Beyond Violence: Subtle Trauma, Emotional Neglect, and the Reframing of Trauma, Attachment, Anxiety and Addiction in Elizabeth Vargas’s Between Breaths
DOI:
https://doi.org/10.17507/tpls.1607.13Keywords:
“small t’’ trauma, childhood emotional neglect, attachment theory, memoir, psychology and literatureAbstract
Trauma is most commonly associated with catastrophic events such as natural disasters, warfare, domestic violence, or the death of a loved one. However, it is also possible for the greatest wounds to be created silently through omission rather than commission. Some of the greatest traumas are shaped by what didn’t happen in childhood, including the absence of emotional connections, comfort, or responsive caregiving (such as never being included in family discussions, never being positively acknowledged by a parent, or having your emotional needs consistently ignored). The absence creates an invisible structure of injury that affects how children develop trust, form attachments, and understand their environment. This study explores “Small T’’ trauma, which refers to the emotional damage resulting from chronic emotional neglect (as opposed to outright physical harm). While there have been many advances in the area of trauma research in the past few years, the long-term impact of subtle emotional neglect upon narrative identity and adult function remains understudied. Using the foundation provided by John Bowlby's attachment theory and integrating Gabor Maté’s trauma-informed model of addiction and Bessel van der Kolk’s neurobiological perspective of trauma, this research provides evidence of the relationship between early emotional deprivation and adult anxiety, fragile relationships, and addiction. Using an analysis of Elizabeth Vargas’s memoir Between Breaths (2016), this study demonstrates that nonresponsive and unpredictable caregiving can create enduring consequences comparable to violent experiences.
References
Alexander, J. C. (2012). Trauma: A social theory. Polity Press.
Bowlby, J. (1988). A secure base: Parent–child attachment and healthy human development. Basic Books.
Bretherton, I. (1992). The origins of attachment theory: John Bowlby and Mary Ainsworth. Developmental Psychology, 28(5), 759–775. https://doi.org/10.1037/0012-1649.28.5.759
Caruth, C. (1996). Unclaimed experience: Trauma, narrative, and history. Johns Hopkins University Press.
Centers for Disease Control and Prevention. (2020). Anxiety and depression in young adults: Pre-pandemic survey. Retrieved December 10, 2025, from https://www.cdc.gov/
Centers for Disease Control and Prevention. (2021). Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020. Morbidity and Mortality Weekly Report, 69(32), 1049–1057. https://doi.org/10.15585/mmwr.mm6932a1
Centers for Disease Control and Prevention. (2023a). Alcohol-related disease impact (ARDI). Retrieved December 10, 2025, from https://www.cdc.gov/alcohol
Centers for Disease Control and Prevention. (2023b). Alcohol-related deaths in the United States. Retrieved December 10, 2025, from https://www.cdc.gov/alcohol/features/excessive-drinking-deaths.html
Dhileep, T. S., & Baisel, A. (2024). Exploring the patriarchal oppression and predicament of women: A radical feminist analysis of Mitra Phukan’s The Collector’s Wife and Arupa Patangia Kalita’s Felanee. World Journal of English Language, 14(2), 527–534. https://doi.org/10.5430/wjel.v14n2p527
Eggert, L., Kenntemich, L., von Hülsen, L., Gallinat, J., Schäfer, I., & Lotzin, A. (2024). Associations between childhood neglect and depressive symptoms: The mediating role of avoidant coping. Depression and Anxiety. https://doi.org/10.1155/da/9959689
Fonagy, P., & Target, M. (1997). Attachment and reflective function: Their role in self-organization. Development and Psychopathology, 9(4), 679–700. https://doi.org/10.1017/S0954579497001399
Heim, C., & Nemeroff, C. B. (2001). The role of childhood trauma in the neurobiology of mood and anxiety disorders: Preclinical and clinical studies. Biological Psychiatry, 49(12), 1023–1039. https://doi.org/10.1016/S0006-3223(01)01157-X
Hildyard, K. L., & Wolfe, D. A. (2002). Child neglect: Developmental issues and outcomes. Child Abuse & Neglect, 26(6–7), 679–695. https://doi.org/10.1016/S0145-2134(02)00341-1
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244. https://doi.org/10.3109/10673229709030550
Lanius, R. A., Vermetten, E., & Pain, C. (2022). The impact of early life trauma on health and disease: The hidden epidemic. Cambridge University Press.
Luyten, P., Blatt, S. J., & Corveleyn, J. (2005). Minding the gap between positivism and hermeneutics in psychoanalytic research. Journal of the American Psychoanalytic Association, 53(2), 571–610. https://doi.org/10.1177/00030651050530020101
Maté, G. (2008). In the realm of hungry ghosts: Close encounters with addiction. Knopf Canada.
Maté, G. (2022). The myth of normal: Trauma, illness, and healing in a toxic culture. Knopf.
National Institute of Mental Health. (2023). Anxiety disorders. Retrieved December 10, 2025, from https://www.nimh.nih.gov/health/topics/anxiety-disorders
Neyah, R. V., & Vijayakumar, M. (2023). Singing the power of Black motherhood in the autobiographies of Maya Angelou. World Journal of English Language, 13(6), 544–548. https://doi.org/10.5430/wjel.v13n6p544
Smith, S., & Watson, J. (2010). Reading autobiography: A guide for interpreting life narratives. University of Minnesota Press.
Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health indicators in the United States. Retrieved December 10, 2025, from https://www.samhsa.gov/data
Teismann, T., Forkmann, T., & Glaesmer, H. (2025). Childhood abuse and neglect in routine mental health care: Associations with treatment outcomes. Frontiers in Psychiatry, 16, 1566560. https://doi.org/10.3389/fpsyt.2025.1566560
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
Vargas, E. (2016). Between Breaths: A memoir of panic and addiction. Grand Central Publishing.
Vijayakumar, M., Baisel, A., Kumar, E., & Rajasekaran, B. (2019). Negotiating aspects of culture, communication, and identity in literary texts: An analytical study. International Journal of Innovative Technology and Exploring Engineering, 8(7C2), 217–219.
Vijayakumar, M., Baisel, A., Subha, S., Senthilkumar, S., Sankarakumar, S., Paulmony, R., & Yogeshwaran, M. (2023). Understanding the factors affecting mental health during the COVID-19 pandemic: An empirical study. AIP Conference Proceedings, 2822(1), Article 040003. https://doi.org/10.1063/5.0172890
Winnicott, D. W. (1965). The maturational processes and the facilitating environment: Studies in the theory of emotional development. Hogarth Press.