Archive for the ‘child development’ Category

I was going to write about re-enactment, a psychological byproduct of trauma from exposure to danger, but I can’t stop thinking about the shooting at Sandy Hook school.  In articles in Huffington PostSFGate, and New York Times Online, I look for pieces in which a more in-depth understanding of the psychology of the shooter Adam Lanza is revealed, but all I ever see is the tired phrase “personality disorder” as if that explains anything.

In other articles, he’s referred to as autistic or Asperger’s. In one article, a high school classmate remembered Adam as a weird kid who ducked in and out of class, carrying a black attaché case. Someone else mentioned that he was ‘one of the Goths’. I just want to know why a kid whose suffering was clear to everyone wasn’t helped. How do kids become such loners?  Why does everyone know that Adam Lanza was different or “socially awkward” or “painfully shy” and obviously needed guidance or friendship but was just left to ‘go his own way’?  And why was an adult who was head of the high school technology club to which Adam Lanza belonged charged with watching out for the boy because he couldn’t feel pain?

Another question I have is, was Adam on medication?  If so, how long?  What are the side effects of these medications?  At what age was he medicated?  What part did a drug play in Adam Lanza’s behavior?

I remember the rage I felt at age thirteen and at twenty-two. I didn’t know how to cope with it and acted out. The school psychologist was worthless; in fact, he exacerbated the situation and increased my rage. The principal of the grade school acted like a bad cop in his dealings with children, further enraging me. When I was twenty-two, the counselor at the college I attended was a Freudian analyst who frightened me. Many times, we are having problems that our parents can’t solve. Sometimes, our family is the problem. We look to society and its institutions for help. Where was the help for Adam?

What do children do with their anger?  Are they given tools to cope and understand themselves?  Is there a space for mental health training in schools?  Was Adam Lanza filled with uncontrollable rage?  Perhaps he had experienced some early trauma that he was unconsciously acting out on?  Maybe re-enactment is a relevant topic of discussion after all. Adam could have been “re-creat[ing] the moment of terror, . . . in an attempt to undo the tragic moment . . . commonly, traumatized people find themselves reenacting some aspect of the trauma scene in disguised form, without realizing what they are doing” (Herman 39-40). Was Adam suffering from undiagnosed post-traumatic stress?

Obviously, the situation is complex and all I have are questions and more questions. I am waiting for an article that honors the complexity of the human condition in its attempt to provide answers. In the meantime, I am praying that our society moves forward and changes in some big, brave ways in response to this enormous tragedy.

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I love this self-portrait I made with colored pencils and magic marker thirty-two years ago this month. I am soft and peachy, vulnerable and open. All my features are accounted for (in previously posted artwork, parts of my face are sometimes either missing or in shadow). And my hair is like a golden crown.

This ‘photo’ was taken after having been in therapy with Lee O. Johnson for two years. When I first arrived on her doorstep, I was in turmoil. I didn’t want to try to kill myself again, so I showed up at the Berkelely Women’s Center where she was womaning the phones. Seeing my distress, she clicked on the message machine and ushered me into another room.

Oddly, she had me sit on the floor between her legs so that my back was to her chest. That was weird, but it made it easier to talk since I didn’t have to look at her face. “I need to cry, but I’m afraid my stitches will burst,” I said. “I had an operation on my stomach when I was twenty-six days old. I know it sounds crazy.”

She pulled me gently to her, and I leaned against her chest. “Go on and cry,” Lee said in a soft and motherly tone. “You’re ok now. The stitches won’t break.” She hugged me to her and I wept. I sobbed. I let myself have my tears. Hardened to my pain and grief for twenty-six years, I was able to find relief. The picture is evidence of my opening to myself. I had come home emotionally after all that time, one of the lucky survivors.

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Here’s a photo of me at 13. I was called a hard girl or a hood, terms popular in working class New Jersey neighborhoods in the ’50s and ’60s. I’m mad as hell and I don’t know why. I smoke and carry a switchblade in my pocket. I glare at everyone I see in a dare and am constantly on guard. What’s the problem?

