How to care for the traumatized child

Below is an article I found for parents caring for the traumatized foster child.  I thought many of the suggestions were good and very appropriate for adopted children who may have been abused in their orphanages or previous foster/adoptive homes, as well.  It must be mentioned that many adoption agencies do not prepare adoptive parents adequately, so while for some, the information below may seem old and repetitive, for many PAPs, this information may be new and not mentioned before.  (I myself would like to know how many AP's featured in our abuse cases did understand the whys and hows behind the "odd" behaviors exhibited by the traumatized adopted child... a child who may very well have PTSD.)

Note the importance given to the time given to the child-in-need of care and comfort.  I would hope those who choose to adopt a traumatized child do so with the intention of being a full-time stay-at-home parent to that child.  Far too often, APs seem to think after a few weeks of adapting to a new home-environment, the adopted child is ready to resume a life of "normalcy", which may mean both parents will be working out of the house, full-time.  It's my strong belief that the use of day-care or babysitters/nannies as a day-long care-alternative is not in the best interest of the child who is very sensitive to abandonment issues.

From:  The Effects of Trauma on Children: Part 3 ~ Practical Keys for Foster Parent to Aid Healing, posted by Helouise Steenkamp, September 20, 2011

 

Airlines suggest to passengers that in the event of trouble, parents should first put on their own oxygen masks, and only then get oxygen to their children.  It is a simple truth that an unconscious parent is of no use to a child in distress!.

Upon learning of the harm, trauma and/or abuse that have been inflicted and forced upon the Foster Child, prior to placement with them, most Foster Parents first reaction will be that of shock, anger and outrage.  But as a foster parent we have to set our own reaction to the side, and focus our attention intentionally upon the following three key needs of the traumatized child.

1.  Foster Parents have to help calm the Limbic system:  Due to trauma inflicted upon/experienced by the foster child, his/her Limbic system has become oversensitive.  In order for the child to realize that the trauma has ended, we have to ‘calm down’ the Limbic system.  Herewith a list of activities that will enable foster parents to help the traumatized child to accomplish this, and that will also promote the bonding process:

  • Hold and Cuddle the Child on your lap: Make a point thereof to peacefully just hold the child on your lap every day, as long as possible.  Lay next to the child on the bed in the evenings, just holding him/her.  Traumatized children need to be held much more so that a normal child.  Just by holding the child you are already giving him/her a sense of security and helps regulate their breathing (traumatized children breath shallow).
  • Rock the Child: Holding the child in your arms on your lap, slowly start rocking from left to right and also from front to back.  Sing a soothing bedtime lullaby or start telling a calming story in a soft toned voice.  After about a month you can also rock the child while together, looking at photo’s or drawings of the bad experiences; or while the child tells you about his/her bad experiences.  If the child wants to he/she may even be given a dummy or baby bottle to suck on.   Rocking relaxes the bodies sensory responses and strengthens a feeling of security in the child.  It also aids development of the ‘corpus callosum’.
  • Let the child rock him/herself:  A rocking chair will help a lot, but the child can just be encouraged to rock him/herself, while listening to calming music.  Give the child a soft toy or blanket to hold while rocking.  The positive effect is the same as above.
  • Daily feed the child yourself:  If the child is a toddler or in his/her early primary school years, feed the child regularly the first few months.  Feeding activities helps the child to catch up on emotional on mothering and clams the Limbic system.
  • Make eye contact:  Promoting the child’s ability to make eye contact, is very important.  Play games that encourages eye contact, and ask the child to look at you when your having a friendly conversation with him/her (not when you are angry).  Making eye contact with the child while holding and rocking him/her on your lap, is very effective in hightening the child’s awareness of other people and aids feelings of ‘being safe’, because it calms the Limbic system.
  • Breathing: Teach the child to take deep and slow breaths of air.  Do regular ‘breathing exercises’.  Deep breathing calms the amygdala.
  • Left Right Brain Communication:  Play games that encourages the child to move between his/her left and right, or enroll him/her into a ‘brain gym’ program.  ’n Handy book to acquire is “Braingym for all” written by M. De Jager.  This activity aids the development of the child’s corpus callosum, and therefore also helps children with learning problems.
  • Therapy:  It is important to also get professional therapy for the child.  Therapy will not only help the child to work true the trauma he/her experienced, but will also provide guidance for you as foster parent to deal with the child’s emotional problems, and encourage and bring about bonding.  Therapy aids the development of the Limbic frontal lobe patterns.

