Canst thou not minister to a mind diseased?
Pluck from the memory a rooted sorrow
Raze out the written troubles of the brain
And with some sweet oblivious antidote
Cleanse the stuffed bosom of that perilous stuff
Which weighs upon the heart
William Shakespeare,
Macbeth, Act V Scene iii
Children can appear
traumatised for many reasons including being gifted and talented. For some children
and young people the stress of being highly able can be a lot to deal with especially
on top of other difficulties and trauma in their lives. Take the following as a
scenario:
What we may know:
A young
child in primary school has an EP assessment and has been identified with a
full-scale IQ of 140 and is high ability in literacy. The child is in the top
set in class. Not particularly high ability in any other area. Is bored in
school and under challenged coasts and is extremely disruptive in class. Can be
difficult, arrogant and indifferent to staff. Has social and emotional difficulties
with their peers; find playtimes particularly challenging. Can discuss on a
very adult level, asks difficult questions and is bossy and opinionated.
What we may not know:
The child
is from a poor socio-economic background, was premature at birth and the mother
is an alcoholic and the father has passed away. The family live and depend on
benefits. The child is the middle child of seven children and has to help with
taking care of their brothers and sisters. Prior to going to school the child
has to deliver his two younger brothers to school (which is two bus rides away)
and then get him to school. The child’s support systems at home are poor and
the child is left to his own devices more often than not. After school this
child picks up the two younger children, goes home and helps to make dinner and
get the children to bed, then endeavours to do his homework and get himself to
bed and so the scenario begins again at 6am the next morning.
If you add all this
together and then consider anything else that we may not know, you may begin to
see how a child maybe suffering from the symptoms of trauma and how this will
impact on their behaviour. If you then add to this the characteristics, traits
and behaviours associated with high ability you may then begin to see how the
behaviours can be heightened.
Behaviours we may
see as a result of ability and trauma:
Disruptive
Fidgets
Precocious
Rude
Competitive
Pedantic
Passionate
Perfectionist
Argumentative
Aggressive
Anger
Frustration
Intolerant
Abusive
Unreasonable
Stuttering
Selective Mute
Dissociation
When children are
traumatised from a young age they can develop Acquired Brain Injury (injury to brain
function). Children who are traumatised may find school difficult to manage and
the trauma may lead to some of the following impairments and distortions:
- Speech,
language and processing disorders
- Learning
difficulties
- Distorted
education narrative
- Emotional
and behavioural difficulties
- Difficulties
with social connectedness and integration
Research tells us
that adversity prior to birth can lead to lasting developmental impairment and
impaired brain function. Such adversity can also have an impact on the capacity
of the child to benefit from the attachment process. Impairment can be caused
by some of the following:
Adverse genetic inheritance Maternal
exposure to illness
Extreme deprivation Trauma
Toxic substances, e.g. alcohol,
drugs, radiation Head injuries at
birth
Lack of oxygen at birth Complications
of prematurity
Low birth weight
Alcohol is a
neuro-toxin which adult brains can tolerate – baby brains cannot. Certain
traumatised individuals have the capacity to turn off the pleasure parts of
their brain and start to crave mind altering substances, e.g. alcohol, sugar,
caffeine and nicotine – to name but a few. Some traumatised individuals show
signs of other illnesses, e.g. migraines and headaches, breathing problems,
aches and pains and avoidance techniques, e.g. not wanting to go to school.
Human brain
development (the useful brain) develops after birth. Very few neuro-connections
are there at birth but during the first year of life the brain mass doubles and
the foundations are laid in the brainstem to begin to regulate our emotional
life. In year one of the development of the baby brain, social interaction is
the main influence. In year two those neuro-connections that have not been used
and developed in babies first year of life “drop away” and the one that are
left become coated in myelin, stay and become physical structures, e.g. fixed
and firm in year two and we begin to integrate all the mass of sensory
information our presents to us. From years one to four the foundations are laid
to regulate our emotional life and from years two to six we begin to establish
the foundations for the thinking cortex. It is now that we begin to be capable
of abstract thought, cognition, meta-cognition, learning and learning how to
learn.
If all goes well we
have laid the foundations for development capacity of integrating our physical,
emotional, intellectual, social and spiritual development. Personality is not a
given from birth. If all does not go well…… our brains can be depleted, damaged
or injured so that the developing personality can be harmed. With help and
support all is not lost and we are never beyond the reach of healing. Primitive
patterning can be changed with time and patience of the caregiver, e.g.
parent/carer, teacher, foster parent.
If a baby’s attachment
needs are not met at birth and soon after, this can affect the structure of the
developing brain. Symptoms for a child can be lack of self-regulation, e.g.
temperature, intake of food, stress and processing disorders. Many high ability
children have great difficulties with the processing of information, e.g.
reading, writing, visual and auditory processing; some children with VPD/APD may
have poor filters in areas like noise, light, crowds.
Babies are born
completely helpless and to survive they must develop a bond between themselves
and their main carer/s through scent, taste, touch, sound and the parental gaze
checked constantly by the baby. To feel safe the baby must develop a deep sense
of safety with their parent/carer in order to become less controlling and
develop a healthy dependency.
Older children and
young people with unmet needs may seek the attention of their parent/carers and
be very controlling and/or very dependent. Children with unmet attachment needs
may:
- Be unable to form core identity
- Be profoundly puzzled by relationships of
every kind
- Lack any fundamental sense of safety
- Be very demanding of attention
- Be very controlling
- Be very dependent
Children with
behaviour difficulties may be suffering from trauma driven by unmet primitive
needs at birth – they are NOT naughty children.
