Friday, November 30, 2012

Trauma ramblings

The American Psychiatric Association's Diagnostic Manual of Mental Disorders (DSM-IV) for the diagnosis of PTSD is that "the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. The person's response to the event must involve intense fear, helplessness, or horror."


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Imagine that you are a few days old, and you wake up alone on the sidewalk on a bridge or in a train station. Instead of the familiar smell, heartbeat and arms of your mother to comfort you when you cry, no one comes for what seems like forever. When someone finally notices you, it is a stranger. Imagine then, that for the next 6 months or a year or more you are confined to a crib where you are cared for sporadically by many people who also care for many other babies. No one picks you up when you cry. You are not fed when you are hungry, but fed when it is convenient for your caregiver. Your bottle is propped in your mouth and if it falls out you may not get more until the next bottle 8 hours later. Your diaper is dirty. You are cold. You are not held enough or loved enough if at all. And when you are scared at night because of the dark and the crying of other babies, you are left to comfort yourself.*
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Trauma occurs when an event elicits fear, helplessness and overstimulation in a child.

I think institutionalization always causes trauma.

There are many studies out there that show that trauma and stress cause physiological and chemical changes in the brain. When the trauma is experienced in children while the brain is still developing, the effects have huge consequences. Trauma can affect a child's cognition, gross and fine motor skills, language development, social interactions, attachment and trust, and self-perception. I am not smart enough or articulate enough to explain all of this, and there are whole books written on this topic. But I think the most important thing for adoptive parents to know is that their kids' brains are different than other kids' brains. These little brains are both physiologically and chemically different because while their brains were developing, these kids were living in a place of fight-flight-freeze-dissociation. Their brains and bodies lived in a stress-induced cortisol bath for weeks or months or years. This can cause behaviors such as aggression/rage, depression, attention/hyperactivity issues, anxiety, or withdrawing/avoidance.

The kind of behaviors that teachers call home about.

From the Post Institute website:

"Any family adopting a child from an orphanage should be informed that regardless of the age the child is going to have challenges in forming healthy, secure attachment for some time. They should be informed that their neurologic development is most likely challenged in key areas regarding social development and this will take time to repair, and their stress response system is highly sensitized and reactive."

"Highly sensitized and reactive". I wonder why.

We have stress reactions in our house. I will share just a couple of them here. One gets stressed and freezes and has a deer-in-the-headlights look (dissociation) ~ maybe triggered by fear of being "bad" or doing something wrong or making mom mad. One increases his neediness and clinginess exponentially and needs mama/baba several times a night and cries about missing whoever is not with him (fight) ~ maybe triggered by fear of losing those people close to him which has happened several times in his life.

I am not sure if we fit the APA's definition of PTSD or not. Thank God we do not have RAD in our house (Reactive Attachment Disorder). I pray God's blessing over all those families dealing with RAD. What we do have is persistent and pervasive issues related to loss and trauma that we deal with daily.

I think this is just an inherent part of adoption.

I think it is really important to always keep this in mind when our munchkins are struggling with anything.

I expect we will be dealing with this for years if not for all their lives to some degree.

While I am talking about these issues caused by trauma, these issues do not DEFINE who are kids are. These issues are just one part of them, and as their parents we need to be aware of the adoption-related issues and remember what caused them. Then we can love them and parent them and help our kids heal from their trauma, while nurturing and appreciating our kids' other amazing parts like
   a great sense of humor or
   an incredible memory or
   a loving attitude or 
   great imaginative play or
   a natural musical aptitude or
   a new addiction to Legos
   a love of books or
   great athletic ability or
crikey I could go on and on.

They are kids first.

Like I mentioned in my last post, these hard places we have been do not define us, but rather that those hard places get woven into us and shape us and become a beautiful part of us. 


Thank you, Lord, for answered prayers.

(((hugs))),
chris

Give your burdens to the Lord,
and he will take care of you.
He will not permit the godly to slip and fall.

Psalm 55:22



*I can't remember where I saw this story, so I can't appropriately credit the author.

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