One day, my beloved, former fifth grade teacher, Mr. Rubin, stopped me in the grammar school hallway, just after I’d gotten kicked out of graduation practice, and asked me why I was making so much trouble. He told me that the principal wanted to expel me from school, making it impossible for me to graduate.

I thought hard about this question. Mr. Rubin had been my favorite teacher and I owed him an explanation because number one, he was going to talk to the principal and advocate for me to graduate and two, he cared about me and I felt his love. I leaned back against the wall and racked my brain, but nothing came. “I don’t know,” I said helplessly.

Of course I didn’t. No one even talked about Post-traumatic Stress in the ’50s much less knew about it. The closest people came was in discussing the hush-hush topic of shell shock that World War II veterans suffered. What I knew for certain was that as an adolescent, I felt vulnerable, terrified, and helpless. A gang, a switchblade, cigarettes, and a tall, strong boyfriend who protected me helped me cope. Drinking on weekends helped. I was drawn to the troubled kids. I was a troubled kid.

At this time, I was also cutting my arms with razor blades, trying to soothe myself, odd as this may sound. After slicing my boyfriend’s initials into my arm, I’d carefully wash the cuts, dab them with cotton balls, and apply ointment, feeling sorry for myself. I remember the satisfaction I felt covering the wound with a band-aid. Caring for my cut helped me have compassion for myself, a diversion from the messages of self-loathing and fear broadcasting in my brain.

When traumatized folks enter stressful developmental periods in their lives, the anxiety they already feel from PTSD is exacerbated. Since I didn’t know that I had PTS symptoms–hypervigilance, exaggerated startle response, difficulty falling asleep, recurrent nightmares, anxiety–I didn’t understand my behavior.

When children are making trouble at school, PTSD may be at the root or be a contributing factor. In any case, blaming and/or stigmatizing the child or teen-ager is not the answer. Caring is the answer. A creative response is the answer.  Understanding and patience are required. Gangs are often how kids cope with PTSD when they aren’t getting help any other way.

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An article by Dr. Bruce D. Perry et al is a must-read for all those trying to understand the impact of infant trauma on a person’s life:  “Childhood Trauma, The Neurobiology of Adaptation, and ‘Use-dependent’ Development of the Brain: How ‘States’ Become ‘Traits.'” I became interested in this article because I believe that there are aspects of my character that, rather than simply being my personality, are actually qualities shaped by early trauma. These so-called “traits” are behaviors, somatic patterns, and thought ruts that no longer serve me. In fact, while they may have saved me long ago, they disempower me now.

The article is somewhat complex, so I’ve selected some quotes to help you see what Perry et al are getting at.

“Traumatic experiences in childhood increase the risk of developing a variety of neuropsychiatric symptoms in adolescence and adulthood ” (273).

“Ultimately, it is the human brain that processes and internalizes traumatic . . . experiences. It is the brain that mediates all emotional, cognitive, behavioral, social, and physiological functioning. It is the human brain from which the human mind arises and within that mind resides our humanity. Understanding the organization, function, and development of the human brain, and brain-mediated responses to threat, provides the keys to understanding the traumatized child” (273).

“. . . traumatized children exhibit profound sensitization of the neural response patterns  associated with their traumatic experiences. The result is that full-blown response patterns (e.g., hyperarousal or dissociation) can be elicited by apparently minor stressors” (275).

In this article, Perry et al make the case that “reactivated” fear coming from an oversensitized brain stem and midbrain due to trauma can cause hyperarousal: “hyperactivity, anxiety, behavioral impulsivity, sleep problems, tachycardia [abnormally fast heart rate], hypertension, and a variety of neuroendocrine [hormonal] abnormalties” (278). These conditions and behaviors are states NOT traits.

