Greetings from sunny La Jolla, California! I hope that you’re enjoying this holiday season, whether with family and friends, or alone, and making time to recharge. My family and I had a quiet Christmas with some close friends. We watched Die Hard after eating lots of sweet potato casserole and apple pie! Now that was a blast from the past! Lots of laughs.
It’s been refreshing to soak up the sun, get in some retail therapy and eat at some super fun restaurants in San Diego. We found this great place called Sipz Vegetarian Fusion Cafe in North Park. Great vibe and fantastic vegetarian faire. North Park city block was lined with boho boutiques and trendy restaurants. And this morning, we ate brunch at a quaint little cafe called Farmer & the Seahorse. There was an old vintage silver RV right in the middle of the restaurant. Most of all, I’ve enjoyed spending time with my daughter and having all this time off from work! I could get used to this kind of life.
As I have reflected on 2018, I’m so glad to let go of a rather difficult year. Worries about loved ones, mental health challenges, people pleasing, health scares, and then losing our beloved dachsund, Peppermint, in November caused much anxiety and fear. I can’t seem to rid myself of worries about finances and relationships. Does any one have a remedy?! I enjoy listening to podcasts about living a life with more ease, creativity, mindfulness and gratitude, but it’s not always easy. I have a lot to be grateful for, and with all the terrible things that have happened in our world this year, I have nothing to complain about. Yet, fears have a way of rearing their ugly heads.
I don’t ever set New Year’s resolutions, but I do plan to focus on a few things in 2019 in the hopes of becoming a healthier, happier, more productive person. I came across a quote from the Dalai Lama recently that I love,
“We are, you might say, ‘brainwashed’ into thinking that money is the source of happiness while what we really need to know is that inner peace is something that comes from within.”
Inner peace for me comes from solitude, prayer, better self-care and self-compassion. I did not do a good job of that in 2018. Life is short. We must make the most of every day and live as though it were our last. I hope to glow in 2019 with peace, despite the challenges that life inevitably brings. More yoga practice, intentional self-care, prayer and creativity. May 2019 be your healthiest, happiest and most abundant year yet! ❤️
I’ve been a little under the weather this week and out of the office. It’s nice to just laze around watching Netflix, drinking lots of hot tea. There is much value in slowing down, although I don’t recommend getting sick in order to do so. When I do get some down time, I often realize how fast life is going and that I’m spinning out of control. Do you ever have those moments? It’s at that time when I try to slow down and bring in things that are comforting. This morning, I tuned into the NPR All Songs Considered Podcast. Wow, so soul-inspiring and just what I needed. The song list included: 1) John Denver: “Poems, Prayers and Promises,” 2) Tom Adams: “In Darkness,” 3) Sharon Van Etten: “Come Back Kid,” 4: SOAK: “Everybody Loves You,” 5: Miya Folick: “THingaming,” 6) Jason Lytle: “Color of Dirt,” 7) J.S. Ondara: “American Dream.” I loved all of the songs, but the song that struck me most was John Denver’s.
“Poems, Prayers and Promises” resonated with me deeply. Perhaps it has to do with getting older, but lately I’ve been giving much thought to the days of old, reflecting on motherhood, going to graduate school and even further back to high school and college. Reminiscing about what felt like easier times. When my daughter was growing up, I taught piano, primarily to young kids and a few adults, so I could be home with her. I often felt pressure to get a full-time job to supplement our household income, but I’m glad I didn’t. Life seemed slower, as being a mom was my primary role. My most favorite role ever. My daughter is now in college; I’m working full-time, working towards obtaining clinical licensure. The chapters related to raising a family have closed. New ones have opened, and honestly, I’m not particularly enjoying the new ones. On most days, it feels like a grind.
I guess it’s taken me this long to realize that graduate school was very idealistic, and I’m not sure it was worth all of the student loans. At times, actually often, I feel pretty disillusioned and tired. More importantly, I realize that all of the misplaced ambitions were to gain a sense of self worth, a sense of significance. After a lifetime of feeling invisible, one desires nothing more than to be seen and heard. To make a statement. To lead in some way. Adoptee stuff.
