Transcript: Violent and aggressive children: caring for those who care

Podcast Episode: Violent and aggressive children: caring for those who care

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.

EG - Edwina Grant
CG - Christine Gordon
KW - Karen Wallace

Adoptive or foster parents often believe they have failed and blame themselves for their children’s violent or aggressive behaviour. It is important that professionals are ’trauma aware’ and dot reinforce these feelings. In this episode, Edwina Grant, Chair of Scottish Attachment in Action talks to Christine Gordon and Karen Wallace of Adapt Scotland about caring for those who care for children who exhibit violent or aggressive behaviour. They explore the reasons for these behaviours and discuss coping strategies.

EG Hello, My name is Edwina Grant. I’m a psychologist and dyadic developmental psychotherapy practitioner. I also chair Scottish Attachment in Action. We’re going to be talking today about caring those who care for violent and aggressive children. And I’d like to introduce Christine Gordon and Karen Wallace of Adapt Scotland. Hi.

KW Hello there.

EG Firstly, could you tell me a little bit about yourselves, Christine?

CG Yeah. My name’s Christine. I’m an adoptive parent - I’ve also got a child by birth and I’ve got 2 grandchildren. So I’m able to practice developmental re-parenting through the generations. I’m a - as you said, a director of Adapt Scotland and work with traumatised children and their families, along side of Karen.

KW I’m Karen Wallace. I have 6 children. I have 3 biological children, a step daughter and I have 2 foster children that I’ve fostered over the course of 11 years. And and as Christine said we’re a director of Adapt Scotland.

EG Thanks Christine and Karen. And Karen I guess then you start to raise the topic that we’re talking about today, which is caring for those who care for violent and aggressive children. I wonder if we could start of with Christine. Can you maybe tell us a little bit about the statistics concerning domestic violence in Scotland, please?

CG Yeah, I read that according to published police statistics in Scotland for the years 2012 - 13, male violence of women accounted for 80% of all domestic abuse. And in 2014 over 2600 violence of women … - no sorry, 2600 children in Scotland were identified as needing protection from abuse. Which is a particular concern, since the NSPCC suggests that for every child who’s been identified there are 8 other children who’re at risk, but who are under the radar, i.e. who have not been identified as being at risk. So I think the statistics highlight that the underlying nature of interfamily abuse is about the abuse of less powerful and more vulnerable family members by more powerful adults. However, we’re not really here today to talk about that. What we’re here to talk about is - I guess what I would say - would be a hidden type of abuse that occurs within families, and that is of child on parent violence, and thinking about the impact of that on the child, on the parents, and on the family as a whole.

EG So I guess maybe - could you start off by explaining the potential impact of early years neglect and abuse on children’s development, so we can get some understanding of why children can be violent and aggressive in families. Even when they’re in a safe family.

CG Yeah. The families that we work with and the children that Karen and I have parented have come from an abusive, and mostly have come from an abusive and neglectful environment. And what the research now highlights - a big body of research highlights the fact that it’s the very early experiences of children that can have a significant impact on the neurological and emotional development. Which basically means that their brains are hard wired to have an expectation of abuse and neglect, which they carry with them into any new family that they come into. I think it’s also intensified by the fact that children, by the time they come to their final family, if you want to call it that, have been in usually something like 4 or 5 different foster care placements or residential establishments. Which then increases the child’s feeling of ‘where am I in permanence - nothing in the world is safe, nobody’s there to look out for me’ and they bring all of those messages to them, or with them into new families.

EG Thanks Christine. And I guess also what you’re saying is that the body and the brain of children - all children, keeps the score in terms of their early experiences. And those…the impact, the emotional impact, the physical impact, social impact, neurological impact, may not emerge until those children are in a safe place. Like a stable family, foster or adoptive placement or even in residential care. And that’s when you might see reactions such as fight and flight and freeze?

CG Yes, that’s correct. I think that these children often live within foster families or residential care in a sort of freeze condition, where they don’t …they’ve got no trust. So they move into new families and they interpret…another thing is the impact of mirror neurons -t hey interpret the loving reactions, interactions of parents as potentially abusive. So they’re in constant alert. But I think part of them might feel safe enough to be able to express some of the innermost feelings that they have. So when they move into adoptive families, not necessarily to begin with, but after a period of time they might begin to act out in a way that they had not been able to act out in other families and other environments because they do get a feeling of ‘maybe I can trust these people, so maybe I can trust them to show them my deepest and darkest moments and thoughts and feelings.’ But it’s not always a conscious level for children.

