I work with many children who have been traumatized in extreme ways, and have Post-Traumatic Stress Disorder.  Before adoption, many children in my practice were raised in orphanages under sub-optimal conditions, or suffered physical abuse or neglect in a birth family torpedoed by violence, drugs or alcohol.   Adoptive parents hope these children will flourish with enough love in their new home.  But lurking beneath the surface, the prior trauma impacts the child’s present life, and the way his or her nervous system functions.

Trauma arises whenever a child’s security and safety is in danger.  

One child at age 4 suffered his birth mother falling into drug addiction, and severely neglecting him.  Birth mother would take off on drug runs every weekend, and the 4-year-old had to fend for himself, without any parental supervision.    There was no food in the house and this boy remembered having to climb up to the top cupboards to find uncooked macaroni he would eat to survive.  That is trauma.  Imagine his terror and fear of being on his own, and the fierce sensations of starvation he faced.   And he faced this alone, without anyone there to comfort him.   Worse still, the neglect was happening at the hands of someone who he had the right to count on.  Repeated traumas like this are the most damaging.  Repeated trauma re-wires the central nervous system, making a child hypervigilant and on guard for the next abandonment, the next time of abandonment and hunger which is sure to come. Unfortunately, when a child such as this is taken into protective services and becomes part of a healthy family, the re-wired nervous system and PTSD travels with the child.

The trauma-wired nervous system travels with the child to their new adopted home

So when adoptive parents take into their lives a child who was previously traumatized, they may be unprepared for situations in which the child shifts rapidly from the Calm State (Regulated, able to handle arising emotions) to Fear-Based Nervous System States (Dysregulated, tantruming, emotionally flooded).    There are three main nervous system / mental states a child can be in at any one time.  A child may move rapidly from a calm state to a more severe state, and then take a long time to recover back to the Calm State.  Here are the three basic states:
The Calm State
The Aroused State (the nervous system is activated and on alert due to a sense that danger may be near)
The Fear/Terror/ HyperArousal State (the nervous system is on red alert because extreme danger is perceived)

The Calm State, of course, is the most optimal.  In the Calm State a child has their Brain Function working optimally, can concentrate, pay attention, take in ideas and learn.  In the Calm State, the child’s nervous system is calm and regulated, and they can show good judgement and maintain control over impulses.

As the Chart below shows, if a child moves into the Aroused or Hyper-Aroused state, all these normal, optimal brain functions are severely compromised:

NERVOUS SYSTEM STATES & DYSREGULATION:

                                     CALM         AROUSAL      HYPER-AROUSAL
                                                                                       Fear / Terror

Brain             Optimal           Unable to        Shut Down
Function                Learning         Think              Disassociated

Concentration,    Good                Distracted &   Attention Narrows.
Attention,                                 Internally         Focus is only on
Ability to Learn                      Preoccupied   The Perceived Threat

Nervous System Calm &            Fight, Flight    Will do anything

Regulated        Freeze,               or say anything
Fidget                 to avoid the threat

Impulse Control Thoughts       Impulsive/    Immediately Reactive
& Judgement        Override       Compulsive     Impulses Take Over                                     Impulses                                 Fight / Flight / Freeze

A child who has been exposed to extreme early-life trauma will be triggered into emotional dysregulation by situations which a non-traumatized child could easily navigate. 

What might be a minor upset for the non-traumatized child, for example not getting a cookie when he wants one, can be lead to a major meltdown for a previously traumatized child.   This is especially true for the child who suffered neglect or food deprivation earlier in life in their birth family or orphanage.

Triggers can push a child from the Calm State into a Hyper-Aroused, fear-based state

One child I worked with years ago, had PTSD reactions which demonstrate how triggering works.  He had spent his first four years in a highly dysfunctional drug family, before being removed from the birth family and adopted.  He had witnessed birth dad regularly beat up birth mom during alcohol-induced fights.  He had witnessed the police come to the family home to break up the yelling and fighting more than 2 dozen times.  Eventually the child was taken from the home.  Because the police came so often, and eventually took him away, he associated the police with danger:  being removed from his birth family which is a scary thing for any child, even if home is highly violent.   Triggers arise years later and make the past trauma, present in the Now.  The child’s nervous system reacts automatically and involuntarily, expecting that the past trauma will occur again in the present.  If police show up, he could be taken from his adopted family too.  One day he was with his adoptive mom at a store at the check out line.  The clerk, noticing the long line, spoke into her shoulder microphone that she needed “backup.”  The child’s behavior changed for the worse instantly.  The boy became very agitated and dysregulated.   He began fidgeting, pulling on adopted mom, demanding “let’s go” and making things fall from the store racks.  Normally a child might get a scolding for acting out, but adopted mom recognized what was happening:  Her adopted son had been triggered into the Fear/Terror/Hyperaroused state.    Adpoted mother recognized that her son was “not just being difficult” but had been triggered into the Aroused State, and she understood that making the child feel SAFE immediately was the correct response.  Many less skilled parents would have given a lecture or consequences for bad behavior.

Knowing which of the three states a child is in makes a world of difference in terms of effectively parenting them in the moment.    For example, words and lectures that require executive function / brain power, won’t work with a child in the Aroused State – their brain is hijacked by fear at that moment.   The first order of business is to calm the child, make them feel safe.  Later when the child returns to the Calm, Regulated State talking and educating are possible.  But no learning can occur when the child is activated and Aroused in fear.

A child in the Hyper-Aroused Fear State

For a child in the hyperaroused fear/terror state, attention narrows and focus is only on disarming the perceived danger or threat.  The child’s nervous system becomes overwrought with fear and the child will do or say anything (including habitual lying) to avoid the threat.  Impulse Control is lost, and the child can become immediately reactive and impulses take over.  Adoptive parents need a different set of skills and tools to help a child in this state.   As adoptive parents,  we may not always know what triggers our child,  but with sensitivity and awareness, we can learn what plunges our kids into The Fear/Terror/HyperArousal State.  And we can be prepared with the key tools to help them return to the Calm State.  (These tools will be the subject of our next blog post.)