What I’m learning is that life is so much more valuable than achieving. It’s about enjoying and letting go of the stuff that brings you down. I’m still very much working on that. It doesn’t come easy. I wish that I could impress this upon my daughter, who is starting her life as a grown up. Our children learn the good and the bad from us, and I have certainly not always modeled how to manage stress and anxiety in healthy ways. She is doing so well, however, despite many challenges in her beautiful young life. I love her so. She has made all the difference.
Mothering has taught me a lot about life and love and ease. I guess that’s why I miss it so much, not that I don’t continue to mother, it’s just different now. It’s more about letting her take the wheel, trusting that even should she veer into the wrong lane, she will get back into the right lane, wiser. This is what I know: Hold the people and things you love the most close to your heart everyday. I would love to go back to Taiwan to see my birth family again. Alas, there are always obstacles. I hold them close to my heart, despite the distance.
There is something to be said and learned from achieving and making a difference. But life is short, and you cannot go back. Do what makes you happy, and don’t let naysayers dissuade you. Surround yourself with others who support you and your dreams because God knows, life is not easy. I wish that someone had told me these things when I was an impressionable young woman. I’ve worked hard since grad school. I truly hope that it has not all been in vain, as things that are most valuable do not come by way of a diploma or a degree or clinical hours. Life is precious. Your life is precious. Every single minute of it.
Today is World Mental Health Day. Let’s talk about it.
It’s estimated that one in five people experience a mental illness in a given year in the U.S. That’s 43.8 million people, or 18.5% of the population. I found a catalogue of great stories, commentaries, interviews and videos that explore mental health issues across a breadth of fields globally on Culture Trip. Check out all of the stories here.
Culture Trip is a global tech startup that inspires people to explore the world’s culture and creativity through innovative technology and a global network of local content creators. It was founded in London in 2011 by former academic psychiatrist Dr Kris Naudts and was named by Forbes as one of five fast-growing UK companies to watch. Naudts says, “In my experience, mental health challenges make you more empathetic and creative, more resourceful. Mental health challenges are a strength. Talk about it.”
Among the stories, Culture Trip speaks to award-winning author Matt Haig about his experience with depression and how sharing his story helped him on the road to recovery. We investigate how hysteria still influences women’s medical treatment today and we look into the scarcity of support in the testosterone-charged world of professional football. We meet elderly birdkeepers tackling loneliness in Singapore, attend a London supper club for people experiencing disordered eating, and learn how virtual reality is revolutionising mental health treatments. I especially love the article on the best free mental health apps for anxiety, stress and depression. Check them out!
Wishing everyone good mental health today and everyday.
Crisis Text Line: Text Home to 741741
National Suicide Prevention Lifeline: Call 1-800-273-8255
We all have that one song or songs that have helped us through tough times. This afternoon, KROQ 106.7 in Los Angeles featured songs from a special playlist called, Songs That Saved My Life. The playlist features artists performing covers of songs that helped them through a personally challenging time. This compilation benefits mental health and suicide prevention charities. Songs That Saved My Life looks to engage current artists with cover versions of those songs and share those stories with the world. Currently, this project benefits Crisis Text Line, Hope For The Day, The Trevor Project, and To Write Love On Her Arms.
This week is Mental Illness Awareness Week. In my last post, I shared research that shows adoptees are four times more likely to attempt suicide than non-adoptees. Suicide is the 10th leading cause of death in the U.S. alone and the 3rd leading cause of death for 15-24-year olds, after accidents and homicide. If you or someone you know is struggling with depression, there is a crisis text line that offers free, 24/7 crisis support in the U.S. Text HOME to 741741, or just follow this link. You can also go to the National Suicide Prevention Lifeline here, or call at 1-800-273-8255.
Visit the Songs That Saved My Life website where you can see all of the artists who contributed to this compilation. The playlist will be available for purchase on November 9th, but you preview some of the songs on iTunes, Spotify, Apple Music, and Amazon.
Millions of Americans struggle with a mental health condition. Mental illness affects us all, directly or indirectly, whether through family, friends, or co-workers. Though it is widespread, mental illness is still frequently misunderstood and stigmatized. Research shows that adoptees are more likely than non-adoptees to attempt suicide.
