(Artwork by me, Pen and Watercolor on Paper)
My first job as a mental health professional was with a therapeutic foster care program. I was what is known as a Qualified Professional; I had a bachelor’s degree and introductory training, but little-to-no clinical experience or formal training. One of my responsibilities was to drive the child I was seeing that day to or from their foster care home. I remember working with a client I will call Ben. Ben was 7-years-old, and while I did not understand much about Ben’s behavior, I knew he had a horrific first 7 years of his life. One day, I was driving Ben back to his foster home. He asked me to roll down the window of the car. For a reason I do not remember now, I said no. All hell broke loose.
Before I knew it, Ben was climbing over all three rows of seats of the company car I was driving. He was screaming and enraged. There was no rationalizing with him, so I pulled the car over to wait. There was no exiting the car or opening the doors- I feared for his safety if I did so. It wasn’t long before Ben found the emergency kit behind the last row of seats and began launching ice scrapers, first aid kits, and anything else he could find my way. To this day, I am grateful he did not figure out how to release the fire extinguisher that was a part of the kit. After what felt like hours, he calmed down.
I resumed driving, feeling completely helpless and bewildered.
Trauma affects us at all stages of development. When children experience trauma, the impact on development can create symptoms that we sometimes don’t think to attribute to trauma… and can end up in overwhelming and terrifying situations like the one I had with Ben. Trauma at critical developmental stages disrupts future development. This is especially true when traumatic experiences are repetitive and chronic in a child’s life. If you are a parent or caregiver of a child who has experienced this kind of trauma, you are often left feeling confused, overwhelmed, rejected, and helpless. Fortunately, there is hope for healing and change.
In this post, we will explore some of the reasons why children with early trauma struggle. My next post will highlight strategies for parents. These posts might be particularly relevant to you if you are an adoptive or foster parent.
As we grow up, we have to accomplish important developmental tasks in order to move on to the next phase of development. Psychologists have theorized for decades about these developmental tasks. Jean Piaget developed theories about child cognitive development. Erik Erikson wrote about developmental stages that span birth to old age and death. Developmental tasks we quickly associate with childhood include things like learning to walk and talk in infancy, or developing a sense of autonomy and identity in adolescence. In adulthood, we work to establish stable relationships outside of our immediate families, and find a sense of purpose.
In childhood and adolescence, brain growth and development underpins successfully accomplishing developmental tasks. Our brains grow through a fascinating interplay of experience, genetics, and relationships. Brain development starts in the womb, and doesn’t stop until early-mid 20’s. And (this is the coolest part) our brains are plastic, which means that we have the ability to continue to change our brains even after development stops. We call this neuroplasticity, and we do this by creating new neural networks through practice and repetition.
Our brains require specific things in order to develop in a healthy way in childhood. Some of these things include caregivers who are attuned to and responsive to our needs, safety to explore and play, and having our basic needs for food, shelter, and care met. If we do not have these things, our brains and bodies are experiencing a type of stress that has been coined Toxic Stress by mental health professionals.
(Video by Alberta Family Wellness)
Our brains grow according to how we use them. If we don’t use it, we lose it. Healthy brains develop to learn and connect with others. If we grew up experiencing neglect, abuse, unpredictable or insufficient parenting, or surrounded by violence, our brains develop to survive rather than learn. Brain scans of individuals who experienced early chronic trauma show brains that are structurally different than the brains of individuals who grew up with safety, and healthy caregivers (Van der Kolk, 2014; Evans & Kim, 2013). The brain scans show altered prefrontal cortex activity, and a much more active amygdala (among other things). Our prefrontal cortex houses our capacity for complex thought, problem solving, and executive functions (planning, completing a task, following steps, learning right from wrong, etc). Our amygdala acts as a smoke alarm of sorts. It detects danger, and signals a stress response to get us to safety. It launches our fight, flight, or freeze response.
Children with early chronic trauma are set-up to have big reactions to seemingly small stressors- their brains are always on the lookout for danger, but have not developed the capacity to problem solve or think ahead to consequences. This is part of why so many children with early trauma struggle with rapidly escalating responses to what might be normal daily stressors.
Some of the difficulties these children often struggle with include a strong need for control and big reactions to feeling out of control. You might also notice difficulty tolerating any uncomfortable feeling (sad, angry, afraid, etc), and difficulty knowing what they are feeling. These kids often have a hard time truly trusting and feeling safe with adults, and might intentionally push adults away or have a hard time with boundaries with adults (for example, hugging strangers). They might have low self-esteem, and carry strong feelings of guilt and a belief that “I am bad.” They might have difficulty in school, and be unable to focus, be disorganized, or unable to sit still. Many experts on child trauma have proposed a new diagnosis called Developmental Trauma Disorder to help professionals and families better understand these difficulties.
Our brains are also state dependent. Remember that whole hyper- and hypo- arousal thing I talked about a few weeks ago? Bruce Perry is a child psychiatrist who has done extensive work with kids with trauma. He suggests that emotional or behavioral states become traits. What he means is that if we spend the majority of our time in a state of hyper- and hypo- arousal, we are patterning brain use that may develop into hard-wired personality traits later in life. Because of neuroplasticity we can still work with these, but it becomes much more difficult.
Children and adolescents have incredible opportunities to heal some of their early trauma. There are many different ways to do this, and the modalities I use include art therapy, SMART, and EMDR. I also believe working with parents and caregivers is absolutely critical. Ultimately, it’s caregivers who provide the most important relationship and opportunity for healing. My next post will outline some of my favorite tips for parents and caregivers. In the meantime, here are some of my favorite resources for understanding the impact of early childhood trauma.
The Boy Who Was Raised as a Dog, Dr. Bruce Perry: "How does trauma affect a child's mind—and how can that mind recover? In the classic The Boy Who Was Raised as a Dog, Dr. Perry explains what happens to the brains of children exposed to extreme stress and shares their lessons of courage, humanity, and hope. Only when we understand the science of the mind and the power of love and nurturing, can we hope to heal the spirit of even the most wounded child."
The Body Keeps the Score, Bessel Van der Kolk: "Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Dr. Bessel van der Kolk, one of the world’s foremost experts on trauma, has spent over three decades working with survivors. In The Body Keeps the Score, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers’ capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments—from neurofeedback and meditation to sports, drama, and yoga—that offer new paths to recovery by activating the brain’s natural neuroplasticity. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score exposes the tremendous power of our relationships both to hurt and to heal—and offers new hope for reclaiming lives."
Becoming Attached, Robert Karen: "The struggle to understand the infant-parent bond ranks as one of the great quests of modern psychology, one that touches us deeply because it holds so many clues to how we become who we are. How are our personalities formed? How do our early struggles with our parents reappear in the way we relate to others as adults? Why do we repeat with our own children--seemingly against our will--the very behaviors we most disliked about our parents? In Becoming Attached, psychologist and noted journalist Robert Karen offers fresh insight into some of the most fundamental and fascinating questions of emotional life."
Let’s Learn Together: This PDF was created by Adoption UK and Health and Social Care. It gives great information and tips to parents of elementary age adopted or foster kids.
ARC Resources for Parents/Caregivers and Kids/Teens: ARC is a treatment method developed for children and teens with early childhood trauma, and their caregivers.
Meg Hamilton, LPC is a therapist practicing in Durham, North Carolina. Meg is an art therapist and specializes in therapy for trauma as well as in supporting LGBTQ+ youth and families. Meg’s work is upheld and informed by a commitment to social justice. Learn more at www.birchcounselingdurham.com.