Podcast Episode: Trauma and looked after children
Category: Young people
What follows is a transcription of the audio recording. Due to differences between spoken and written English, the transcript may contain quirks of grammar and syntax.
FL - Fiona Lettice
CG - Christine Gordon
KW - Karen Wallace
How do we deal with trauma? Most of us have a reference point for what is 'safe' which allows us to make sense of traumatic events (for example a car crash) and provides a framework to deal with it. Looked after or adoptive children often have no such reference point which makes it difficult for them and their parents to deal with trauma. Christine Gordon and Karen Wallace - co-founders of Adapt Scotland - talk to Fiona Lettice about their first-hand experience of fostering, adoption and trauma.
CG My name is Christine Gordon - I am a social worker, I am an adoptive parent. I was a co-founder of Family Futures in London, a therapeutic organisation working with adopted and fostered children - and I am now Co-Director, along with Karen with Adapt Scotland, which we'll talk about later.
KW I am Karen Wallace, I have 6 children - 3 birth children, a step-daughter and 2 foster children that I have had for 10 years. I am also a qualified social worker and I have worked with children in various settings in education and the community and in residential care. I am also Co-Founder of Adapt Scotland with Christine.
FL And I'm Fiona Lettice, I am an adoptive parent. For the last 10 years I've been working in the field of adoption support - I now work for Scottish Attachment in Action as a development worker, and I am also just becoming a Mentor for Adapt Scotland. So we'd like to start the discussion today on what people's knowledge and definition of trauma is. And Karen I think you are going to say something?
KW Yes, well according to the Oxford English Dictionary, the definition of "trauma" is "it is an emotional shock following a stressful event".
FL And I think what we wanted to tease out and think about, if we look at that definition, is how trauma applies to looked after, adopted or children not living in their birth families, and what the difference is and the sort of trauma we are talking about.
CG So I thought I could give an example of a traumatic incident that I was involved in, and then we could use that to compare my traumatic incident to what it's like for traumatised children and the parents who are caring for them. So my traumatic incident happened many years ago - I was involved in a car accident. I was driving to work one day and I was coming onto the motorway and a lorry moved into my lane and basically squashed me, and I then bounced from one side of the motorway to the other and eventually stopped, looking down at a kind of embankment. And my memory is I was saying "why am I not dead?" Because I thought the lorry was going to kill me basically. And following on from that, you can probably understand that the next time I got into my car it was a very difficult experience, and the next time I had to drive to work along the same road, because I needed to drive along that road to get to work - it was incredibly difficult for me. For many months afterwards I could tell you every single solitary lorry on the road and I could tell you their movements, if they came an inch close to me, I could actually see it in a way that people sitting in the car with me couldn't. So that's my traumatic incident that I wanted to share.
FL And how old were you when that happened?
CG Well I was in my 30's.
FL And had you had any previous accidents in the car?
CG No, not in ... I had never had an accident like that - I had had many, many years of safe driving, I had driven a number of cars, I had driven along that road many times and had had no accidents, and yet that incident had an impact on me for a very long time to come.
FL And I suppose what we are trying to look at is that's a one off incident, that people ... it's a traumatic incident - how could that be different to the sort of trauma we are talking about for children who have experienced neglect and abuse in their early years.
KW Well I guess we are talking about developmental trauma when we talk about that. The term "developmental trauma" was introduced by Bessel van de Kolk to explain how neglect, abuse or abandonment in infancy can affect the actually physically structure of the child's brain, whilst their brain is actually doubling in size in the first two years of life. So the kind of trauma we are talking about isn't a one-off incident like Christine's, which was, as traumatic as it was, the trauma that we are talking about, developmental trauma for these children, it's long-lasting, it's endured, it inutero and over the first couple of years of life, so it's more crucial, at a crucial period in their life, and it changes the structure of the brain. So actually, children who suffer from developmental trauma, their brain is actually wired differently from an infant who experiences love and care, physical touch and emotional responsiveness from a parent - these children don't, and their brain is wired quite differently, and it's how that impacts on the child and also on carers and parent figures. And I suppose that's what the article is about - it's about how that presents as secondary trauma and block care responses.