Although it’s suggested that a majority of adopted individuals are well-adjusted, adolescent adoptees experience a greater risk for disruptive behavior disorders, and to a lesser extent, internalizing disorders (depression, withdrawal, anxiety, loneliness) than comparably aged non-adopted individuals. 3 4 In young adulthood, adoptees have increased odds of being diagnosed with substance use and other psychiatric disorders relative to non-adoptees. Furthermore, research examining Swedish national cohorts,1 2 revealed that both intercountry, or international, and domestic adoptees were at increased risk for even more serious indicators of maladjustment, including suicide attempt and completed suicide, compared with non-adopted individuals.
Keyes, Malone, Sharma, Iacono, and McGue (2013) at the University of Minnesota studied the risk of suicide attempt in adopted and non-adopted offspring in the U.S. The results of their research have become well known and oft-quoted. Their research indicated that the odds of a reported suicide attempt were four times greater in adoptees compared with non-adoptees. You can read the research article in full here.
The adoptee community has lost a number of adoptees to suicide, including Phillip Clay. Phillip was deported to his birth country, S. Korea, because, through no fault of his own, he never obtained U.S. citizenship. He had lived his entire life in the U.S. He ended his life at age 29. There are ongoing advocacy efforts being made related to adoptee deportation. It is with great sadness that I also include Kaleab Schmidt, age 13, Gabe Proctor, age 27, Emilie Olson, age 13, Thaddeus Farrow, age 27, and Jane Trybulski, age 14, who tragically took their own lives. There are others.
October 7-13, 2018, is Mental Illness Awareness Week. It was established in 1990 by Congress. World Mental Health Day is Wednesday, October 10, and National Depression Screening Day is October 11. To take an anonymous screening for depression, follow this link to helpyourselfhelpothers.org.
If you or someone you know is struggling with depression or experiencing suicidal ideation, please take the screening and reach out for help. Call the National Suicide Prevention Lifeline at 1-800-273-8255. The Lifeline provides 24/7, free and confidential support for people in distress and prevention and crisis resources. Support can also be found in adoptee groups – many can be found on social media including InterCountry Adoptee Voices, Adoptees from Asia, Adoptees On, Adoptee Suicide Prevention, Overcoming Odds, and a Korean-American Adoptee Suicide Prevention Campaign. Additionally, check out Koreanamericanstory.org.
The more we bring awareness to mental health conditions, the more we take down the stigma and misunderstanding. I’ve struggled with anxiety my entire life, and I have loved ones who struggle with the debilitating effects of anxiety and depression daily. It is real, and it’s ongoing, sometimes despite medication. Support from others is essential. Just listening to someone who is struggling and validating their feelings provides more support than you know. Please help to educate others about mental health by openly discussing what it is and how to get help.
1 Hjern A, Lindblad F, Vinnerljung B. Suicide, psychiatric illness, and social maladjustment in intercountry adoptees in Sweden: a cohort study. Lancet. 2002; 360(9331):443–448.
2 von Borczyskowski A, Hjern A, Lindblad F, Vinnerljung B. Suicidal behaviour in national and international adult adoptees: A Swedish cohort study. Social Psychiatry & Psychiatry Epidemiol. 2006; 41(2):95–102
3 Juffer F, van Ijzendoorn MH. Behavior problems and mental health referrals of international adoptees: a meta-analysis. JAMA. 2005; 293(20):2501–2515.
4 Keyes MA, Sharma A, Elkins IJ, Iacono WG, McGue M. The mental health of US adolescents adopted in infancy. Archives of Pediatric & Adolescent Medicine. 2008; 162(5):419–425.
In this post, I’ll discuss attachment and attachment styles, including adult attachment styles. This will be a very broad discussion of attachment because it’s such a complex subject!
We know that children who are in foster care and/or have been adopted experience disruption in primary attachment relationships due to relinquishment, abuse, neglect, multiple placements, etc. The separation of a child from his/her first or natural mother is the most significant disruption. The Primal Wound by Nancy Newton-Verrier is a great resource for learning more about the significance of this initial disruption in an adoptee’s life.
Attachment can be described as “a reciprocal process by which an emotional connection develops between an infant and his/her primary caregiver.”2 It influences the child’s physical, neurological, cognitive and psychological development and becomes the basis for development of basic trust or mistrust.” It shapes how the child will learn and relate to the world and others. In other words, attachment is the give and take relationship between the child and parent primary caregiver. It is critical to a child’s healthy behavioral, social, emotional and neurological development. Healthy attachment teaches a child to trust and to form healthy relationships throughout his/her life.