On the other hand, oversensitized brains can be  result in “dissociation.” For example, if an outside  stimulus evokes the trauma, a person may freeze or numb him or herself. A child may “disengag[e] from stimuli in the external world and attend [. . . ] to an ‘internal’ world” (280) as in daydreaming or fantasizing. As a result, a child may falsely be understood to be extremely shy or uncooperative. Dissociation and hyperarousal are “states” created by early trauma. In adulthood, many of us have wrongly come to accept them as our personality “traits.”

Another major point from the article is that traumatized infants and children do not simply get over their traumas. According to Perry et al, “children are not resilient, children are malleable” (285). In fact, to assume infants and children were not affected by the trauma or will grow out of it is not only incorrect but destructive. Perry et al leave us with this final point: “Persistence of the destructive myth that ‘children are resilient’ will prevent millions of children, and our society, from meeting their true potential” (286).

For me, I just want my real self back.

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In the Realm of Hungry Ghosts –  Close Encounters with Addiction,  a book by Dr. Gabor Maté, provides new information about addiction. “He locates the source of addictions in the trauma of an emotionally empty childhood, making it a relational rather than a medical problem,” according to Dr. Harville Hendrix. Maté contends that our brain chemistry is altered by early trauma, making addictions of all sorts more likely. Here’s some quotes to interest you in the material. I’d love to hear your thoughts about it.

“From a medical point of view, addicts are self-medicating conditions like depression, anxiety, post-traumatic stress, or even attention deficit/hyperactivity disorder (ADHD)” (36).

“A hurt is at the center of all addictive behaviors. . . . The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden—but it’s there. As we’ll see, the effects of early stress or adverse experiences directly shape both the psychology and the neurobiology of addiction in the brain” (38).

“We shouldn’t underestimate how desperate a chronically lonely person is to escape the prison of solitude. It’s not a matter here of common shyness but of a deep psychological sense of isolation experienced from early childhood by people who felt rejected by everyone, beginning with their caregivers” (45).

“‘Recent brain imaging studies have revealed an underlying disruption to brain regions that are important for the normal processes of motivation, reward, and inhibitory control in addicted individuals. This provides the basis for a different view: that drug addiction is a disease of the brain, and the associated abnormal behavior is the result of dysfunction of brain tissue, just as cardiac insufficiency is a disease of the heart–Nora Volkow, MD'” (133).

“Three-quarters of our brain growth takes place outside the womb, most of it in the early years. By three years of age, the brain has reached 90 percent of adult size . . .” (191).

“The dynamic process by which 90 percent of the human brain’s circuitry is wired after birth has been called neural Darwinism because it involves the selection of those nerve cells (neurons), synapses, and circuits that help the brain adapt to its particular environment, and the discarding of others” (191).

“The three environmental conditions absolutely essential to optimal human brain development are nutrition, physical security, and consistent emotional nurturing. . . . The third prime necessity–emotional nurture–is the one most likely to be disrupted in Western society. . . . emotional nurturance is an absolute requirement for healthy neurobiological brain development” (193).

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This post is inspired by Fred Vanderbom’s Survivors of Infant Surgery blog post “Scar Acceptance 2.” He writes about the challenge of making peace with our pyloric stenosis scars. And in his post, he includes a wonderful photo of he and his wife in swimsuits, lounging on beach chairs at the side of pool. He has come a long way with regard to “scar acceptance.”

I have always had a love/hate relationship with bathing suits because of my feelings about my scar from pyloric stenosis surgery. In my family, I was taught to feel ashamed of my scar.

Here’s a photo of me standing next to my brother at Sandy Hook, New Jersey. I am wearing what I think of as the dangerous suit. Since the straps tied behind the neck, I was always worried about them coming loose. Once while swimming in the Atlantic Ocean, the top of the suit literally flopped forward from the waist up, exposing my scar!  I quickly submerged myself to my chin and re-tied my straps, double knotting the bow. My scar was ugly and I wanted to stay cute. When that bathing suit wore out, I bid it good riddance.

