SNEAK PEEK FROM "THE CENTRAL ISSUE OF TRAUMA" CHAPTER
During our preparation to adopt, whether in the counselling sessions or our own reading (back in the days when we could still sit and read a book), we focused on attachment and its potential malfunctions in an adopted child. We quickly understood that helping our children to form a secure attachment to us was our most important job.
What we missed in our early research, though, was a robust understanding of the root of attachment issues being the child’s initial trauma. Developmental trauma refers to a specific type of complex trauma that primarily focuses on the effects on a child who experiences abuse or neglect early in life.
Developmentally traumatised children are at high risk of facing challenges with attachment, health, emotional regulation, dissociation, behavioural/impulse control, cognition and self-concept.
For absolute clarity, understand that our belief is that the critical issue is trauma. Trauma has a range of potential impacts, with attachment issues being one grouping.
Having had secure and happy childhoods, we read the words and took in concepts around attachment (and trauma), but didn’t really understand what we had to deal with until we were in the thick of adoptive parenting. When we started out, we truly believed that if you loved your child enough, you could compensate for their trauma and loss.
Almost ten years into our adoption journeys, each of our kids has been with us for far longer than they were anywhere else. It can be hard to accept that the loss of birth parents is so primal, so beyond words, that even if they were only with them for weeks, or months, or didn't even know them beyond birth, the scar is still deep and permanent. The pain from this loss rears its head viciously and unexpectedly. It often manifests itself as anger towards you as the adoptive parent. It becomes your fault. It doesn’t matter that you didn't cause this separation or this loss; you're the living, breathing permanent reminder of it.
One of the most painful realisations of experienced adoptive parenting is that your love isn't enough to fill the hole. Adopted children have been deeply traumatised and that pain will stay with them, sometimes front of mind and sometimes barely noticeable, through their whole lives. The loss of, or inability to live with, your birth family is not something that just goes away, and at stressful or milestone moments in their lives, it will become front and centre for them again. Your love is absolutely enough, though, and absolutely critical to ensuring they get the help and support they need to move through their trauma.
Introduction to Trauma
The starting point to understanding your child is to acknowledge that, without question, he or she has suffered an emotional trauma. This can be difficult to accept, but we believe it is universally true of adopted children. You, the adoptive parents, are the ones who must deal with it, or at least find a way of helping the child to manage it so that it does not become an all-encompassing, chronic cause of economic, social, relationship and health issues.
What is a trauma? It is any event or series of events that overwhelms a person’s capacity to process and cope, physically, mentally and emotionally. These events cause a rupture in the normative development of the mind-body. The trauma might be neglect, abandonment or abuse, for example.
This experience has changed the child, who has adapted in order to survive. This adaptation made perfect sense at the time, but now the child cannot move on from this mode of adaptation, even post-adoption. It is one thing for them to cognitively understand that their new family loves them, that they are safe and that it is not necessary to continue with the survival adaptation (though this realisation is hard enough for a child), it is quite another for the child to truly feel safe enough to let go of what has been a successful strategy thus far.
The adaption necessary to survive the trauma can become a permanent state of dysregulation. Often a child uses up most of their energy simply trying to survive post-trauma. This leaves very little energy or opportunity for learning, positive relational interaction, developing a sense of self and identity, and fully experiencing all the things that a child of their age would typically do.
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I cannot stress enough the importance of having some understanding of brain development following a trauma in childhood. Investing time in understanding trauma is crucial for parents, as it allows you to replace frustration with empathy.
Many things about your child’s behaviour may be perplexing and, possibly, quite infuriating. Why are they always chewing stuff? Why can’t they follow simple instructions? What’s with the tight clothes? Why are they playing with baby toys? Why are they so uncoordinated? Why do they do things that they know they shouldn’t? How do they know all the words to the latest songs on the radio, but can’t remember their times tables? Why are they so impulsive? Why do they get up in the middle of the night to take food? Why are they stealing and stashing food? Why do they get so upset about minor things? I am sure you have observed many other behavioural issues that seem strange and unfathomable.
