In the current medical model (discrete disorders) paradigm of mental health, individuals who have experienced multiple traumas over the course of childhood and adolescence (i.e., developmental trauma) are frequently diagnosed with multiple disorders in adulthood. This leads to multiple treatments, each designed to address a supposedly separate problem (e.g., motivational interviewing for alcohol dependency, mood stabilizer for mania, anti-depressant for depression, cognitive behavioral therapy for anxiety). Often, the result is a temporary reduction in symptoms of one disorder, followed by exacerbation of another (e.g., an anti-depressant lifting mood but increasing mania and anxiety). Individuals suffering from developmental trauma therefore tend to be in and out of treatment for years because different problems keep arising, yet treatment of multiple discrete disorders fails to address the fundamental underlying problem.

 

Within this context, I argue that an overarching process related to the “self” and its construction over time is what needs to be addressed for holistic healing and recovery from developmental trauma to occur. My program of research therefore investigates the effects of trauma on self-development. Central to this perspective is the idea that humans are active agents who construct and modify their self-concept as they adapt to specific relational environments. A person’s memory of past pain, expectations, and beliefs about themselves create their symptoms, but under certain therapeutic conditions these assumptions and distress states can be modified to give way to a host of healing processes. I examine this construction of self through work in three domains:

 

1. Advancing a cognitive science-based Framework of Self-Development that explains how the phenomenology of “self” is implicated in developmental trauma
    

2. Conducting empirical studies that use this framework to investigate the
   Role of Relational Schemas & the Self in Distress
    

3. Conducting empirical studies that use the framework to investigate associated Psychological Change Mechanisms

 

I began building this program of research as a graduate student at the University of Illinois at Urbana-Champaign (UIUC) and continue to publish with collaborators there. Since this time, I have expanded my research collaborations to work with researchers at the Grady Trauma Project in the Emory School of Medicine. In the past two years, I have further developed research studies at Agnes Scott proposing pilot studies in the Psychology 400 Research Capstone course each year, and by building a volunteer undergraduate research lab of eight students who are actively conducting larger studies based on these pilot studies. These activities have led to research conference presentations, publications, and cross-institutional collaborations that are focused on the causes of adult psychopathology and the ways treatments can be tailored to address the effects of developmental trauma more effectively.

 

1. A Framework of Self-Development

 

Current models of psychopathology fail to situate symptoms of distress within the larger context of self-development. The first facet of my program of research begins to address this issue by advancing a new conceptual approach to psychopathology research. The initial work I have completed in this area is a theoretical article (Thomas & Sharp, 2019) which demonstrates how psychological information processing functions can be understood as implemented in biological structures. This approach, in turn, grounds a concept of causality (counterfactual dependency) that can be used to rigorously test claims about the phenomenology of the “self” and its relation to psychological distress. In an invited symposium at the International Meeting of the Society for Psychophysiological Research in Vienna, I engaged in a rich discussion of the paper in relation to translational research priorities at the National Institute of Mental Health (Sharp et al., 2017).

 

I have since used this conceptual approach to propose a trans-diagnostic developmental model of psychopathology. It contends that distressing expectations, beliefs, and feeling states tend to cluster into meaningful themes, or “parts-of-self,” called relational schemas—implicit constituents of an individual’s self-structure that are causally implicated in psychological distress. Although these relational schemas (e.g., abandonment, defectiveness, emotional inhibition, recognition-seeking) are often formed as an adaptive response to the thwarting of core emotional needs in childhood and adolescence, they become maladaptive when activated in later life contexts. As a broad developmental model, I propose that this Relational Self Approach can explain how an individual’s self-structure forms over time and how it can be decomposed into specific schemas that are linked to signs and symptoms of distress.

 

I have received useful feedback on the model when presenting it at UIUC (Thomas, 2015) and at the Nineteenth Annual Meeting of the Society for Interpersonal Theory and Research in Berlin (Thomas, 2017). The next step will be to finalize and submit the manuscript describing the model for publication in the coming year (Thomas, 2024).

 

References for recent Framework of Self-Development work –

 

Sharp, P. B., Thomas, J. G., Miller, G. A., Rockstroh, B., & Cuthbert, B. (2017, October 11-15). Constructing riskier tests of theory, linking psychological and biological phenomena, and introducing a new mechanistic philosophy of science [Paper presentation]. Symposium at the 57th Annual International Meeting of the Society for Psychophysiological Research, Vienna, Austria.

 

Thomas, J. G. (2017, July 29-30). New insights into the self: A relational schema model [Paper presentation]. Nineteenth Annual Meeting of the Society for Interpersonal Theory and Research, Berlin, Germany.

 

Thomas, J. G. (2015, December 4). A relational schema model: A developmental explanation for the effects of early emotional wounds on adult psychopathology [Paper presentation]. Clinical/Community Psychology Division Brown Bag, Urbana-Champaign, IL, United States.

 

Thomas, J. G. (2024). Discovering the relational self: A human growth approach to psychological distress. [Manuscript in preparation]. Department of Psychology, Agnes Scott College.