EG So also, actually to be in some senses re-enacting and showing what happened to them in their early years in this new family, once they’re safe to do so. What type of behaviours are we talking about here?

CG There are 3 main responses to traumatic events I would say, fight, flight or freeze. For children as babies most of these possibilities aren’t there. Babies are far too powerless I would guess to fight. They can’t run away - if you’re a baby you can’t run, you can’t walk. So most of the children or many of the children…the only recourse is really the freeze response, which is to dissociate and switch off from feelings. So the body has the feelings - because the feelings occur at a pre-verbal stage. Well they don’t have any words to put those feelings into expression, so the only way that they can put those feelings into expression is through the way that their body responds. And the child themselves don’t have any sense of that. They don’t know why they’re acting the way they are.

EG So I guess what you’re saying Christine is that children can interpret the actions of safe parents, safe adoptive parents or indeed of fosters carers who have good intention or residential workers and they’re still interpreting that world as dangerous. So many of the behaviours that they have - the violent or aggressive behaviours that they have - although obviously not OK, are actually to be understood in terms of the children being scared and demonstrating what they’ve seen before. Would that be right?

KW Which often comes out in their behaviour. And that’s why we say that their language is their behaviour, because they’re not able to verbalise that.

CG And I think it’s quite hard for people to get their head around I guess, to put it that way, around the fact that violent children are scared children. We can see children who are in flight mode, or dissociative mode as scared children and we sort of see the aggressive way of children as being a fight mode. And part of it I think is fight, but I think also a part of it is dissociation and also flight. So it’s a very confused mix that these children are actually demonstrating by their behaviour.

EG And I guess it can be one child can have all those different responses as well and I guess it’s not just scared actually sometimes, is it, it’s terrified. So I’m wondering, what can trigger the fear response - the terror response?

CG Well anything and nothing. And I think that’s one of the issues that makes it very difficult to understand some children who are acting out - because a very small trigger can lead to a major explosion. The way that I like to help here is to think about it, is thinking about domestic abuse. Often women will describe knowing when their husband or partner is going to be aggressive by something like the footsteps and how they put their foot on the floor when they come into the room. How they turn the key in the door. Which you and I, who’re not in a domestic violence situation wouldn’t really notice, but they notice because they have to because for them that is survival. And I think for our children it could just be a slightly raised voice and I think that connects with the dissociative stage because we tend to dissociate when there’s a tiny trigger to things rather than when’s there’s been a major thing to keep us safe, or as safe as we can be. So it can be a tiny thing that triggers that feeling for the child - that I’m not safe and I might be really - die. And that’s the level at which these children operate.

KW It could be a tiny gesture or a look. You know, it’s could just be something physical. The sense that they’re not safe.

EG Even a smell, I guess as well?

KW Yes, all the different senses.

EG So very often the triggers might not be even external triggers, they can be internal triggers, like a memory, a reminder. So it is extremely complex. I wondering…you work - we all work with foster parents and adoptive parents and residential workers who work really hard to care for and love children who have come through very traumatic early experiences. I wonder what your experience would be of how parents feel when they’re being hit, hurt, lied to, spat at, at times by the children that they’re trying to love?

CG I feel that they can often have the same sort of responses as children - as their children - so they respond with either a flight, fight or dissociation response. I guess one of the problems for parents is that often most of those responses - they’re not available to them. The fight response means an angry response and it’s (1), it’s not helpful for children and (2) it’s not acceptable. The flight response isn’t available because that means giving up on your child and most of the parents that we work with - they’re absolutely committed to their children and do not want to give up. So the only response that’s really available to them is dissociation. And I think that what they then tend to do is try to feel safe by perhaps re-interpreting their child’s behaviour and minimising it. For example, saying that the child who’s punched them or kicked them has just hit them. It’s not as bad as it was yesterday. That can be really difficult because it means that parents aren’t really…well it’s the only way they can survive, but it means that they’re not really aware of what… of the reality of their situation often.

EG So I guess what you’re saying is parents sort of accommodate that and also get thrown back to a sense of hopeless/helpless? What can they do about this? And that can also lead to parents giving it - is it me? Is it me, am I bad parent?

