Healing Traumatized Children. Faye L. Hall
Model (ECTM). It has changed and morphed since co-author Jeff Merkert began using storytelling to illustrate the impact of trauma on developing infant brains and internal beliefs working with client families. Over the years, Jeff has perfected the presentation and provides it to families and their support systems. We struggled with naming it. Faye gravitates to emotional work and Jeff to cognitive work; thus the name. The story links neurology, the impact of trauma on the brain and the damage created with attachment disruptions.
Throughout this book, parents are encouraged to see themselves as the ones who will help their child heal. The task can be overwhelming, especially for families with more than one foster or adoptive child in the home. The parents are on duty 24/7.
In this chapter, keys to success and goals are clearly defined and parents are instructed in interactive skills with their children. These are the foundations to navigate healing, without which treatment will not be successful. Please remember this is relational and emotional work, not behavioral.
Keys to Success
1. Parents explore their own emotional and cognitive world. Some of our most successful families are those who have explored their own history. They’ve done or, even better, are still doing, the hard work of examining their own fears and changing their response to them. These parents have empathy for their child and can be an encouragement as the child is challenged to do the same. Parents with a trauma history that is not explored or integrated into their narrative tend to be punitive and demeaning. Some have stated that “I got over it, why can’t they?” This lack of empathy prevents co-regulation between parent and child.
2. Parents increase or improve their self-regulation skills. Self-regulation is needed for co-regulation and the ability to remain calm when the child has disruptive behaviors. Our own histories and upbringings leave some parents with a “short fuse” or a feeling of being easily overwhelmed. Parents need to be on their “A” game in self-regulation when interacting with traumatized children. This leaves most of us with room to grow. Fortunately, this growth actually facilitates the same growth in our children. Children with a history of abuse and neglect likely have not learned to co-regulate with their birth parent. This will be one of the first interventions that occurs with treatment. Parents will be handicapped if they cannot regulate their own emotions. Without regulation, parents can overreact to the child’s behaviors and reinforce the child’s N-IWM. Sadly, parents are often counseled to over-regulate their own emotions. The professional may state, “Keep yourself calm; don’t communicate sadness or fear to avoid triggering your child, which causes an escalation cycle.” The problem with this strategy is that observation is the primary tool for learning personal emotional regulation. Can we really expect children to learn from lecture alone without observation of our own emotional responses? Being emotionally regulated does not mean being unemotional or flat in our expression of emotion.
3. Parents model for their children ways to explore their emotional and cognitive world. Parents know that their children follow the parents’ model much more than their words. Children with early trauma are always watching their parents to maintain a sense of safety. This hyper-vigilance drives the child to learn from the parent’s behavior, on a deep, experiential level, much more than the many lectures parents tend to give.
4. Parents use interactive repair. Parents are the adults in the relationship. They should model appropriate behaviors for their children. Interactive repair demonstrates how to repair relationships. Parents have to demonstrate for their children the skills they want them to use. These skills are not gained by lectures or demands. Sometimes, parents state their child was wrong and the relationship cannot be healed until the child “takes responsibility and apologizes.” This stance assumes the child is reflective, evaluates the behavior as wrong and desires to repair the relationship, all of which are higher-level thinking skills and require a healthier internal working model.
5. Parents build the environment to support the child’s development of healthier affect regulation and healthier views of self, others and the world. The environment will either support or hinder healing. The essence of parenting is simply the agreement to supply the growing environment for our children. Chapter 16 has suggestions for environment interventions.
6. Parents recognize and label their child’s fear level. Parents learn to read their infants’ internal states. Now, the task is reading a child’s internal state that has grown to avoid even the perception of fear. Hurt children often take great care in keeping others from knowing their thoughts and emotions. For healing to begin, parents must recognize their child’s fears and label the emotions for the child. These skills will be new to the child and may initially create more fear.
7. Parents address the child’s stress but not necessarily always the circumstance. In some ways, addressing a healthy child’s stress is easier than changing the circumstance that created the stress. Parents may go to great lengths to eliminate stressors to keep the child more regulated instead of helping the child develop new self-regulatory skills. When a parent knows the child is stressed, they can help with the stress. Not all circumstances have resolutions. Further, it is not unusual for the child’s emotions to not match the circumstances. Identify the disparity.
8. Parents reduce the use of cognitive interventions during emotional responses. As parents use the ECTM, they will understand the neurological impact of trauma and the brain’s response to triggers. When a child has an emotional response, the brain has less ability to process or respond to cognitions.
9. Parents label emotional states and notice the increased cognition. As parents read and label their child’s emotions and offer comfort, the child’s brain may become less emotionally flooded and be freed up to have increased cognition. The goal is for the child to notice how his or her body changes with/without stress. Complex early trauma causes children to avoid feelings of fear and sadness. In the early stages of life, the baby’s brain was dependent upon the caregiver’s brain to facilitate moving out of “fear.” If the relationship with the caregiver did not prompt this change of state, children will lack a dependable means of regulating emotions. They feel as if any small fear could wind up being overwhelming! Since they have no experience with modulating and changing emotions, they default to avoidance. Consequently, such children grow to have just two “emotions,” mad and more mad! We as parents must demonstrate that first we and then they can feel fear and sadness and then stop feeling it. We all have a wide variety of tools we use to accomplish this for ourselves. It is very hard to teach these skills to little brains that have already learned to avoid those feelings as a survival skill.
10. Parents explain what their child experiences without shame or blame. Parent self-regulation is important with this intervention. The parent’s task is to relay what is going on with the child, separate from their frustration about the problematic behaviors that may have occurred. They can use storytelling or just describe the events as if they were talking to a younger child.
11. Parents use “helpful statements” to assist their child in internalizing a healthier sense of self. Interventions are provided in chapters 16 and 17.
12. Parents provide a wide range of developmental activities for their child. Due to Trauma-Disrupted Competencies, most children with early trauma experience developmental delays. To help children mature, they must be exposed to multiple age activities. Children who have not fully mastered skills at one developmental level will experience “gaps” in their ability to function at the next developmental level. When healing begins and the child feels security, he or she will often automatically gravitate toward activities that are not necessarily age-appropriate. These activities will become the building blocks for more “mature” activities. They should not be seen as primarily pathological.
13. Parents accept, enjoy and parent their child at his or her developmental level. These children