In this photo, I wear my black tank suit, as it was called. Why it was called a tank suit, I don’t know, but I did think of it as protection. This suit was stretchy and the straps didn’t need to be tied. See those three white discs on my chest?  The buttons were big and clown-like. Just beneath them and a little to my right sat the pyloric stenosis scar. To me, the buttons and I had a secret; we knew the scar was underneath but no one else did. We fooled everyone. I felt powerful.

I wonder what it would have been like if my brother had been the one with the stomach scar.  He certainly would not have been able to hide it during swimsuit season; it would have been much harder for him. One thing’s for sure–parents can help kids accept and befriend their scars. They can help them see their scars as marks of power and survival. Scars can show how strong one is and how good one is at healing.

Scars can also be cool. I remember reading a scene in a memoir in which a little girl pulls up her dress at her birthday party to show off her cancer surgery scar. The kids oooh and ahhh. One child actually says that he wishes he could get one!  She lowers her dress, and they all go back to batting balloons around the room. You bet her parents had everything to do with her ability to accept her scar. Luckily, my illness was cured unlike hers. But she inspires me to one day be able to feel pride about my scar. Scar Pride!  Would make a cool T-shirt.

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Right before I left for Iowa to attend The Examined Life Conference, I saw my chiropractor. She has helped me for the past year recover from a concussion and whiplash, so I am in deep gratitude to her. But after this particular adjustment, I had a problem. As I lay on my back, she suddenly pulled me up by the shoulders in such way that made me lock my hips in defense. She did it again. I felt discomfort but didn’t think it a big deal at the time. It was, however, a big deal the next day.

My  back and hips were so sore that I couldn’t make a move without pain. Here I was preparing for my plane flight to Iowa, contemplating hauling luggage around the airport, and I couldn’t even sit down comfortably.  At first, I was clueless about  what had brought on this condition. I thought and thought about any strange movement I had made or whether I had pushed myself to move in a way that had hurt me. Nothing came to mind. Then the light bulb lit up. It was that sudden move my chiropractor had made.

I felt angry.  Had she warned me of what she was going to do, I would have been ok. But I was expecting her to do what she always did when I was on my back–adjust my cerebral spinal fluid by a gentle lifting of the head, accompanied by my taking deep breaths. I was in relatively good shape when I walked into her office and I was in pretty bad shape a day later. It felt right and natural to be angry because indeed, I’d been violated, albeit unintentionally.

The next day, my neighbor, a Reiki* practitioner, suggested I let her work on me. After an hour of healing touch, trust returned. As I walked home, I felt my feet firmly on the ground and heard these words: My body is sacred. She had helped me regain a feeling of wholeness and integrity. She had rebalanced my body. I still felt pain, but it had diminished. Most importantly, I felt that a negative energy was gone. In its place was love.

This experience of injury and healing was such a great lesson for me. I thought back to what it must have been like for me to undergo a stomach surgery before I was even a month old. At that time I was violated, no matter the intention and the circumstances, and must have felt so angry. And when no one was available to soothe me in recovery–my mother was relegated to looking in through a window from the hallway and the nurses were so afraid of infection they dared not linger–I must have felt hopeless. And if my pain was not properly managed, which seems likely due to the PTS symptoms I experience, I must have gone numb–a sort of fugue state, if you will. Another name for it? Depression.

As I was pondering all this after my wonderful Reiki session, I realized that babies who’ve experienced trauma need some type of ceremony to help them regain trust, balance, and most of all, a feeling of the sanctity of their own bodies. Sacredness must be re-established. Touch is the key to this act of reconstitution. Loving touch must be a part of the healing. There must be some way that hospitals incorporate this understanding and make an effort to provide care. Touch must be administered as wisely and carefully as medicine. Otherwise, the wounding continues. What was meant to heal creates lifelong disturbance, countering the very intention of well meaning doctors and medical staff and the practice of medicine itself.

* “Japanese technique for stress reduction and relaxation that also promotes healing” (International Center for Reiki Training <www.reiki.org>)

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