I will not discuss attachment theory fully, as there are a plethora of textbooks and articles written specifically on that. Suffice it to say that key researchers include John Bowlby, Mary Ainsworth, Mary Main, and Vera Fahlberg. Bowlby believed that a child’s healthy psychological development was dependent upon a safe and functional relationship with a parent or caregiver. Bowlby theorized that attachment begins in infancy via a bond between the child and the most present, attentive caregiver. This first relationship forms the basis of the internal working models for the child, influencing his or her thoughts, feelings, and expectations with regard to future relationships. Mary Main developed the Adult Attachment Interview (AAI), which is widely recognized as the tool for assessing adult attachment. And Vera Fahlberg is a doctor who formalized the arousal-relaxation cycle, the positive interaction cycle and claiming behaviors in the early 1990s. She wrote A Child’s Journey through Placement, which is a standard training textbook for child welfare workers. Many others have stepped forward and contributed to attachment theory over the years.
In my last post, Healing Childhood Trauma, I discussed the arousal-relaxation cycle and how it influences the attachment process in the infant’s first year of life. In a nutshell, an infant expresses a need through crying, fussing, or otherwise raging, which causes her stress response system to become aroused. Her caregiver meets the need, and the infant relaxes. The child’s parasympathetic nervous system helps calm her body once the distress has passed. This dance between infant and caregiver occurs multiple times throughout the first year of life. The signs and symptoms of attachment problems develop as a result of the way a child’s parent/caregiver behaves toward her, environmental factors, and her own particular psychological traits. If a child’s caregiver is unresponsive toward her needs or inconsistent in meeting her needs, she will be at risk for attachment problems. Unattached children have difficulty relating normally to others. For example, it’s common for foster and adoptive parents to report that their child is manipulative, lacks a conscience, or is unable to show genuine affection, when these behaviors are very likely the result of insecure attachment and significant trauma. It’s important to recognize this so that the child is not punished repeatedly for bad behavior, but rather the most appropriate interventions and parenting strategies are sought and learned by the parents. The child does not have it in his wheelhouse to respond in behaviorally/emotionally appropriate ways because brain wiring and neurochemistry have been greatly altered by trauma. Essential areas in the brain that control executive function, common sense, emotional control, etc. are underdeveloped and must be healed in order for change to occur. And this takes time…I’ll say more about trauma and attachment sensitive parenting strategies in another post.
Mary Ainsworth pioneered an experiment called the Strange Situation Test. This test was developed and is used to examine the pattern of attachment between a child and the mother or caregiver. The results of the experiment were categorized into four specific types of attachment: Secure, Insecure/Avoidant, Insecure/Ambivalent, and Insecure/Disorganized. Parenting styles are associated with each of these types of attachment. The Insecure/Avoidant and Insecure/Ambivalent attachment styles are interchangeable with or otherwise known as the Anxious/Avoidant and Anxious/Ambivalent attachment styles.
Children with a Secure attachment style have a caregiver who consistently responds to them when upset. The infant cries and learns to trust that a caregiver will be available to respond to her needs. Children secure in their attachment go on to have healthy social functioning, have fewer behavioral problems at school, and can become competent leaders within their peer group. They grow up into adults who trust that they are worthy of receiving love, are able to give love/care/nurture, negotiate their needs, and remain autonomous.
Insecure Avoidant Attachment
In Ainsworth’s studies of mothers and infants, observations showed that when some infants became distressed, their bids for comfort were rejected by their mothers. The mothers of these babies were also uncomfortable with close bodily contact. The behaviors exhibited by these infants were later categorized as Insecure/avoidant. Avoidant children do not have caregivers who consistently respond to their needs. When activation of their attachment system leads to painful rejection, infants may develop a strategy where their attachment systems are activated as little as possible.2 These are infants who learn not to cry when they have a need. Avoidant infants and adults appear to suppress activation of their attachment systems, or in other words, have trouble seeking care.
In laboratory studies of babies separated from their mothers, observations revealed that some babies did not seek the mother for comfort or even interaction upon her return as most infants do2. These infants rather actively avoided the mother and became focused on toy play. Avoidant children learn to turn defensively toward self-soothing behaviors, e.g., a play activity, due to past painful rejection when expressing a need.