CG So I mean my thoughts on it are that I had a template for safe driving because I had been driving safely for a long time. The children that we are talking about, the children we live with and work with don't have a template for safe care because they were traumatised before they were born through things like their parents being involved in domestic violence situations, alcohol, drugs, even tobacco can hugely impact a growing foetus. So these children can be born traumatised with no template for safe care - and then if they are remaining in birth families where they are being abused, neglected and abandoned on a regular basis, then that continues to be ... means they have no template for safe care. So they are looking at the world through the prism of abuse - so when they move into new families, that's their template for understanding a new family, and they don't have another way to look at it. I mean I did have a template for safe driving, but I was looking at every lorry through the prism of that traumatic experience. Our children don't have that.
FL I think sometimes what I feel is people are very keen to talk about children who have had a very adverse experience in their first few weeks and months of life, or indeed from when they were conceived. They talk about these children as being resilient, and they perhaps over-egg the emphasis on this, whereas I think I would rather say that these children have learned to survive. I wondered what you thought about that Carrie?
KW No, absolutely, I mean I think when these children go into new families it is quite alien to them, and I think they see us as aliens because they don't understand that showing them kindness is ... they can't use you properly, you know, they can't use you and use your kind of empathy and understanding of them properly because they just ... like you say about the template, that's not their normal template, so they expect more of the same.
FL So when we are saying about a child who has had good enough parenting and hasn't had these adverse conditions, they learn very early on that adults are people you can trust and also they learn to regulate their stress, and quite often the people that we are living and working with, they have this inability to regulate stress, and this causes lots of problems for families, because it's not a question of the children won't regulate their stress, but they can't regulate their stress, and I think that might go back to the templates that you are talking about Christine.
CG Yes, I mean they don't have a way of regulating stress. Babies learn how to make sense of different feelings, because they have an adult that helps them to understand. So if you pick up a baby who is crying, a good enough parent will be saying "oh look at that, how are you, I wonder if your nappy is wet, I wonder if you're needing fed", so adults put the words around ... even though the babies can't understand the words, but they put a template around what that feeling is for a child, for a baby. If a baby, on the other hand, has a mother who one day will feed that baby and the next day she ignores it, and the next day that baby is lying in her cot for hours being hungry or being wet and nobody comes to them - they don't learn about how to connect what is happening in their body to what is happening outside. There is no coherence. So they don't learn regulation because they have not had any regular pattern or ways of interacting.
KW I guess in terms of brain development - I mean normal development in children that are of healthy attachments - for them, they can expect to be cleaned and loved and fed, whereas our kids, it's almost like, for their part, they are kind of wired to expect a threat, you know, so anything that is coming in, they are wired to kind of expect it to be threatening and to be fearful.
CG And often, if you can imagine - if I was having that car accident every day, I would need to find a way of actually managing that within my body, to be able to go on living my life. So our children somehow learn to block off, dissociate, switch off from the overwhelming fear that they have - and that, I think often is interpreted as a resilience to survival. Whereas in actual fact we believe it's a trauma response to living with ongoing, persistent fear of death almost for our children ... we can't ... we couldn't go on living like that and surviving if we didn't find a way of disconnecting.
FL And I guess a lot of the children have been in fear of their life in their first few weeks and months, because people haven't actually done the basics to keep them alive, so they are in a very fearful state a lot of the time, which can manifest itself in all sorts on ongoing issues for them. I am thinking of my younger son who, as well as having a very traumatic time in the womb, which was effectively he was beaten up in the womb and he was subjected to alcohol and drugs, etc - the first 16 weeks of his life before he was taken into care, he wasn't fed and he was left alone in a dirty nappy, in a cot, with lots and lots of strangers in the house that he was living with. And even now he has issues with food - and he can't regulate ... he is fearful of being alone in the dark and so on. Is this common, do you think, with children who have experienced these ...
CG Definitely, I think it is very common, because I think that what happens ... as adults we look at ... well if we can't get our dinner for 4 hours, you know, we'll survive. But baby's template - they don't have a timeframe that is similar to ours. 4 hours for them or 2 hours feels like life or death. So therefore, for your son, not being fed gave the message "I could die", and when you've had that belief system that is imprinted in your brain, and for that matter in the chemical makeup of your system, then you aren't going to be able to change that pattern readily.