2.  Handling the Traumatized Child’s Emotions:  It is VERY important for the Foster parents to learn how to catch and contain the foster child’s emotions.  When emotions are permitted and being acknowledge, it enables the child to show and process negative emotions.  This in turn teaches the child to accept, think about and take control of his own emotions, and not to take it out in others in fits of rage and anger.

Most people have a ‘non-containment’ reaction to the intense emotions of others.  We want to get rid of the painful emotions as soon as possible, and want to make the person ‘happy’ again.  The following ‘non-containment’ responses are common:

  • The Sifting Response:  The communicators emotions, runs straight through the listener, as water runs through a sift. Because the listener experiences anxiety due to being unable to process such raw emotions.  This is a passive reaction to emotions.
  • The Dishcloth Response: The child’s painful emotions are wiped away – “it’s not that bad, try and forget about it, you will feel better tomorrow”.
  • The Sponge Response:  The person completely sucks-up and absorb, all of the child’s emotions, just like a sponge.  This renders them unable to support the child.
  • The Dustbin Response:  The painful emotions are discarded.  ”You mustn’t feel like this way, it is wrong to feel like that”.
  • The Stonewall Response:  No reaction.  The ‘negative’ emotions are just ignored.
  • The Containment Response: The listener calmly listens to the emotions that the child is communicating, without becoming anxious.  The appropriate response must be to re-verbalize these emotions, in your own words, back at the child to convey the message that “you understand”.  ”It’s ok to feel this way. I would have felt the same way if I was in your shoes”.

The ‘containment response’, communicates to the child that he/she is not alone. Once your Foster Child trusts you enough to open up, take time to talk about the trauma, and his/her reaction to it.  Following trauma, a child may be upset by his or her own reactions to the event. They experience the crisis situation as out of control, and then confronted by experiencing him- or herself as out of control.  This amounts to a re-traumatization, and it often has as detrimental an effect upon the individual as did the original trauma.  The child doesn’t understand that his/her reactions are essentially normal, for that of a child who experienced trauma.  The feelings, memories, and troublesome reactions attached to critical incidents are often experienced by children in isolation.  They often don’t understand their reactions.

3.  The Paramount Importance of Promoting Bonding:  The foster parents must actively work on promoting bonding between them and their Foster Child.  Bonding takes place when:

  • You daily spend time with the child
  • Giving the child your unconditional attention WHEN he/she are needs it
  • Providing for his/her emotional and physical needs

The Positive Interaction Circle: The foster parent reaches out to the child and initiates positive interaction (such as playing games, reading a story, cuddling the child, etc.) and the child reacts positively.  Because both parties experience the interaction as ‘positive’, they will continue the circle.  The emphasis should be on the initiating of positive interaction, rather than just reacting to the child’s behavior.

Capitalize on Strong Emotional Outbursts: After a child has had a strong emotional outburst, their ‘self-protection mechanisms’ is very low, opening them up for easier bonding with the person who is there to treat them lovingly and comfort them.

Share Your Background with each other:  With older Foster Children, the foster parent can create an opening for the child to share his/her experiences with them, by sharing some of their own background with him/her. It is very important not to ask questions.  When the child is ready to talk about his past, encourage him/her to do so.  Foster parents should make use of the ‘mirrorring’ listening technique.  The foster parent can also assist the social workers, by informing them of any unknown information pertaining to the child’s trauma, that has not yet been recorded,  communicated by the child.