Evidence demonstrates that avoidant children tend to mask negative affect and replace feelings of sadness with a smile.2 These children often avoid adult eye contact, thus precluding any comfort or reassurance an adult might offer. Although avoidant children may feel and display sadness, they may do so only when there is no child-adult eye contact or when an adult is not present.
Data shows that individuals with an avoidant or Dismissive Adult Attachment style have trouble seeking or receiving care and giving care. For example, they may fail to share their concerns with others, and may, in fact, withdraw from others as they become more anxious. A number of other studies report that avoidant adults are less likely than secure adults to seek support in response to stress.
Insecure Ambivalent Attachment
Ainsworth observed that mothers of Insecure/Ambivalent infants were inconsistent in providing care. Sometimes these caregivers were loving and responsive, but only when they could manage, not in response to the infant’s signals. An infant whose mother is sometimes responsive, but at other times, preoccupied or overwhelmed, may develop a strategy to stay near the mother at all times.2 The infant cannot count on her mother to monitor her needs. She may cling and vigilantly monitor her mother’s availability in case some need arises. The infant/child takes on a disproportionate share of the burden in maintaining the connection. As a result, hyperactivation of the attachment system occurs.2 These infants/children may show extreme distress on separation and difficulty in calming upon reunion. They may display angry, resistant behavior toward the parent. The negative emotionality of the ambivalent child may be exaggerated and chronic, as the child recognizes that to relax and allow herself to be soothed by the presence of the attachment figure is risky – she may very well lose contact with the inconsistently available caregiver.2 The child may have trouble maintaining boundaries between another person’s distress and his own. Furthermore, the child may feel that the only way to gain care is by sending exaggerated signals of need.
This hyperactivation in adults with an ambivalent or Entangled Adult Attachment style manifests as an insatiability for closeness to others.2 These adults may have a desire to merge with a significant other. They portray themselves in relationships as ‘preoccupied’ and may be particularly upset by relationship breakups. The heightened desire for closeness reflects an impairment of the attachment system. Ambivalent adults may expect others to fill all their needs; thus, they have difficulty negotiating needs and remaining autonomous. They may be codependent or threatened by another’s desire for autonomy. Obviously, this behavior can lead to ambivalence and resentment in both the individual and the significant others in his life.
Children with an Insecure/Disorganized Attachment style have had experiences of maternal/caregiver behavior that is so frightening or unpredictable that they are incapable of developing an organized, strategic response to it.2 Their attachment systems are behaviorally disorganized. The child has no pattern for how to relate to her caregiver. She may behave erratically with toys and might prefer a stranger over her caregiver. These infants may demonstrate a high-pitched cry and/or shriek.
Children with a disorganized attachment style may have the most severe difficulties related to seeking care. Frightening behavior by a caregiver activates simultaneous competing tendencies: to flee to the parent as a safe haven, and to flee from the parent in response to alarm. In this paradoxical situation, there is no organized behavioral strategy available.2 The infant/child is in a terrible position, as neither proximity-seeking nor proximity-avoiding is a solution, and the resulting behavioral responses become freezing, disorientation, and/or disorganization. The adult with a disorganized, or Unresolved Adult Attachment style, has difficulty giving and receiving care/love/nurture, negotiating needs, and remaining autonomous.
It’s important to know that these attachment styles are fluid. You may see features of yourself in each of the attachment styles, or may notice that you lean toward one attachment style with one person, e.g., your spouse, and a different attachment style with another, e.g., your mother. This is normal, the point really is to notice and gain awareness.
None of us has a perfect attachment style. Learning and understanding which style I lean toward has given me incredible insight into why I behave as I do and why some of my relationships are more difficult than others. As a younger adult, I was often told that I seemed aloof, that other’s did not feel connected to me, and that I lacked facial expression. Can you guess what my attachment style is?
Upon reflection, I recognized that I did not have a strong attachment, if any at all, to any one person during infancy, as I was in an orphanage for the first four months of my life. My relationship with my adoptive parents was not emotionally close. They provided for all of my physical needs, but I did not feel connected to either of my parents. I loved them, but I had great difficulty expressing my needs and showing affection. My adoptive parents were ill-equipped to nurture a strong attachment. They did the best they could with the knowledge they had, which was pretty minimal. This insight has empowered me to be more intentional in how I interact with certain others in my life. It’s also helped me to understand how important it is for fost/adoptive parents to understand attachment, and furthermore, to get appropriate training and education. I hope that this very brief overview of attachment and attachment styles is of benefit to you and gives you some insight into your own particular style.
