When we adopted children, I felt prepared. Looking back, I laugh at that notion.
My parents are psychologists, I had worked with children for years, we had gone to foster care training as well as workshops by leading experts, and I had read a bunch of books prior to adopting. Of course, the messages from “the system” and society tell us that therapy and structured, nurturing parenting will do the trick.
For the first two years, I was sure we would turn a corner at any moment. But things only got worse, and our family only became more dysfunctional. At the six-year mark, things fell apart completely. That was three years ago, and I’ve spent those years trying to figure out what went wrong.
Last year I finally read “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma,” by Bessel van der Kolk, M.D. It helped me understand trauma in a way no other book, person or workshop ever has. I don't know if reading this book before we adopted would have changed the outcome, but it certainly would have changed the way I approached our children's trauma, and it definitely would have given me a better understanding of how that trauma had impacted their brains — and therefore their outward behavior.
The messages from “the system” and society tell us that therapy and structured, nurturing parenting will do the trick [for children with developmental trauma]. For the first two years, I was sure we would turn a corner at any moment. But things only got worse, and our family only became more dysfunctional.
If I had read the book earlier, I would’ve at least questioned more of what professionals had told me. Perhaps we could’ve saved thousands of dollars on therapy and other interventions that only made things worse. Perhaps the years we had with our children could’ve been better spent with less chaos in our home.
On trauma
Our rational, cognitive brain — the prefrontal cortex — is the youngest part of the brain, and brains are built from the bottom up, with the most primitive, survival parts active first.
“The impact of trauma is located in the survival part of the brain, which does not return to baseline after the threat is over,” van der Kolk says in this helpful Q&A from his website. “This part of the brain is by definition unreasonable — you do not stop being hungry by reminding yourself how fat you are, and it’s pretty difficult to talk yourself out of being angry, shut down, or in love.”
Trauma is overwhelming, unbelievable and unbearable. The book taught me that we must suspend our sense of what is normal when dealing with traumatized individuals. Children like ours with developmental trauma, who have suffered ongoing trauma during an early and vulnerable age, but are now “safe” live in a dual reality. The past is not over but ever present inside them.
In the Q&A, van der Kolk goes on to say: “Through brain imaging technology, we can visualize how traumatized people even have problems processing ordinary, nonthreatening information, which makes it difficult to fully engage in daily life and to learn from experience. As a result, they are frazzled, unfocused, and tend to repeat the same nonproductive behavior patterns, with the same miserable results.”
We see this played out with our children who lie, steal, rage and push anyone close to them away, over and over again.
Children like ours with developmental trauma, who have suffered ongoing trauma during an early and vulnerable age, but are now “safe” live in a dual reality. The past is not over but ever present inside them.
In “The Body Keeps the Score,” van der Kolk explains that trauma produces actual physiological changes, including a recalibration of the brain’s alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant. After trauma the world is experienced with a different nervous system.
Traumatized people chronically feel unsafe inside their bodies and are constantly bombarded by visceral warning signs that they attempt to ignore or control. The book helps us understand that trauma is not just a past event — it leaves an imprint on mind, brain and body. Trauma results in a reorganization of the way mind and brain manage perceptions, changing not only how we think and what we think about, but also our very capacity to think.
That’s why our children’s behavior often makes no sense to us.
No matter how much insight and understanding a traumatized person develops, the rational/cognitive brain is basically impotent to talk the emotional reptilian brain and limbic system out of its own reality, which is exactly why traditional talk therapy barely scratches the surface.
On traditional therapy and medication with a developmental trauma brain
“Psychologists usually try to help people use insight and understanding to manage their behavior,” van der Kolk explains. “However, neuroscience research shows that very few psychological problems are the result of defects in understanding; most originate in pressures from deeper regions in the brain that drive our perception and attention. When the alarm bell of the emotional brain keeps signaling that you are in danger, no amount of insight will silence it.” This helps explain why our kids can recite things like coping strategies but are unable to actually use them when triggered. The medication approach also has its limits, looking at the problem as just a chemical imbalance, when the trauma is far more complicated.
On healing for children with developmental trauma
Luckily, van der Kolk devotes much of the book to approaches that can aid in healing.
Of course, attuned and loving relationships are key to felt safety, healing and learning regulation. At RAD Advocates, we recognize that families dealing with reactive attachment disorder/developmental trauma disorder are often too far gone by the time they find adequate help. If the parents are in a state of constant stress and are suffering from post-traumatic stress disorder themselves, they will likely not be able to therapeutically parent their traumatized children. In these cases, out-of-home placements are needed; yet quality out-of-home treatment options are scarce. RAD Advocates helps families find resources and form networks of support.
Need help navigating developmental trauma and the frustrating systems that go with it? Consider support memberships.
In addition to relationships, addressing the unconscious body and brain impacts of trauma are also key to healing.
“Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies,” van der Kolk writes. “Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.”
My personal therapist was always asking me where I felt an emotion and what it felt like in my body. I’d often describe a tightness in my chest, for example. I didn’t understand why she always asked this until I read the book, where van der Kolk also describes asking his patients this. While I could do this exercise, my adopted son never could.
But this can be practiced and learned.
No matter how much insight and understanding a traumatized person develops, the rational/cognitive brain is basically impotent to talk the emotional reptilian brain and limbic system out of its own reality, which is exactly why traditional talk therapy barely scratches the surface.
“The mind needs to be reeducated to feel physical sensations, and the body needs to be helped to tolerate and enjoy the comforts of touch,” van der Kolk says. “Individuals who lack emotional awareness are able, with practice, to connect their physical sensations to psychological events. Then they can slowly reconnect with themselves.”
He recommends practices like yoga for this same reason. The book also discuses things like dance, theater and music in healing. All these encourage a connection to the body and its sensations, feelings and needs.
“If you are not aware of what your body needs, you can’t take care of it,” van der Kolk writes. “If you don’t feel hunger, you can’t nourish yourself. If you mistake anxiety for hunger, you may eat too much. And if you can’t feel when you’re satiated, you’ll keep eating. This is why cultivating sensory awareness is such a critical aspect of trauma recovery. Most traditional therapies downplay or ignore the moment-to-moment shifts in our inner sensory world. But these shifts carry the essence of the organism’s responses. … Traumatized people need to learn that they can tolerate their sensations, befriend their inner experiences, and cultivate new action patterns.”
Until someone learns to observe and tolerate their physical reactions, opening up the past will only compound their issues.
If parents are in a state of constant stress and are suffering from post-traumatic stress disorder themselves, they will likely not be able to therapeutically parent their traumatized children. In these cases, out-of-home placements are needed; yet quality out-of-home treatment options are scarce. RAD Advocates helps families find resources and form networks of support.
For our children to learn self-regulation, they don’t just need us as parents: They also need a friendly relationship with their body and its sensations. “Without it you have to rely on external regulation — from medication, drugs like alcohol, constant reassurance, or compulsive compliance with the wishes of others,” van der Kolk says.
He goes on to say: “Our great challenge is to apply the lessons of neuroplasticity, the flexibility of brain circuits, to rewire the brains and reorganize the minds of people who have been programmed by life itself to experience others as threats and themselves as helpless.”
The book is 444 pages long, so this short blog highlights only a fraction of the amazing information covered. If you read one book on trauma, let it be this book.
Van der Kolk is also the driving force behind getting developmental trauma disorder recognized and, hopefully, added to the DSM — “Diagnostic and Statistical Manual of Mental Disorders.” Because, as he says, “When there’s no relationship between diagnosis and cure, a mislabeled patient is bound to be a mistreated patient.”