Learning New Behavior: Encourage the child, that does not enjoy physical contact, by playfully practicing ways to be loving (such as giving a quick hug, sitting on the foster parents lap while reading a story book, a playful bedtime kiss on the cheek, etc.).  They will slowly but surely, become more comfortable with physical contact and cuddling.

Play with the Child:  When you spend time playing with and focusing all of your attention upon your Foster Child,  he/she will experience it as something very special, and this promotes trust and bonding.

Summary:

It is extremely important to remember that un-processed trauma, repressed mourning and emotions, negatively influences and hampers the bonding process.  Therapy may be needed to address these issues, before proper bonding can take place.  Foster Children may feel attached to their foster parents because he/she likes them and feels safe with them, but this doesn’t necessarily mean that bonding has been established.  If proper bonding is not established, the child will probably present behavior problems in his/her teenage years.

  • Do not under estimate the Vital Importance of Vitamins and Supplements for the Neglected and Traumatized Child:
    • Multivitamins: Because of neglect and malnutrition, Foster Children generally have vitamin shortages in their systems.  It is important to supplement the child’s diet with multivitamins, for at least the first 6 months in your care.
    • Omega 3, 6 & 9: Omega oils are essential for the ‘mylination’ process in the brain.  It also promotes the overall physical wellness of the child, but is specifically important for the development of the child’s brain and emotional well being. Most children have a shortage of Omega 3 & 6 in their diets, but Foster Children have years of shortages, that hamper their development.  Especially Omega 3, are very important, and in big doses.  [dosing of recommended products was edited out of text;  please seek your pediatrician's suggestion for appropriate recommendations]
    • Glutamine: Glutimine supplements the Gamma Amino-Butyric Acid (GABA) in the brain.  This is an vital neurotransmitter in the brain, that is required for normal brain functions.  People with a shortage of GABA suffer from anxiety, concentration problems, depression, hyperactivity, frustration and anger tantrums.  Glutamine has been tested on Foster Children with phenomenal success, and are highly recommended.  A reliable source of glutamin is ‘Glutamag’.
    • Antidepressants:  Some Foster Children, that have been extremely traumatized, or are in intense mourning for their biological parents, might experience severe depression, that might call for the use of antidepressants just to start the process of healing.   In such cases only Pediatricians or Child Psychiatrists should be consulted to subscribe antidepressant.  It will allow some time for the recovery of the neurotransmitters in his/her brain to recuperate, so that the child can start to recover emotionally.

Taken and adapted in part from:  ”Die Effek van Mishandeling en Verwaarlosing op die ontwikkeling en binding van die kind”  written by Magriet van Schalkwyk (Private Social Worker – Trauma)

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Nurture in a relationship

I feel compelled to comment on behalf of those adoptees who do (or did) not get a reliable, nurturing adoptive parent. 

I believe when a traumatized victim is given to a person who lacks a consistently safe positive nurturing style, that victim will begin to think/realize people and kindness cannot be trusted; they are temporary givens that can quickly and easily change into something harmful, or be taken away (not to return again).  This mind-set can easily lead the victim into a state of general mistrust towards others, making it very difficult to nurture the one who needs nurturing love the most.

In my own experience, I have found for some victims, this mistrust leads itself to the complete shut-down (denial) of any emotional vulnerability.  For other victims, the desire to trust goes into over-drive.  This hyper-state makes the person so desperate and needy for anything that resembles love, she (or he) will take what ever crumbs of kindness she can find, even if the end-result becomes dangerous and abusive.

Just going through the list of "do's" I'm amazed how those very simple consistent acts can be seen in good healthy adult relationships, and in the same flip of the coin, they are absent or warped in the more dysfunctional/unsatisfying intimate relationships chosen by those who were poorly nurtured.

