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"TRAUMA SENSITIVE" CARE IN SCHOOLS Pt. 1

 

“ Troubled children with histories of abuse and neglect who show up in clinics, schools, hospitals, and police stations, the traumatic roots of their behaviors are less obvious, particularly because  they rarely talk about being hit, abandoned, or molested, even when asked.

Eighty two (82%) of the traumatized children seen in the National Child Traumatic Stress Network do not meet the criteria for PTSD. Because often they are shut down, suspicious, or aggressive they now receive pseudo-scientific diagnoses such as “oppositional defiant disorder”, meaning “This kid hates my guts and won’t do anything I tell him to do,” or “disruptive mood dys-regulation disorder”, meaning he has temper tantrums.

 

Having as many problems as they do, these kids accumulate numerous diagnoses over time. Before they reach their twenties, many patients have been given four, five, six or more of these impressive but meaningless labels. If they receive treatment at all, they get whatever is being promulgated as a method of management du jour: medication, behavior modification, or exposure therapy. These rarely work and often cause more damage.” Pg. 157

 

 

Dr. van der Kolk work went on to call the diagnosis for this group of very troubled young people: Developmental Trauma Disorder.“ As we organized our finding, we discovered a consistent profile:

  1. A pervasive pattern of dys-regulation
  2. Problems with attention and concentration and
  3. Difficulties getting along with themselves and others.

These children’s moods and feelings rapidly shifted from one extreme to another-from temper tantrums and panic to detachment, flatness, and dissociation.

When they got upset (which was much of the time), they could neither calm themselves down nor describe what they were feeling.

 Having a biological system that keeps pumping out stress hormones to deal with real or imagined threats leads to physical problems: sleep disturbances, headaches, unexplained pain, over-sensitivity to touch or sound.

Being so agitated or shut down keeps them from being able to focus their attention and concentration. To relieve their tension, they engage in chronic masturbation, rocking, or self-harming activities ( biting, cutting, burning, and hitting themselves, pulling their hair out, picking at their skin until it bled ) It also leads to difficulties with language processing and fine-motor coordination. Spending all their energy on staying in control, they usually have trouble paying attention to things, like school work, that are not directly relevant to survival, and their hyper-arousal makes them easily distracted.

Having been frequently ignored or abandoned leaves them clinging and needy; even with the people who have abused them.  Having been chronically beaten, molested, and otherwise mistreated, they can not help but define themselves as defective and worthless. They come by their self-loathing, sense of defectiveness and worthlessness honestly. Was it any surprise that they didn’t trust anyone?

 ( The Body Keeps the Score, Bessel van der Kolk, M.D. )

These young people often are in a persistent state of alarm! 

Rather then continue to get into escalating power struggles or expel these young people to "No-Where" we can begin to learn what it is we see everyday in more and more of our schools!

As always... take a second a let me know what you think and would your school or organization be interested in trauma informed training.

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Modeling calmness and not taking anything personal have worked well for me when trying to understand a child's behavior within the framework of trauma-informed care.  Too many adults, even professionals in their fields, are reactionary to a child's attempts to repeat a negative pattern of behavior that they have adopted to survive.  No services can be provided until the child feels at least a modicum of safety.  Jonathan W. you are right.  I've heard it said that the children who are the hardest to love are the ones who need it most.  Even if you are not a provider, modeling calmness is always a teachable moment and chance to lessen the unhealthy cycle.

Good examples of why the kids who need the most love get the least (because of the way they 'ask' for it).  Another reason is the prevailing 'strict father' frame (see George Lakoff) which most of us feel compelled to adopt when chaos and stress dominates.  The Strict Father frame is why zero-tolerance and Dr. Phil interventions are so popular.

Thank you Michael for sharing your powerful post highlighting our heightened awareness of our schools having such imperative opportunities to support our students with their awareness of, education with, and healing from their traumatic experiences. Your region is very fortunate to have such a passionate Champion on the front line of systems change! Thank you Michael!!

We must do all we can to help troubled students, but the greatest takeaway from the ACE Study is the benefit to be derived from preventing adverse childhood experiences...and the only way to accomplish that is by improving the quality of parenting in communities.  Visit advancingparenting.org to learn about a small nonprofit organization pioneering passive/public parenting education.

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