KW I think that’s often a response by a lot of our parents. I think they kind of blame themself.

EG In the same way actually that the children have blamed themselves and they think they’re bad kids.

KW Yeah, they think they’re bad parents.

CG And I think sometimes professional involvement…

KW Can reinforce that?

CG Can reinforce that. So that makes it really difficult, because what we feel is that our parents are their own worst critics. They’ve got such a critical parent inside them that they don’t really need other people to be criticising them because they beat themselves up all the time. They say, well ‘I never knew myself to be this angry and I don’t know how I’ve got to this place.’

EG And of course I guess foster and adoptive parents are - they’re not expecting, no matter I guess what different information they might have in terms of the child’s background, and what they’ve come through, and the number of transitions they’ve had - the level of aggressive behaviour can still absolutely take them by surprise. They had no expectation that they were going to have to parent in such extreme circumstances. Would that be right?

CG I’m sure that’s right. I don’t think people are told. But I think even when you are told - if I think I was told, it’s difficult to comprehend what it actually means to be living in that situation 24/7. For small things to happen like to lose your car keys, which I do on a frequent basis and not being sure whether actually you’ve lost your car keys or your son’s stolen them to maintain a level of control and stop you from getting out of the house. So you end in panic mode, not really sure if you lose your money, you don’t know whether you’ve actually spent it at Tesco’s or whether it’s stolen. And then how do you actually confront or deal with your child in relation to that, knowing that if you speak to him the likelihood is he’ll be swearing at you, telling you to fuck off and potentially hitting you and kicking you. So you tend to tiptoe around the children and not really address the issues.

EG You paint a vivid picture of what it can be like to live with children who are violent. Not all the time maybe, but the fact is if it’s there - and you know it’s going to be there, then the response is as you say, to be very wary about talking about behaviour, even though you know you want to boundary that behaviour because you know it’s not safe.

KW Well you start becoming a little bit …you’re on constant alert as well, yourself, aren’t you, because you’re anticipating and you’re waiting for it to happen.

EG Yes, yeah.

CG So even when there’s a good day you can’t actually relax. And parent’s adrenaline levels are sky high, as for that matter are the children’s. So everybody’s living in hyper alert.

EG On if you like an escalator where everybody’s on the escalator going up and up and very stressed. And it makes family life so difficult for everybody.

KW Well it makes it very unpredictable.

EG So can I ask you then, what can professionals do to help to support?

KW I think the professionals need to be hugely empathetic. They need to be trauma sensitive and trauma aware. I mean they need to know about trauma and be sensitive to how that impacts on parents as well as children. Because I think some professionals…they’re getting better at knowing how it impacts on children, but I guess maybe the same can understand they’re there for parents and empathy for parents isn’t there. They need to be able to do that because they already feel judged, like Christine said they’re their worst critics. They’re their own worst critics. So for other people to come along and criticise them or make them feel like they’re doing it wrong - they’re not doing it right, they haven’t walked in their shoes.

CG And I think that…what professionals I think need to do is be aware of the reality, because parents will minimise things. Validate and offer parents feeling of self-worth and I think professionals can do that more easily and more readily if they are able to try to put themselves in the parent’s shoes. And think ‘how would it feel if this was happening to me on a daily basis?’ because most of us do not live in families where they have to worry each day about saying a small thing, and having a violent major reaction. So you have to really think ’this isn’t a one off incident’, this is something that’s ongoing on a daily, sometimes hourly basis, that children can go from calm to exploding. And so therefore I think that professionals need to try to put themselves in parent’s shoes. And while we have to be clear with parents that reacting with violence to violent children is not OK, we need to understand and empathise with why parents get themselves in a situation where they’re perhaps shouting at their children, or responding in ways that is not necessarily as helpful as other responses might be.

EG So I guess what both of you are saying Karen and Christine, is that the core attitude of professionals who are going to support families where the children have come from these traumatic backgrounds - the core attitude actually of developmental repairing parenting and dyadic developmental practice is that of acceptance, real open curiosity about what’s going on here. I really want to figure it out with you, and for you to tell me, and empathy about how hard is this, for everybody in the family and how hard this is for the parents - would that be right - with some boundaries around that too in terms of safe and unsafe behaviour?

CG I think that’s absolutely right, that that’s what parents do need. And I guess one of the things that they also sometimes need is helpful ways of managing children’s behaviour.