Babies and young
children require physical attunement with their parent/carer; babies and
children need a network of main carer's and bonders in order to survive and
develop into balanced adult individuals. They engage in an intimate dance of
conversation from birth where their bodies and brains, feelings and thoughts
begin to work in tune; this attunement patterns within the baby brain.
Attunement provides the blueprint for all human interaction and stress
regulation is the first pattern. Young babies cannot regulate stress and
unregulated stress injures the brain. When a mother or carer is soothing a
stressed baby as the carer’s heart rate, blood pressure and muscles calm, so
the baby’s calm. Self-regulation of stress at birth is nil and children who do
not have these needs met as babies may be unable to regulate stress. It is
important to help children self-regulate.
Children
suffering from trauma can be:
Hyper-aroused OR Dissociative
(Gifted/Over-excitable/ADHD) (Gifted/hypersensitive/solitary/isolated)
Dissociation
reduces pain and creates a coping mechanism for the survival of acutely
traumatic situations.
Dissociation – a defense against overwhelming stress
where the individual cuts themselves off from conscious awareness of their senses
that makes use of the human capacity to split awareness.
Hyper-arousal – a disorder involving persistent
deregulated stress.
Attunement – the process through which the infants
carer, by mirroring and then leading change in the vitality and effect of the
infant, enables the young child to develop regulation of stress, affect and
impulse.
Extreme stress
causes loss of blood to the brain and this incites rages. Traumatised children
often find it difficult to self-regulate mood. Young children are subject to
limbic storm rages when their brains are at an unstable point of development
consequently they need their attuned carer to keep them safe, contain the rage
and reintegrate them. When this happens the adults are role modelling self-regulation
patterns and the young child learns:
- To manage aggression
- To manage destructiveness
- To manage anger
Limbic
System – A group of linked
structures in the brain centrally involved in emotion, memory and the
processing of complex social and emotional information.
When children do not
develop these skills they may find it hard to manage such behaviours. Add to
this the stress and misunderstanding of being gifted and having to manage the
traits, characteristics and behaviours associated with high ability and you can
then, perhaps, understand the impact of trauma on a gifted and/or high ability
child. Many of the processes for speaking our feelings can be knocked out of us
by trauma. The child that stands blank when asked why they did or said
something often really cannot remember why or what they said due to trauma and
dissociation.
Children
with positive attachment will generally respond:
impulse – thought – action
Traumatised
children will often respond:
impulse –
ACTION – thought
This may account in
many cases why gifted children tend to display what some professionals may
consider negatives behaviours. When working with children how do we know what
traumas they may have dealt with in their short personal lives (and may still
be ongoing)? Add to this the traits and characteristics of giftedness (which
many professionals do not recognise or understand) and it may begin to come
clearer as to the levels of trauma in some children within our schools.
Being gifted, or
having gifted characteristics that are not understood, can, and will, cause
trauma in children which can lead to (or exacerbate) unwanted behaviours.
Children who have unmet attachment needs from birth and who are gifted will
have double the dose of difficulties. When working with children we need to be
aware of these concerns and difficulties in order to have empathy, compassion
and understanding of what is required to endeavour to support, help and heal
and traumatised child.
Recovery is not quick,
but traumatised children can learn to think differently and have healthy happy
lives. The traumatised child will need to be surrounded by a secure team of
adults who understand and are able to work with the child; a multi-disciplinary
team. Trauma disrupts cognitive functioning and some children can think it is
their fault, they can try to stop themselves recovering because we do not know
how or who we will be once we recover and this can be extremely scary. Trauma
can take over our identity and being gifted may be one of the triggers for
trauma. Trauma can stop articulation as it turns off the part of the brain that
enables us to articulate our feelings. Intelligent individuals can’t articulate
under severe trauma or stress.
You will find that
traumatised children/individuals tend to stick together because their internal
physiology matches and mirrors each other – like minded. Just like gifted
individuals understand each other and stick together so do traumatised.
Carers, teachers and
professionals living and working with traumatised children are likely to suffer
from Secondary Trauma which is where it becomes very stressful for the
caregiver or teacher to be in the company or around the traumatised child; they
may be unable to continue to enter the emotional space of the traumatised child
and begin to share the child’s avoidance. They too will begin to show the
following symptoms:
Anger
Tearfulness
Fearfulness
Changes
in health
Eating disorders
Excessive drinking
Substance abuse
Illness
Jumpiness
Anxiety
Nightmares
Hyper-vigilance
Change in sleep patterns
Depressions
Those working with
traumatised children are the ones most likely to suffer from Secondary
Traumatic Stress Disorder (STSD). The three key preventative factors are
training, support and regular supervision.
Traumatised
children need:
1.
Help to develop trust - Affective
attunement – soothing, stimulation, trust
2.
Responsibility - Re-integrative
shame – impulse, choice, responsibility
3.
Self-control - Sociability
– self-control, reflection, reciprocity
Appropriate
treatment for trauma:
1.
stabilization – safety, explanations, words
for feelings
2.
Integration – physiological, emotional,
cognitive
3.
Adaptation – social connectedness, self-esteem,
joy
Working
with traumatised children:
1.
Safety
– soothing hyper-aroused children
2.
Engaging – stimulating interest and teaching
about trauma
3.
Trust & feelings – learning
connectedness
4.
Managing self – regulating impulse and the
body
5.
Managing feelings – choices and emotional
processing
6.
Taking responsibility – making sense of the
world we share
7.
Developing social awareness – learning self-control
8.
Developing reflectivity – promoting self
esteem
9.
Developing reciprocity – learning that life
can be joyful
You have brains in your head
You have feet in your shoes
You can steer yourself in any direction you choose
You're on your own
And you know what you know
And you are the child who will decide where to go
Dr Seuss