FL So what you are effectively saying is that as an adult, and you having your car accident, you could see where that was coming from and you could make sense of the world because you had a fairly self template from your early life experiences, you knew you were competent of driving a car, and you could somehow rationalise what had happened to you, even though it was traumatic, and come to terms with it. But these children have an almost ... well they are having overwhelming feelings that they can't understand, they are just feelings trapped in their body - so it's pre-verbal responses to things that have happened in their own years.
CG Yes, I mean when I was driving along the road, if I had not had a good morning, I would be more anxious - then I would notice lorries on the road, and sometimes I would go into panic mode at that point in time. And in reality, I had another accident just a couple of months later when I thought a bus was going to squash me. The bus was nowhere near me, but I actually pulled out in front of the bus because I thought it was moving into my lane. But the difference between me and our children is that after I got to work, made myself a cup of tea, stopped shaking - I could then make sense of it because I knew and remembered about the car accident and I therefore could say to myself "actually this was about before, not now". So therefore when I went home at night I would start off saying to myself "I am going to be driving along the road, and if I see a lorry it is not the same lorry as the one that nearly killed me". But our children don't have that because their traumas occurred before they were verbal and they need a lot of help to make sense of that, of their experiences, so that they can put a story around their trauma.
FL Right, so can we then sort of move onto really talk about what it can be like parenting traumatised children? Perhaps quite often people have waited a long time to have children, perhaps adoptive parents, and have spent a long time being assessed and so on - they have these children placed with them, and quite quickly it feels as if they are moving into the traumatised child's world and almost become overcome with the trauma of the child. Does that ring any bells?
KW Absolutely, I mean I worked with a parent recently, and her way of describing that and explaining secondary trauma was she said to me "you know that you are suffering from secondary trauma when you are having a bad day because your child is having a bad day, or you are having a good day because your child is having a good day", and I think that really highlights how quickly we can be immersed in their world. And trying to separate that, and know whether you are having a good day because they have had a good day, or you know, it can become immersed, you know, you just don't know "well is this a good day because they are having a good day"?
FL So we are talking about children who very early on have learned not to trust adults - they don't see adults as safe people, because they haven't met their needs, and the impact they can have ... their early history can have on the people that are looking after them. So I'm wondering then what we think about ... because very much when we talk about helping children and the adults they are living with, we talk about looking at the children's history and find out exactly the details ... we always say the devil is in the details of what is actually happened to these children, so we can understand their world. So how does that fit in with looking at the children ... at the people who are caring for and the parents and carers, about looking at their histories?
CG I mean the way that I feel is that often ... and the reason why we wrote the article was often what professionals see is adoptive and foster parents suffering from secondary trauma - and that is defined as the impact of caring for a traumatised individual. And David Conrad would say that the more empathetic a carer is, the more able they are to be able to understand therefore parent and empathise with their traumatised children. But on the other side, they are more ... that kind of parent will be more likely to suffer from secondary trauma. But I guess our viewpoint is it's more complicated than that - because if you are living with a child who is constantly punching you or stealing your purse or, in my son's case, he would sometimes steal my car keys so I wasn't able to go out of the house to go to work. So that it meant that even when I had just mislaid my car keys, which I quite frequently do, I never knew whether or not he had hidden them or I'd lost them. So I would then have a completely traumatic reaction to that. So that, to me, is primary trauma. If you were out in the street and somebody came up and punched you in the face, nobody would say to you "that's secondary trauma". So a lot of our parents, I think, suffer from primary trauma symptoms, and then overlaid on that are secondary trauma symptoms, which is involved in ... I guess it's by being involved in looking after children who are traumatised and hearing their stories and hearing their disclosures, and seeing the way that they behave, their history imprinted on their bodies. And when you are trying to understand those issues, it can be really different. Example - my son eventually was able to be brave enough to share some of his trauma history with me. He was 10 at the time. He had lived with that story in his body and his brain for 10 years. I felt sick when he told me the story and could not wait until my husband came home at night to tell him, because just holding on that story was really traumatising, and it just made me think "if I feel like that, how must he feel?"
KW For me, I suppose the biggest thing for me over the past 10 years was just realising that life is no longer predictable, you know, life becomes unpredictable. So things that we take for granted or just everyday life situations like going for a meal, which seems like a nice day out or a nice event - can just very quickly change, because your child is like having a moment or a melt-down. Family celebrations, birthdays, you know, they are so difficult - so just everyday life situations for me, that is the kind of the biggest impact, is that your life is no longer predictable - it's very unpredictable.