1 The Association for Treatment and Training in the Attachment of Children (ATTACh). Retrieved from http://www.attach.org/about-us/attach-accepted-definitions/.
2 Cassidy, J. (2001). Truth, lies, and intimacy: An attachment perspective. Attachment & Human Development, 3(2), 121-155.
Hello everyone. In this post, I wanted to talk about childhood trauma. To heal childhood trauma, it’s important to understand how trauma affects a child’s development. So, that’s where we’ll begin. If you have not yet read my last post on adoption and preverbal trauma, you can check it out here. Today, I’ll present a very brief overview of brain neurosequential development and how trauma affects this process. I am a trainer and educator to fost/adoptive parents on complex developmental trauma, attachment, and TBRI®.
First, let’s talk about childhood trauma. You can go to this link to learn more about adverse childhood experiences, or ACES, and the impact of negative experiences on an individual’s lifelong health and wellness. We know that children in foster care and children in orphanages have suffered trauma, and their ACE scores are high. The very fact that they are in such institutions is a trauma. Children in foster care typically come into care due to neglect, physical/sexual/emotional abuse, domestic violence between parents. Kids in foster care and kids who have been adopted experience separation, loss, and grief, feelings of abandonment, instability, and have often not been provided with the kind of sensory diet that promotes healthy development. Additionally, many kids in foster care have experienced multiple placements. Prolonged exposure to one or more of these factors can lead to complex developmental trauma, which psychologist Bessel van der Kolk describes as “the experience of multiple, chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature (italics and bold added).” Complex trauma impairs social, emotional, and cognitive development.
Dr. Karyn Purvis, Developmental Psychologist and Co-founder of Trust-Based Relational Intervention (TBRI®), described six early risk factors that influence the way children from difficult backgrounds think, trust, and connect with others: 1) Difficult pregnancy – the birth mother has experienced medical problems, drugs/alcohol, crisis, or other trauma. Persistent and high levels of stress throughout pregnancy affect the infant in-utero. Stress response chemicals in an infant’s brain can remain for up to a month after the mother gives birth. 2) Difficult birth – a difficult and traumatic birth is risky for lots of reasons, including perinatal hypoxia, which can lead to mild neurological insult. 3) Early hospitalization – children who experience early hospitalizations often experience painful touch rather than nurturing, comforting touch in the first days of life. 4) Abuse – the brains of children from abusive backgrounds have been trained to be hypervigilant, or always on guard, to the environment around them. 5) Neglect – children from neglectful backgrounds, e.g., orphanages, often suffer from the most severe behavioral problems and brain deficits. The message they have learned is you don’t exist. 6) Trauma – this may include witnessing an extreme event, like a natural disaster or 9/11, or any number of traumas in the child’s life. A child’s developmental trajectory will change as a result of trauma.
As you probably already know, different parts of the brain have different functions. Author and psychiatrist, Dr. Dan Siegel, says the brain is like a two-story house. Emotional reactivity, motivation, attachment, and the “fight, flight, or freeze” response are regulated in the downstairs brain. This is where the brain stem and limbic system are located. I’m not going to discuss all of the structures in the brain, but will highlight the areas that pertain to this discussion. The limbic system is involved in emotions and motivations related to survival, including emotions that are pleasurable, e.g., eating and sex. The upstairs brain regulates executive functioning, thinking, planning, control over emotion and body. It’s where the cerebral cortex or “grey matter” is located.
When you experience a strong emotion such as fear or stress, your downstairs brain sounds an alarm, and a stress response is activated. The sympathetic nervous system triggers the fight or flight response. This causes certain physiological responses to occur in your body. Think back on a time when you felt frightened or stressed. Your heart and respiration rates increased, your pupils likely dilated, and the blood flow to your muscles increased in preparation to fight or flee. This is a survival response. Other parts of your brain are off-line when your stress response is activated. In other words, thinking clearly or executing a well-defined plan become much more difficult when your stress response system is activated.
