't go back and change the past, therapy can help to resolve some of the lasting impacts that are a result of a childhood of emotional neglect. Not all therapists are well versed in this topic and specific treatment approach, so if you want someone who specializes in CEN in your area, you can check out Dr. Webb's site where you can search her therapist directory. Her book "Running On Empty" is also a great resource and you will know pretty early on if you can relate to some of the scenarios she shares. If you haven't explored this topic before and would like to know more or to see if you may meet criteria for CEN, I have included a link to Dr. Webb’s questionnaire   here .    If you happen to reside in Idaho, and are looking for a therapist that is passionate about working with individuals with CEN, feel free to check out my webpage to see if I may be a good fit for your therapy needs. In conclusion , the goal here is not to blame or create undue negative feelings towards your caregiver(s), as a lot of them were doing the best they could with what they had at the time. My goal instead, is to provide answers and validation to those that find themselves unsure why they feel the way they do. To know that you are not alone, and there is hope for healing. This form of trauma is more common than many realize. I hope that you will find healing and be able to allow good things to happen for you. You deserve to be seen and heard! ABOUT THE AUTHOR Cassy Collins, LCSW Cassy is a person-centered and affirming therapist who works towards empowering individuals to become their own advocates and heal some of those early wounds that may be holding them back from building the fulfilling life they want and deserve. Whether it is working through past traumas, decreasing anxiety, or improving relationships, she believes everyone deserves to be seen and heard. In her free time she enjoys spending time with her spouse and their fur and feathered babies on their hobby farm; and when she’s feeling extra ambitious, she enjoys being creative and working on home improvement projects.