 

Thomas, J. G. & Sharp, P. B. (2019). Mechanistic science: A new approach to comprehensive psychopathology research that relates psychological and biological phenomena. Clinical Psychological Science, 7(2), 196–215. https://doi.org/10.1177/2167702618810223

 

2. Empirical Investigation of the Role of Relational Schemas & the Self in Distress

 

A key contention of the framework of self-development I have proposed is that the “self” can be decomposed into specific relational schemas that are linked to signs and symptoms of distress. To understand how relational schemas are related to distress, the second facet of my program of research empirically investigates whether these schemas can be activated in real time and associated with changes in emotion, beliefs, and behavior. To begin this work, I proposed a functional decomposition of an abandonment schema that could be examined experimentally. Two-hundred college students were then randomized to two conditions of a social rejection paradigm in which implicit and explicit schema measures, psychophysiological (skin conductance) data, and video of facial/non-verbal behavior were used to test causal relationships between schema activation and distress. The results indicated that (1) an implicit schema measure predicted skin conductance response better than any self-report schema measure, (2) self-report schema measures better predicted observed responses, (3) both kinds of schema measures were associated with significant differences in reactions to a non-rejection rather than rejection stimulus. The study demonstrated that situations in which the meaning of a relational event is open to interpretation are highly relevant to how schemas work (Thomas et al., 2024a).

 

Following this initial study of abandonment schema activation, I have been conducting collaborative work with researchers at the Grady Trauma Project on the role of overall self-stability in relation to trauma response. This includes one study, which demonstrates that the relationship between early trauma exposure and stability of self in adulthood is mediated by attachment dynamics (Thomas et al., 2024b). A second study further demonstrates that self-instability in adulthood predicts severity of post-traumatic symptoms such as suicidality and depression (Thomas & Bradley, 2024). Together, this work will lay the empirical foundation for validating the “self” as defined in my framework of self-development as both investigable and critical to understanding the varied manifestations of developmental trauma.

 

I value having students involved in my research lab as it both helps them develop the requisite research skills to apply to graduate programs and contributes to the shaping and development of my research program. For instance, students in my Psychology 400 Research Capstone course in 2022 have worked with this data from the Grady Trauma Project and have presented on the role of self-stability as a coping factor in dealing with trauma (Panchapakesan, et al., 2022). An additional, emerging area of my work on the role of relational schemas and the self in distress involves the culturally shaped nature of schemas and the self. In my Psychology 400 Research Capstone course in 2023, we have examined the relationship between the Strong Black Woman Schema (SBWS), emotional inhibition, and self-perception. We found that SBWS endorsement predicted greater emotional inhibition, but only if participants’ self-perception of the schema was self-sacrificial (Carr, et al., 2023; Dicks et al., 2023). This student-led study revealed that self-perception of cultural identity affects the way schemas manifest, implicating the important role that cultural empowerment and self-perception can play in addressing the effects of historical trauma. In a similar vein, a study completed by a student I mentored in the Grady Trauma Project examined the role of subjective social status among Black women who had experienced high levels of trauma exposure. This study found that the subjective perception of social standing relative to society predicted level of trauma symptoms over and beyond socioeconomic status (Obenauf et al., 2023). This suggests that the way the self is perceived (for example, through experiences of discrimination and dehumanization) is a key factor in the way trauma manifests and highlights the need for both structural and individual attention to this dimension of the healing process.

 

Future work in this area includes studies I have been getting off the ground with my volunteer lab of eight students. We collectively read and discussed Bessel Van Der Kolk’s The Body Keeps the Score (2014) over the summer of 2023. This led to the further development of three research projects that will be completed by these students through 440 courses in the spring of 2024 (Kaelyn Dicks, Meleah Oliver, MaryRose Schwier, and Anise White). The studies span a theoretical review of dissociation (and proposal of a general mechanism by which trauma-related dissociation may arise), an empirical study of the role of emotional awareness in body coordination, and an empirical study of the role of coherence and complexity of self in mediating the relationship between emotional clarity and wellbeing.

 

References for recent Role of Relational Schemas & the Self in Distress work –

*Mentored student presentations and publications

 

*Carr, E., Dicks, K., Randall, R., White, R., Egboh, D., Acker, D., & Thomas, J. G. (2023, April 15). Emotion Inhibition as it Relates to Emotion Perception, Peripheral Empathy, and Cultural Identity [Poster presentation]. Nineteenth Georgia Undergraduate Research on Psychology Conference (GURP), Kennesaw State University, Kennesaw, GA, United States.

 

*Dicks, K., Carr, E., Randall, R., White, R., Egboh, D., Acker, D., Anderson, G., Snoad, C. C., & Thomas, J. G. (2023, April 25). Emotion inhibition as it relates to emotion perception, peripheral empathy, and cultural identity [Conference presentation]. Thirty-second Spring Annual Research Conference (SpARC), Agnes Scott College, Decatur, GA, United States.