FL And I guess life was very unpredictable for our children ...
FL ... and therein lies part of the problem.
KW Yes, and I guess for me - I always try and remind myself, "well if this is how I am feeling ...", because it can be overwhelming for me and the other children. And I kind of always take myself back to "well if this is how I am feeling, how is my child feeling?"
FL And I think perhaps if you have had good enough care and you have enjoyed a good quality of family life, so your expectations of birthdays and Christmas's, are they good experiences? But perhaps for our children, things got significantly worse ...
KW More chaotic.
FL ... around Christmas. There was a lot of alcohol drunk, perhaps the Christmas presents were sold or stolen or didn't exist. So what we see as enjoyable experiences have a very different meaning. And I know quite often for adopted and looked after children, even going on holiday when ... I remember being excited about going on holiday and not worrying about it in that sense. But for our children, it means one more move - and are they going to come back to the same place? Is the house going to exist and so on? These are big, big things to be putting on little children's shoulders, aren't they?
KW Absolutely, and I think that is what the motivation for writing the article, to say "get that out there", it's helping parents to understand that and to like unpick why their children behave the way that they behave - because if they don't then I think parenting them can be quite overwhelming if you don't have an understanding of their history and where that is coming from. And I think for professionals - professionals kind of get ... they get the trauma from the child's perspective, but I don't known that there is enough emphasis on ... or enough realisation about how it impacts parents.
FL And I think that might go back to where we were talking about looking at your own attachment history as an adult - and how that can be ... although it might be painful, and can be really helpful for when you are looking after these children. And Christine, you have got quite a good example about that? I have heard you speak about before, about stealing and how stealing was seen in your family and how you had to rethink that.
CG Well it was more ... I guess lying.
FL Oh sorry.
CG Yes, lying - basically when I was little, I was ... I wasn't a particularly naughty child, although you might not actually believe that now - but the message that I got from my parents was if I did something wrong, that wasn't very good, but it was terrible if I lied about it. So lying became almost like the worst crime in the world that you could possibly do. But I was never beaten up or anything ... if I did something wrong I was given a row, as it were, but nobody actually deprived me of food, abused me, abandoned me. When my son came to stay with me, he would tell the most outrageous lies - he would maybe have eaten a whole packet of biscuits, the crumbs were all over his face ... and he would be saying not only had he not eaten the biscuits, that he had never seen a biscuit in his entire life before. So just tell me ... and I would hear myself saying "but just tell me the truth - if you told me the truth, we could sort it out" - until I actually realised that his relationship to lying was different from my relationship to lying - he had had to lie to survive - he had been told to lie by his birth family "oh just tell them that you fell down the stairs rather than we punched you". So he had to lie for survival, and he had been taught to lie by people who wanted to protect themselves from other people I guess knowing what was happening. And so therefore I had to put aside my concept of what it meant to be ... what lying meant, I guess, to understand and connect with my son's concept of lying. So although, of course, I wanted eventually to get to the point where he would tell me the truth, I had to actually go back and say "right we will deal with the lying issue over a period of time - at the moment we are just dealing with why did you eat all the biscuits" - so that you were actually addressing the issue, because I would find that I would be going round in circles, and I'd forget what I was actually talking to him about in the first place 2 hours later anyway. So you have to really think through where we come from in relation to particular issues and where our children are coming from in relation to that issue as well.
FL I would like to discuss what people think might be helpful for families who are looking after traumatised children.
KW I think a lot of the time, traditional forms of parenting don't tend to work for these kids, so I think a therapeutic parenting that takes account of the child's history and helps parents understand the history in the context of their children in the here and now helped for me, you know, because understanding my son's history and understanding why he was behaving the way he was behaving, helped me to parent him. I think without that understanding, then you are just muddling through and trying to parent the way you were parented, and that doesn't tend to work for these kids. So in order to, I suppose, offer trauma sensitive support, you have to have a depth of knowledge about trauma. And I think in our experience, we adapt - there is some professionals that get it, but there are just some professionals that just done, you know? And we have worked with families where they feel that they have been judged, they don't feel that they have been understood or that their children have even been understood. So I think there has to ... one of the motivations for the article as well is to help professionals understand just what it's like living with a traumatised child, because I think you can read stuff and you kind of get a sense of it, but it's hard to really get it unless you have lived it. But if you have a really ... if you skill yourself and be knowledgeable about trauma, then at least you are half way there.