For instance:

  • Holding and cuddling; if holding and cuddling is not done, or it's done with sexual overtones, the child can get a mixed confusing message about the way in which a person safely demonstrates love or affection.  For many of us, because we were not held and cuddled, (or the holding felt wrong or unwanted), we in-turn developed serious touch issues that can get very annoying to others.  A point to note: In some circles, Holding is used as a form of therapy; others describe it as a form of abuse.
  • Rocking; I always found when done in a smooth calm rhythm, rocking in a chair invites a sleepy sort of conversation.  Rocking, huddled on the floor, in a ball, is the closest some of us got to holding and cuddling. 
  • Daily feeding;  I think there is much truth to the adage "The quickest way to a man's heart is through his stomach".  Feeding and satisfying a basic need had by another has all sorts of implications and connotations.  I don't think any parent should underestimate the many ways food can be used to bring people together, or tear them apart.  Some of our abuse cases illustrate how food deprivation is used by an AP when trying to teach the adopted child "a lesson".
  • Eye contact; in healthy trustworthy relationships, maintained eye contact means the person speaking can be trusted.  Maintained eye contact takes on a whole new meaning and effect when it's used as a means to threaten or intimidate, or show who is in-power.  Not maintaining eye contact can indicate lying, or insecurity... in either case, the person does not feel safe.
  • Breathing;  A person who is petrified will hold his breath.  Rapid breathing indicates a stress on the body.  Often times victims of severe trauma have to be reminded to stop their fast-paced activity and deep breathe, especially when they are feeling overwhelmed or stressed.  
  • Responding to emotions; How many marriages and relationships end because the partner would not respond well to the other partner's emotions?  Response to emotion matters, as it can help validate and build, or it can minimize and diminish a person's sense of value and worth.

If we look at all these basic tasks, and then look at what's being done to some adoptees, in the name of "parental control" or "teaching cause and effect" or  "religious instruction" or "therapy", or maybe out of sheer utter frustration, one has to seriously wonder how these adopted children are going to respond to those they see as being "less than" or inferior.  Eventually these adopted children will leave their adoptive family and become someone's spouse, partner, even parent.  How well did these AP's prepare these kids for the next significant  relationship in their lives?

In some cases, the frustrated and abusive AP will gets rid of the problematic by "re-homing" through underground AP networks, or they will send the child either back to the orphanage, or be placed a residential treatment center; an institution has become his home.  For those left to live with abuse or neglect, I can only hope in later years, a child's true (but untapped) good nature comes out and through, and does not resemble or reflect the type of "care" and treatment they received pre and post adoption.

Sadly, I don't think the many good nurturing supportive AP's out there realize just how poorly prepared, poorly trained, and non-nurturing other agency approved adoptive parents can be.  This fact really disturbs me because all too often it is assumed all adoptive parents know how to be good loving parents.  The truth is, good parenting needs serious instruction and example, and I'm afraid far too many adoption agencies fail the children they place because they are not screening and preparing the parents properly, for the sake of the child, the home, and a good sense of family.  

Just another institution

Kerry you stated:
"Note the importance given to the time given to the child-in-need of care and comfort. I would hope those who choose to adopt a traumatized child do so with the intention of being a full-time stay-at-home parent to that child. Far too often, APs seem to think after a few weeks of adapting to a new home-environment, the adopted child is ready to resume a life of "normalcy", which may mean both parents will be working out of the house, full-time. It's my strong belief that the use of day-care or babysitters/nannies as a day-long care-alternative is not in the best interest of the child who is very sensitive to abandonment issues."

I agree with you on that. I was always amazed to see so many APs go back to work just after two weeks (!!!) or a month of being home with their newly adopted child. The child is placed in a daycare center, which is just another form of an institution when you come to think of it, to a child who has either been with a foster family or in an orphanage. High turn over rate, many children, and not the same as the one-on-one care needed to nurture and heal a child.

So many kids are placed in school settings, with extra-curricular activities and having to "fit in" like they are just a normal family that has always been together. APs have to realize that this may not be in the best interest of the child. What choice does the adoptee child have in this? What say do they have in this matter? The sad part is that I feel that there may be alot of APs that may think that this does not pertain to their adopted child. Surprise, it is exactly your child that we are talking about.

Pound Pup Legacy