 

*Obenauf, C., Mekawi, Y., Lathan, E. C., Hinojoso, C., Thomas, J. G., Stevens, J. S., Powers, A., Michopoulos, V. & Carter, S. (2023). Indirect effect of race-related stress on traumatic stress and depression symptoms via subjective social status in a Black community sample. American Journal of Community Psychology, 2(1-2), 116–126. https://doi.org/10.1002/ajcp.12693

 

*Panchapakesan, S., Galiano, M., Gentry, S., Hibbitt-Maguire, S., Mays, M., Miner, K., Reeves, R., Villarreal, M., Williams, S., & Thomas, J. G. (2022, April 26). Self-Stability as a Resilience Factor in Coping with Trauma [Conference presentation]. Thirty-first Spring Annual Research Conference (SpARC), Agnes Scott College, Decatur, GA, United States.

 

Thomas, J. G., Bogdan, P., Katsumi, Y., Dolcos, F., & Berenbaum, H. (2024a). Implicit abandonment distress: Testing the dynamic links between schema activation and physiology. [Manuscript submitted for publication]. Department of Psychology, Agnes Scott College.

 

Thomas, J. G., & Bradley, B. (2024). Identity and coherence of self as predictors of trauma response. [Manuscript in preparation]. Department of Psychology, Agnes Scott College.

 

Thomas, J. G., Kuzyk, E., Mekawi, Y., Fani, N., Powers, A., Stevens, J. S., & Bradley, B. (2024b). The effects of developmental trauma on self-stability: Evidence for the mediating role of attachment. [Manuscript in preparation]. Department of Psychology, Agnes Scott College.

 

3. Empirical Investigation of Psychological Change Mechanisms

 

The third facet of my program of research examines how schemas can be modified during therapy and the optimal relationship between common factors of therapeutic change and specific techniques of intervention (Kivlighan et al., 2015).

 

In an initial study, I designed a double-blind therapy analog to clarify the causal role of empathic support and expectation in symptom change. Seventy-six college students scoring above the 80th percentile on trait negative affect were randomized to three conditions of an eight-session, sham “neurobehavioral training program:” (1) expectation plus empathic support, (2) expectation only, and (3) no expectation control. Participants who were in the clinical range for anxiety and depression had recovery rates comparable to empirically supported treatment trials, with medium effect decreases in the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) in the expectation plus empathic support condition (Thomas et al., 2022). The study showcases an innovative approach to disambiguate and quantify components of therapy and demonstrates that expectation and empathic support are significant causal factors in symptom change. A second study involved assessment of a hospital-based outpatient program for suicidal patients developed by Dr. Robert Gregory at SUNY Upstate Medical University. The theoretical approach of this program overlaps significantly with the approach to self-dynamics articulated in my own research. This study found close to an 80% reduction in subsequent emergency department visits for suicidal patients compared to treatment as usual (Thomas et al., 2022).

 

Moving forward, I am completing the write-up of a two-year clinical case study of work I completed with a client that successful utilized a Relational Self Approach to distress (Thomas & Hund, 2024). I plan to publish the papers listed in this document prior to tenure. My broader goal after tenure is to publish a philosophical book on self-development, Neohumanism: An Existential-Naturalistic Ontology of Human Being. This work will then inform and situate a subsequent Relational Self Approach to Developmental Trauma text that can serve as a handbook for the treatment of individuals with chronic struggles due to early trauma.

 

References for recent Psychological Change Mechanisms work –

 

Kivlighan, M. D., Goldberg, S. B., Abbas, M., Pace, B. T., Yulish, N. E., Thomas, J. G., Cullen, M. M., Fluckiger, C., & Wampold, B. E. (2015). The enduring effects of psychodynamic treatments vis-à-vis alternative treatments: A multilevel longitudinal meta-analysis. Clinical Psychology Review, 40, 1–14. https://doi.org/10.1016/j.cpr.2015.05.003

 

Thomas, J. G. & Hund, A. (2024). Therapeutic change within a relational self approach to developmental trauma: A two-year clinical case study. [Manuscript in preparation]. Department of Psychology, Agnes Scott College.

 

Thomas, J. G., Sharp, P. B., Niznikiewicz, M, & Heller, W. (2022). A double-blind study of empathic support and expectation as mechanisms of symptom change. Psychotherapy research, 32(1), 115–125. https://doi.org/10.1080/10503307.2021.1909770

 

Thomas, J. G., Sperry, S. D., Shields, R. J., & Gregory, R. J. (2022). A novel recovery-based suicide prevention program in Upstate New York. Psychiatric services, 73(6), 701–704. https://doi.org/10.1176/appi.ps.202100162

 

In summary

 

Overall, my scholarship aims to address the lack of adequate conceptualization and treatment of developmental trauma. It spans philosophical work on the phenomenology of “self,” and empirical domains that aim to test the role of relational schemas in distress and associated psychological healing processes. Ultimately, the aim of my research is to (1) provide an empirically testable model of self-development that causally explains how signs and symptoms of distress develop, and (2) to outline integrative approaches to assessment/intervention that target these processes with greater specificity. I am excited about continuing to develop this program of research in my volunteer lab and Psychology 400 courses, and plan to continue to build on these areas of scholarship throughout my future career.