Healing Traumatized Children. Faye L. Hall
emotional response: Children may become frightened if they sense danger or feel that they are losing control of their environment. The child may have an exaggerated physiological response to stimuli, activating the autonomic nervous system with changes in heart rate, blood flow, respiration and stress hormone secretions. Otherwise stated, their “fight, flight, freeze” reflex is unnecessarily activated. Cognitive processing is then reduced, resulting in an inability to answer questions or make logical decisions. The brain processes information from the autonomic nervous system more rapidly than rational thoughts, as the former call for activation of automatic reflexes to keep the person alive. Typical behaviors include fighting, running away and being unable to answer.
• Object relations problems: Many children have a history of impermanence. Adults appeared and disappeared, caregivers changed, homes changed, people were not constant or permanent. For healthy development, children need consistent, constant and permanent caregivers and environments. Typical behaviors include reliance on smells for comfort (smells provided clues to the environment) and inability to sleep (fear of what happens at night).
• Self-regulation problems: Research reveals that complex trauma leads to “impairment in attachment, biological functions, affect regulation, dissociation, behavioral regulation, cognition and self-concept.”13 Many of the children with whom we have worked are dysregulated in eating, sleeping, temperature regulation, elimination, energy and emotion. Typical behaviors include not knowing when to stop eating (inability to recognize “full”) and wearing a coat in summer (inability to recognize “hot”).
• Sensory processing problems: These often have their roots in early deprivation and abuse. The children may be sensory defensive and hyper-sensitive. Touch tends to be uncomfortable or scary. Food choices may be limited due to previous deprivation. Hearing may be on hyper-alert for dangerous sounds. The children may appear hyper-vigilant to environmental stimuli. Typical behaviors include rejecting mom’s touch (inability to differentiate good touch from bad touch or suspicion about the other’s motives) and only eating macaroni and cheese (comfort with familiar food and little past exposure to a variety of foods).
AN OPPORTUNITY FOR ATTACHMENT
Child Development and the Secure Base/Safe Haven
The Trauma Lens Paradigm Shift encourages changes in the parent’s perception of the child and the child’s behaviors. Parental actions and interactions must support the new paradigm. Parents must form a relationship with their children as they are now, not based on a preconceived notion of who the children should be. New positive interpersonal experiences and interactions build healthy relationships. Attachment research has found that children need a secure and dependable relationship with attuned caregivers before they can explore the unknown. Renowned developmental psychologist Mary Ainsworth depicts the attachment figure as a secure base that allows the infant or child to venture away and return to the parent.14 Gillian Schofield and Mary Beek studied children with early trauma and found that these children have a “profound lack of trust” in the caregiver that prohibits the child from perceiving a secure base. Such children are “highly resistant to accepting or learning from new experiences of responsive and secure care giving.”15 Sheri Pickover, Clinical Director at University of Detroit Mercy Counseling Clinic, notes, “Attachment patterns become a self-fulfilling prophecy, trapping the child in a circle of despair.”16
Intentional therapeutic parenting revolves around emotional and physical security. The child’s perception of that security will ebb and flow over time. Some days the child will be more open to the security than other days. Figuratively, this secure base must be like a concrete foundation without cracks and swept clean of dust and debris. The family will not be perfect, but must be conscious of personal shortcomings and openly share their life struggles. They must “sweep” their foundation daily by discussing life’s difficulties, how they resolved problems and how they managed distress. These experiences become the child’s building blocks for how to handle distress, accept others’ and their own imperfections and learn problem-solving skills.
The secure base includes the child experiencing the parents’ taking care of all physiological, safety and relational needs. At times when the child “perceives” the parent not meeting one of these, their secure base is threatened. Trust is the first relational skill babies learn. When a baby can trust his caregivers to keep him safe, the baby is free to explore. Without this safety, a baby’s exploration is restricted. Early trauma and attachment disruptions prevent healthy growth. Children with early trauma do not always know how to play or even occupy themselves without making poor behavior choices.
Amy’s Family
Lori felt like she was a one-woman entertainment program. All day long, Amy demanded to be played with or occupied. When Lori ran out of ideas, she and Amy went shopping for new toys or clothing. Lori was afraid to ask Amy to play by herself, because she always got into trouble—mostly rummaging through her parents’ belongings or breaking things. Amy was not developing independence or a healthy curiosity about how the world works. Evaluating Amy from a secure base/safe haven model, one would say that she did not have a secure base from which to explore.
Each new independent action supports the child’s belief that “I can do it myself.” Through years of exploration and returning to the secure base/safe haven, children will move through stages with mastery. In a secure base, parents are emotionally regulated and available. Emotionally-attuned parents of infants co-regulate with their children. Co-regulation is a corrective interpersonal and emotional experience that occurs when an infant expresses fear to the parent (cries), the parent feels the same emotion (fear), the parent calms him or herself (understands the infant’s need) and then connects (soothes baby) and conveys that same calmness to the baby via words and actions (meets need). This series of events calms the infant. Healthy babies and caregivers interact similarly dozens of times a day.
Emotionally-dysregulated parents equal insecurity and fear. A dysregulated parent may not be safe or able to meet the child’s needs. Parents will have emotions. As they demonstrate ways to handle their emotions, their child will learn new skills. These skills will be addressed in a later section. Treatment professionals frequently ask that children be taught to regulate their emotions. Emotional regulation cannot be cognitively taught, as cognitive information is stored in the thinking part of the brain. We all lose our ability to think when emotionally dysregulated. We all have emotional responses. Children benefit by watching their parents regulate their own emotions and thereby experiencing co-regulation.
Creating the Healing Home with Parenting Goals and Skills Creating the Healing Home with Parenting Goals and Skills
Allan excitedly opened his mail, a letter from his maternal grandmother. She rarely contacted him, but she did remember his birthday. When Allan gazed down at the card, he exclaimed, “Doesn’t she know I am not a little kid?” Throwing down the card, he walked away. I tried approaching the topic throughout the day, but he always changed the subject. It felt like he was punishing us for the card. All day long I was settling fights and handing out consequences. I knew I should talk to him about his fears and sadness, but I could not force him.
Nothing provokes him enough to express his deep feelings. Even letters from his birth family don’t seem to interest him. He did like the dog drawing his birth father sent. Shouldn’t he want to talk about everything that has happened to him? When I told him that he can talk to me about anything, he said, “Why is it that everyone says that to me?” I have no answers.
—Faye Hall
EMOTIONAL COGNITIVE TRAUMA MODEL
Fourteen years of hard work,