FL Because quite often you will hear adoptive and foster parents saying "we went through the training and we thought we got it, and we ticked the boxes, and so on, but it's not until you are living 24/7 with children who have learned not to trust adults, and you are trying to make a relationship with them, that people ..."
KW Well I had a wealth of knowledge and understanding about children, because I had worked with children for 20 years in different settings - I had worked in residential, but it wasn't until we actually fostered these children and they lived with us 24/7 that you actually get it - and it's hard, it's hard for somebody to actually get it if they have never lived it. But I'd like to think that they are trying to get it.
CG I think it is also that people need to understand that parents, what parents are living with aren't just the issues, it's how you go on being able to show empathy for that scared and hurt child, because underneath our children's anger and acting out, the core reason for them acting out like that is fear - and a lot of the time you can actually understand that, but if you are actually standing there dealing with a child who has just kicked you, or kicked the cat, or thrown your dinner in your face, then it's ... your understandable natural feeling is anger. And so therefore, how do you then, when you are feeling that way - angry, upset - still be able to hang onto the knowledge that although this looks like an angry child, and he or she is an angry child, there is a very scared child there motivating, I guess, if you want to call it that, the reason for that child's behaviour. They are not bad kids or angry children - they have got angry behaviour, but actually what they are is terrified children.
KW I guess for me, that's when I try and remind myself that ... because I know that when that's happening and you are in the midst of that, that your heart is racing in there and you are feeling really anxious yourself, and that's when I try and remind myself to just take a step back and just kind of look at my child and look at the terror. You know, like if this is how I'm feeling, then where are they at? And that helps me kind of go on providing empathy when I am feeling in that ... because you are angry, you know, we are human - we are angry, we get angry - but it's staying in that moment, I always try and go back to empathy by reminding myself that if this is where I am at, where are they?
CG And I guess for parents, we try to help them because it's not possible always to be able to do that when you are actually faced with the moment, because you are operating (... unclear) in connecting with you in limbic mode or (... unclear) mode, and you are also connecting in (... unclear) mode and limbic mode - so we help parents to almost forgive themselves, when they'll say "oh I really lost it and I got angry and I shouted at my child" - well actually you can repair that 'break' if you want to call it in attachment, by being able to go back and say "do you know what, I'm sorry". So we can't always do it, and it's totally un ... it's impossible to ask anybody who is faced with a very angry, rejecting child, to always be able to be empathetic in the moment. So we need to be able to forgive our parents, or understand - because I guess that's what we do, is we understand, so therefore there is no need for forgiveness. But for parents, they often need forgiveness. And I guess professionals sometimes go in and look at the moment in isolation and say "well you actually smacked your child, and that's not right". And of course we would say that's not right to hurt a child, particularly one who has previously been hurt physically or in other ways. But we would need to understand why that might have happened, when that parent had probably never hit a person in their life before.
FL I think what I have found over the last 12, 15 years is how isolated adoptive and foster carers can feel, because quite often if children are acting out, other parents don't like it, children get blamed, they get described as naughty and bad and so on, and so I think for me the experience of peer support and people who do get it can be very powerful - because people do feel isolated and judged. And I guess it's the only role where most people who have children, birth children, they don't have to be assessed beforehand, and adoptive and foster parents go through quite a rigorous assessment, and quite rightly so. But then it can be very difficult if you have gone through that assessment and go the child, and things aren't working out the way you thought they would, to go back and ask for help. So in my view it's really important that when people are assessed and going through that process, that professionals should say "we expect there to be problems, we expect you to be able to come back and talk to us about things that are very normal really for children with these histories - it's not ...". I guess what I am trying to say is we wouldn't have any hesitation for a child who had a hearing difficulty, or any other disability - we would expect them their parents to access support for them or go to hospital, etc, doctors and so on - that would be normal. But there almost seems a reluctance to say, if children have emotional difficulties and behavioural difficulties, I think we should view it in the same way that they are going to need help, ongoing support. And I just think the population of people who have been adopted and fostered, it's completely natural that they would need ongoing support. And more importantly, that the people who are caring for them are going to need ongoing support.