Some of these behaviours can be explained through a deeper understanding of how the child’s brain develops in response to trauma. There are many excellent books in this area, and I highly recommend that you take a look at the work of Dr Bruce Perry of the Child Trauma Academy, who wrote The Boy Who Was Raised As A Dog, and Bessel van der Kolk’s The Body Keeps The Score.
This topic can appear highly complex and limitless, but you only need to go as deep as you want. The model that I have found most helpful is again from Dr Bruce Perry, and is called the Neurosequential Model of Therapeutics (NMT). This is neither a treatment nor a diagnosis, but a framework that plots a child’s neurological development and compares it to a “neurotypical” child of the same age. The premise is that a child’s brain needs to develop in a particular sequence, and trauma can interrupt that sequence, thereby skewing their development. Each child adapts to survive his or her particular traumatic circumstances, and this can cause the sequence of development to be disturbed or incomplete.
Depending on the situation, the impact of trauma may be evident from day one, with the child exhibiting tantrums, rage, violence and dissociation after even a trivial interaction. Or nothing may manifest for years, until the additional burdens of school, friends and puberty overwhelm their survival mechanisms and they suddenly start to struggle. By looking at when and what happened, and the child’s subsequent survival strategy, we can hypothesise which parts of the brain may have been affected, and then seek targeted therapies to enable the brain to complete its development.
It is possible to have your child assessed for an NMT “mind map” that can give you insight into areas where your child is relatively stronger or weaker compared to a typically neuro-developed child. This then allows you to target activities that will help your child the most, for where they are at that time. It is pointless having a maths tutor, for example, if your child has not developed the neurological structures necessary to enable them to access the higher levels of abstract thought and logic. Your child might need other occupational therapy-type activities first. An NMT assessment can give you a framework to target therapies (where “therapy”, in this context, is simply a beneficial activity, eg. skipping or one-on-one play). See the Child Trauma Academy’s website for more information about NMT, including where to find a practitioner in your area. The website also has educational articles and presentations you can download for free.
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The earlier in life that trauma occurs, the more likely it is that basic level functioning will be affected. By age two, a child’s brain is 75% of its adult size, and by age six, it has reached 90%. This means that the impact of trauma at age ten is going to be very different to a trauma at age one. If we understand that, say, trauma occurred at a time typically associated with sensory development, we would not be surprised to find that the child has sensory input difficulties, movement problems and issues processing sensory data. How this manifests is unique to that child. It could be in gait, balance, sight, touch, perception of space, motor skills, etc. In this scenario, targeted trauma-enlightened occupational therapy is your best friend. Using targeted OT, we can harness neuroplasticity to complete the development of sensory processing. This then frees the child from having to spend so much energy and attention on the body. It also enables them to make stronger connections to other parts of the brain, and to move towards a more typical neuro-biological level of functioning.
If a child is primarily dysregulated at a sensory level and frequents the fight/flight/freeze state, she will often be unable to use her own cognitive abilities to regulate herself – hence the How many times have I told you? exasperation for parents. When a child is calm and feels safe, she can access her cognitive abilities and agree that a particular course of action is unwise. However, once the child feels stress, she literally cannot access that part of the brain. The fight/flight/freeze reaction dominates, to the exclusion of rational thinking.
A child who has experienced trauma will have the same brain structure that everyone else of their age has, of course. But the issue is how to move past, in this case, sensory dominations over rational thinking. Talking therapies seek to access the cognitive part of the brain – the rational thinking part that is difficult to access for these children. As a result, talking therapies, while useful and illuminating, can be an exasperatingly slow way to facilitate change.