Now let’s talk about brain neurosequential development. The brain develops sequentially from the bottom to the top and inside-out from the brain stem to the cortex. Our downstairs brain comes much more developed at birth than our upstairs brain. Each part of our brain develops at different times beginning in-utero and continuing to adulthood (the brain is fully developed around 25-years of age). An infant’s brain stem is the most developed region of her brain. When distressed, she needs a responsive caregiver to help her regulate. She has a need and expresses it through crying, fussing, or raging. The need is gratified when a caregiver changes her soiled diaper, feeds her, provides movement, skin-to-skin contact, speech, and warmth. The parasympathetic nervous system helps to put on the brakes and calm the body once the distress has passed. All of these actions serve a very important purpose – to teach the infant how to self-regulate. We refer to this dance as the arousal-relaxation cycle.
When abuse and neglect occur, it interrupts the arousal-relaxation cycle, and consequently, affects the attachment cycle. This leads to serious problems in the development of personality, which has long-lasting effects into adulthood. When the cycle is not completed and repeated, difficulties may occur in very critical areas, including social/behavioral development, cognitive development, emotional development, cause and effect thinking, conscience development, reciprocal relationships, parenting, and accepting responsibility. Furthermore, positive or negative experiences that occur during critical or sensitive periods of brain development alter the development in that particular area, which cascades and alters other areas of the brain. When children experience repetitive activation of the stress response system, their baseline of state of arousal is altered. The child lives in an aroused, hypervigilant state, ill-prepared to learn from social, emotional and other life experiences. She is living in the minute and may not fully appreciate the consequences of her actions. Her brain stem has “muscled up” in fight, fright or freeze mode, as any part of the brain that we use most often is the part most developed. Her ability to control her emotions and body and behave in ways we consider age appropriate may be severely compromised.
As a side note, two Yale pediatricians, Provence and Lipton, found that if caregivers did not meet the needs of infants quickly, they stopped crying within a period of 30-60 days. The infant learns that no one comes. She has lost her voice. Despite the absence of crying, the baby may still be hungry, scared, soiled, or in pain. Additionally, she is likely to have high levels of cortisol, or stress hormones, released in her brain, though outwardly she may appear to be calm and not at all distressed.
Infants and young children need to feel safe. They use attachments with their caregivers as models for future relationships. Caregivers are a secure base from which infants can explore their physical and social worlds. As you can well imagine, children who have histories of abuse or neglect very often have not experienced felt safety or secure attachment. This sets them up for attachment difficulties with foster and adoptive parents and difficulties in relationships with others.
There are numerous theories and therapy approaches directed at parenting and healing children who have experienced trauma, including abuse, neglect, grief and loss. I will delve into this in later posts, but a good resource is Attachment Theory in Practice: Building Connections Between Children and Parents edited by Karen Doyle Buckwalter and Debbie Reed. There is a chapter at the end of the book called The Voice of the Adoptee written by adoptees Faith Friedlander, Clinical VP and co-founder of Kids and Families Together, and Melanie Chung-Sherman, Licensed Clinical Social Worker and psychotherapist. Finally, an attachment-based professional/parenting resource that includes adoptee voices!
We know that traditional parenting does not work with kids who have experienced trauma. With deep fear comes a desperate need for deep control. It’s a survival strategy, as these kids do not know to do anything better. The way they think, feel, learn, process the senses, and interact with peers has been profoundly altered due to trauma. Their stress systems stay on, and the smallest thing or a transition can cause a meltdown. They fight or flee. They have lost their voice. Timeouts, spankings, and lectures are not effective and may further traumatize the child. There is hope. Parents must become healers and help repair their child’s brain by creating the proper environment for change. The brain can adapt and new behaviors can be taught and learned. In the next few posts, I’ll offer more resources. Stay tuned for an overview on attachment and attachment styles in my next post.
Keck, G.C., & Kupeckty, R.M. (2009). Parenting the hurt child. Colorado: Navpress.
Perry, B. (2005). Maltreatment and the developing child: How early childhood experiences shapes child and culture. Retreived from http://www.lfcc.on.ca/mccain/perry.pdf.
Provence, S., & Lupton, R. C. (1962). Infants in institutions. New York: International Universities Press.
Purvis, K. and Cross, D. (July 2013). The healing power of “giving voice.” Retrieved from http://www.adoptioncouncil.org/files/large/f7bb17e8fba418b.