KW I think that has only been recognised though in the last few years - I think that is becoming more recognised. I mean I guess as a foster carer, you kind of expect to get a level of support, but for adoptive parents it's not the same - it's like they get the child and they kind of go off on their merry way, and they don't have the same access to support.
CG And I guess it's also hard because often our friends and our family don't understand, so they'll say "oh all children do that", or "if you just gave them a bit more love", or "you are far too lenient with that child - they need a bit of discipline in their life". And so therefore we don't get the acceptance and support from our wider families and our friends, the friends that we thought might be there to support us who aren't actually maybe living with ... because they have had their birth children - they are not living with a traumatised child. And then I think it is also important to think about the stress on couples in relationships, so often we find that if one parent ... usually Mum's, but not always, are working from home, looking after their child, and the Dad is out at work - somehow work becomes ... the outside work becomes more all-consuming to the parent who is out at work, because it just becomes too overwhelming to come home. And I certainly found that - and we talk about vicarious trauma in our article - my ex-husband would be at work, worrying all the time, about what was happening at home. So even if things were going reasonably well at home, he had no means of knowing. And he started needing to do extra shifts, stay on for a meeting, because he was getting the feelings of self-worth that he needed through his work situation that he just wasn't getting at home, because he would be coming home to see me frazzled and my son telling him he was a completely ... if I'm allowed to use a swear word, 'crap parent'. So he wasn't getting the feedback ... and we all need feedback, and I think that's another thing that we need to think about for our parents. Often our parents don't look after themselves, and so they are being told all the time that they are terrible parents by their child. How do they get a sense of feeling okay about themselves if other people around them are also giving them that message? So one of the things we are quite prescriptive about Adapt, is helping parents to have a nice time - go out and buy themselves a bunch of flowers if they don't have time, sit down and not dust their house, but have friends round for a coffee, and not feel guilty.
CG People begin to feel okay within themselves, because when you feel okay within yourself, you are then more able, I think, to go on parenting a child who is so not okay within themselves that they can't let you know that you are okay as well.
FL We have to have self-care for all parents of children who have been traumatised - that has to happen.
CG Yes, and I think that at Adapt what we do is we try to offer all of that, and we offer parents specific bespoke parenting programmes, so we will give them specific pieces of advice and support that they then need to think whether that would work for the children. But I'm thinking back towards the beginning when you mentioned, Fiona, about holidays. Often what parents do is they think it is really good to have their stuff packed in one bag and their child's stuff packed in another bag, because that makes just packing easier and then they think well their child has got their own bag and they can go and get their stuff out if they want. But for our children, that might convey a message that my stuff is in my bag because they are going away and leaving me with their stuff, and so often for our children, what actually works best, even in things like holidays, is if their stuff is packed along with their parents - so they get the clear message that you are going with us, and hey ho, we have only got one case between us, so guess what? We are all coming back together as well. Taking pictures of the house and leaving something important of the parent's and the child's together in the house again conveys the message that we are all going on holiday, but we are all coming and packed at our own house. And I think if we can help parents to understand that by giving them specific suggestions, then it gives parents more of a feeling of empowerment and able to say "yes, I can do that - that' quite simple - yes, I can do that". And then we can say "well done you".
KW Absolutely, and I think that most of the parents that we have worked with, a lot of them are well-read, you know, they want to understand their children - so they really are well-read. I mean I have went in and some parents have got books up to here, but what they have said at kind of Adapt is, is like what's missing is the strategies, you know, and how to put all this stuff in the books and how to parent their children ...
FL And do it for your family ...
FL And actually, being able to address the vulnerabilities and the relationships between that particular family, with that particular set of children, with their background, and the parents with their background, and how you can strengthen their relationships. Finally, finally - I think you have got a quote from a carer?
KW Yes, I just wanted to finish with this - it was one of the parents - I think it is on the website. It was just one of their testimonials, and she said that ...
"the greatest gift you can give to an adoptive parents is the support of someone who is non-judgemental, confident and who has expert knowledge of your situation. You feel safe, trusting and able to accept your child for who they are and what they are going through. Through the use of therapeutic re-parenting, it then becomes possible to move forward and help to repair the trauma from which your child is suffering. Adapt Scotland has been just such a gift for our family".
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