This approach seeks to complete the neuro-development that has been interrupted by the trauma-enforced adaptation. It does so through trauma-enlightened, targeted activities (in this scenario, we were considering a child with sensory input issues – OT is not the answer for everyone, but the fundamental methodology is the same). This means we can attempt to redirect the brain’s focus and energy on the body and the fight/flight/freeze response towards building stronger neural connections with the cognitive system. In time, this will mean that talking therapy is more effective and will increase the child’s ability to self-regulate (in other words, make good decisions when you are not there!).
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Understanding trauma and its impact on your child’s brain also helps you to parent them with empathy and understanding. If you know your child craves sensory input because his brain has not completed a neurotypical development, you are less likely to get annoyed when your 12-year-old climbs into a tiny space under the sofa and stays there. If you understand that pressure is a calming thing for your child, instead of having a bedtime routine of soothing music and stories, you might want to wrestle with your child.
In addition, if you understand that your child is living in an emotional space controlled by hypervigilance that stems from a permanently “on” sense of danger, then you will reasonably expect that they will not be accessing the rational, forward-thinking part of the brain. They may not understand even the simplest of instructions, or you may have to repeat them more than you think is necessary. They may be quicker to take offence to small things, and become argumentative and sullen.
You need to become experts in your child’s psychological rehabilitation. While you can get excellent support, you cannot outsource this to psychologists, psychiatrists, respite carers, counsellors or anyone else. It’s up to you. This is not an easy job. It will take many years of concerted effort, and put great strain on you personally, as well as on your relationships with your partner, your children and your family.
For some foundational reading on attachment and trauma, we list our favourite books in the resources section of our website. Read these for the theory, and read our stories that follow to understand you’re not alone, and to find the practical tips and strategies that resonate with your family.
General Strategies Around Attachment Issues
Dealing with attachment issues can be devastating. You will often feel hopeless and helpless and clueless and just less – you never thought it was going to be this hard. You had no idea that not only would you feel you were having little impact but that, at times, your very presence would seem to be making your child’s issues worse.
Dealing with attachment issues is isolating. Many people in the broader community have no idea of the challenges you face inside your home day in, day out. We had no idea of the hard work we would all have to put in over years to shift the dial for our kids, even a little.
Remember, attachment issues stemming from trauma are areas where you need to bring in the big guns. Read the books from qualified professionals, get help from your family doctor (but make sure they have trauma and attachment experience, or they’ll tell you “It’s just kids”), psychologists, psychiatrists, whatever you need.
It takes a huge amount of patience and understanding to parent a child who lacks the basic foundations of a secure attachment. A child who feels “unsafe” often struggles with basic family concepts. They’ll often exhibit negative behaviours, they might always question authority and the purpose of rules, and will rarely self-reflect. All of these behaviours add up to children that are very challenging to parent.
Solutions and effective techniques will depend largely on their history, their developmental age and also their cognitive and chronological age. All children learn differently, and all parents parent differently, so there is not one solution that fits all. The majority of children who have suffered disruption in childhood have a distorted and faulty perception that they are bad, not worthy, not good enough. With this in mind, a child may subconsciously believe that “I am bad, so what’s the point in being good and changing the way I act.”
As humans, we behave in a way that supports our primary beliefs about ourselves and others. For example, a child may believe that they are only “good” when they have your undivided attention, so they do everything possible to get it, even if it’s negative. You screaming and shouting at them is giving them attention and, in their eyes, this is what they want. They may feel that when you correct them, you do not love them. If we, as parents, do not highlight and correct these faulty beliefs, then standard parenting techniques will not work. Most parenting strategies assume that a child’s core beliefs are positive, and therefore they work for your “standard” child. But a child with faulty beliefs is inspired by very different choices, and therefore views and interprets the world very differently.
Attachment to a primary caregiver can alter these beliefs, but it’s not a quick process. A family counsellor who is experienced in trauma and attachment is likely to work with your family on strengthening parent-to-child bonds through life story work, active discussion and parenting with Patience, Acceptance, Curiosity and Empathy (PACE), rather than dealing with the actual behaviours. As the child becomes safer and more secure, the behaviours tend to diminish or subside, and relationships become easier to heal.
Below, we list some general observations and strategies that will help you as you try to understand your child, and work with them to feel safe and secure in your family.
No matter the age of the child, or your sense of how well-adjusted they are, assume when you first parent them that they are scared, confused and grieving for another place, a centre, a foster family, a birth family. Give your family time and space to become established before adding lots of other people to the mix.
Think of how much attention babies receive – they are held, fed, tickled, smiled at, talked to. They are constantly on the receiving end of a whole lot of love from the world at large. Institutionalised kids don’t get this. They sit in cots and are fed and changed, but little else. When they can walk, they wander around with other kids, in a situation that sometimes verges on resembling Lord of the Flies. It is hard to understand the profound impact of this. I suggest that the best way to learn what it was like to be your child as an infant is to read Building the Bonds of Attachment. Reading this allowed me to make sense of my child’s infancy and early years.
Often the children are more comfortable with negative attention because it matches their faulty belief system. It’s also more intense for them, and generally undivided. Emotional regulation is difficult for these children and therefore they can become frequently overwhelmed with strong emotions that cause blockages in their coping strategies. These blockages, in turn, create a need for control. Control is often a massive concern for them. Not only do they feel that they need to control situations, but they can also become very self-reliant, take care of themselves and rarely ask for help. This habit can be hard to break and may lead to increased anxiety and defiance, which in turn feeds the need for control.
Regulating the child’s emotions, establishing a more connected relationship, and giving your child frequent opportunities to accomplish things can begin to combat these negative beliefs.
For every negative thing you say to your child, find three positive things to say, too. With children suffering from trauma, it is easy to spend most of your time saying “no” or other negative comments – don’t do that, stop that, etc. I read years ago that you should aim to say three positive things for every negative. This might seem a challenge at times, but the three positive things don’t have to be major. It could be praise for listening, completing a task, doing something for someone else, not getting into trouble at school, or a success in some activity. Try not to link the positives and negatives in a “compliment sandwich” – don’t just say positive things because you are about to say something negative. Try and find positive things to praise all the time. You will be surprised by how responsive your child is to praise.
Try not to start with a positive and then set an expectation. For example: “See how well you behaved today at granny’s house. Now let’s see if we can do that next week, too.” It’s important to praise the moment. Don’t finish it with an expectation for next time, as this just sets them up for failure again, and instils the feeling of “I’m never good enough.”
All children need boundaries and discipline in order to learn how to navigate life. Many children with disrupted attachments read verbal and non-verbal signs incorrectly. They often wrongly interpret things as negative because of their own negative belief system. For example, telling them “We are leaving soon” may be immediately met with a “Why?” response, as if you’re punishing them (when you simply need to pick up a sibling at 3pm). By giving warnings, managing expectations and being consistent, a child will learn to accept authority a lot easier. So this simple request could be phrased as follows: “Just to let you know that we need to collect your brother at 3pm,” or “I’m hoping to leave about 3pm today,” or “Do you think you can be ready to head out in ten minutes?”
Remember that their chronological age is often older than their developmental age. Trying to reason with a 12-year old who is arguing with her two-year old sister about who gets the yellow cup is frustrating and tiring. When we expect them to act their chronological age, the children may become overwhelmed (which may, in turn, present as oppositional behaviour). Try to observe and evaluate your child’s actions separately from her chronological age to find parenting strategies that will work for her as she is now.
Be consistent! Always follow through with what you say. Children need to know and understand consequences: “What will happen if I do this?” By following through, you keep your word and establish a boundary that will help your child feel more secure and safe in your presence. You cannot be one of these parents who threatens and doesn’t follow through.
Don’t give up. What doesn’t work today, may work tomorrow. Children move through different developmental stages. As they mature, different parenting strategies may start to work even if they were not initially successful. For example, logical and natural consequences may not be understood by a child who believes she does not deserve good things, or work for a child who is developmentally like a two-year-old — an age at which autonomy may be more important than self-benefit. However, as she gets more attached to you and revises her core beliefs, it may become a successful parenting method.
Be upfront and clear about your good intentions. One way to defuse negative interpretations is to be explicit. For example, if you answer a phone call from a friend and your child starts constantly interrupting the conversation, instead of getting mad and gesturing for them to go away, ask your friend to give you 30 seconds. Tell your child: “You are interrupting a conversation. I want to hear what you have to say, and I will be more interested once I’ve had this phone call with my friend. It would be better if you wait quietly until I finish this conversation. I will then ask you what you want and I will listen to what you have to say.” This is hugely draining, time-consuming and so repetitive. It can, however, defuse the child and you can usually see an immediate change. Other times, it may not work, but consistency will pay off if you remain in control.
A phrase we have learned to rely on throughout our parenting journey is “everyone does something for a rational, logical reason.” I find it helpful to always come back to this when one of the kids is behaving in a way I don’t understand. I accept that there is an underlying reason for it, and trust that at some point, whether tomorrow or next year, I will understand it. It takes some of the “why” pressure off today, and allows you to work on the issue at hand in a more practical and less intellectual way. Of course, if you can already pinpoint the “why,” it makes the response a whole lot more likely to succeed.
Acting on impulse as a parent is doing exactly what children do with their negative actions. We need to learn to think and regulate ourselves before dealing with incidents. This looks silly bolded, but it is absolutely critical.
Don't take attachment issues personally. This involves you, yes, but it's not about you and it’s certainly nothing to do with your parenting abilities. If you take it personally, your child will feel they can't discuss their feelings with you, for fear of upsetting you. Your child needs to know you will hear their pain without judgement or ego. Help them to name and understand their feelings. Tell them it's OK to be angry, that every child should have the opportunity of being raised by their biological parents, and that it is sad that they do not. Hug them.
Don’t assume that kids will want to heal by talking. In fact, as explained in the section on trauma, talking will often prove pointless for kids who can’t access their faculties of higher thinking. Some of our kids function best when we allow them distraction when they're really sad. For them, talking only adds more pain, and watching a movie about something else altogether makes them feel better. Also, doing something together, like making biscuits or drawing pictures, allows some space for the child to safely process their feelings and is likely to lead to a more useful conversation for both of you.
We each sent our kids to day-care or preschool close to when they were “supposed” to go. With hindsight, we believe that kids who have been institutionalised are likely to do better and develop more rapidly if they’re kept at home for as long as it’s practical (or as long as you can bear it!). Intense time at home, learning who’s who in the family, will help bonds to form faster, without confusing them by introducing other caregivers. The kids are also likely to get more from school in terms of learning and social interaction if they have had some adjustment time at home.
All that said, institutionalised kids typically have behavioural issues that are hard to deal with. With some of our kids, the hours they were at nursery were precious snippets of time that allowed us to recover. If you need to put the kids into care for whatever reason, do it without guilt.
When an older child is adopted, they will often decide to be “good”: to lap up the love bestowed upon them, to try not cause trouble, to fill up with praise that they’ve never had before. One of my children was “good”, though perhaps not true to herself, for over five years.
Parenting a child with attachment issues can be extremely hard work and hugely draining, not to mention very isolating. Be kind to yourself, and look after your own wellbeing. Do not parent in isolation. Your support network becomes your lifeline during these times. We don’t always admit to it, but there are other parents feeling exactly as you are right now.
In the end, there is no single parenting strategy that will be the answer for a successful relationship with your child.
 The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist's Notebook--What Traumatized Children Can Teach Us About Loss, Love, and Healing, Bruce Perry & Maia Szalavitz
 The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, Bessel van der Kolk M.D.
 This is a technique that has been developed by Dan Hughes, a leading authority on attachment and trauma.
 Building the Bonds of Attachment, Awakening Love in Deeply Troubled Children, Daniel A. Hughes.
 Except in the beginning of your relationship, when praising them could cause them to stop and do the exact opposite!