EG Absolutely.

CG Because acceptance of the underlying reasons for the child’s behaviour is not the same as accepting the behaviour, and I think that parents sometimes fall into the - shall I say the word ’trap’ of feeling that accepting the behaviour equals or accepting the underlying reasons that they’ve accept…and I know I did that. So therefore it was difficult for me then to be proactive, because I thought unconditional love meant unconditional acceptance of behaviour. Whereas I think that unconditional love means helping your child to banish their feelings in a different kind of a way.

EG So I guess what you’re saying - you need boundaries, clarity about safe behaviour and unsafe behaviour and empathy?

CG Yeah.

KW Get ready to help our children to practise new ways of managing their failings and their behaviour.

EG Of course. Yes of course.

CG And that’s difficult to do, but I think one of the things that we try to emphasise to our parents is that some family activities are absolutely sacrosanct. That is not dependant on behaviour. So that your bedtime story isn’t dependant on you deserving it because our children some days will never deserve it - if you want to classify deserving by equals how they’ve behave that day. So the bedtime story, the Friday night movie night or what have you - there are certain things that are totally sacrosanct, because our children need to find a way of integrating joy into their lives, and their parents need to find a way of integrating joy into their lives. And another big thing we have is encouraging and supporting parents to look after themselves.

KW Absolutely. Yeah, if they don’t look after themselves it’s going to get more difficult to look after their children.

EG Absolutely.

CG As is in an aeroplane - you put on your own oxygen mask first. Unless professionals can offer their unconditional support, then it’s very hard for parents to be able to do that - so one of the things that we sometimes say that we parent the parents - so that they can parent their child. So that sometimes when we begin our work, we’re kind of almost creating a dependence on us in the way that children are dependent on their parents - or should be dependent on their parents. Often our children of course are not. But when we can get children to be dependent on parents we can help parents to depend on us, and then gradually over a period of time as the programme and as our work progresses and parents begin to feel more confident and able to stand on their own two feet, as it were, then they can become less dependent and flee the nest as it were.

KW I think that’s a great point because I think all their parents - or most of the parents that we’ve worked with - they’re parent confidence is so low when we start working with them. It’s lovely to see that increase as the programme goes on - it’s lovely to see it coming back.

EG And I think also it can help, can’t it? Well I think what you’re saying - this is a nice phrase - dependency has to taste good? And that applies to our children as well as to parents.

CG I can remember one parent we were working with who said - and she’s had quite negative experiences - and she said to me ‘why should I trust you, just because you tell me that you understand it - you’re a professional.’ And rather than become defensive I said ‘well, there is no reason why you should trust - it’s not your job to trust me, it’s my job to be trustworthy. And then at some point you might be able to trust me, but it’s never your job to trust me if that’s not what you feel.’ Another thing I think’s really important to emphasise is that because we’re talking about a lack of serotonin, which is the feel good chemical and a lot of adrenaline - when we’re engaging in physical activities and I’ll say walking and cycling, because that’s one of the things that I like doing, introducing these activities within the structure of family life is really good for children and for parents. We would support things like walking to and from school because that can be a very difficult time for children. We support, you know things like having a snack at the end of the school day, because the parent knows that the child is going to be stressed in school, and isn’t necessarily able to express that distress within a school environment. And it can work really well even if the parent’s don’t - sorry if the children don’t get involved - for the parents start skipping up the road. The children will mostly either look horrified and be so embarrassed, or what have you, that they will join in, which then creates a kind of more fun environment. And it’s that sort of fun environment which increases serotonin and decreases adrenaline that I think can make a huge difference in quite a small but significant way for families and it’s not difficult to do.

KW It made me kind of think about what we used to get called the karaoke family, cos we used to love to sing and it encouraged the kid’s confidence as well but it was just that kind of increase in serotonin as you’re singing.

CG I think it’s really important to help parents to name their children’s behaviour alongside of a clear message that aggression, while understandable in light of the child’s history, is not acceptable. But it must be come to be messages that parents are willing to help their children manage their anger and different and healthier ways. So it’s not about ‘you’, it’s about ‘we’.

EG I can help you with that.

CG I can help you with this. But I think when to do it is really important because often people ask children ‘why did you do that?’ in the middle of them having a major flip out or tantrum or whatever you want to call it. The children aren’t in thinking mode at that point and they’re not able to name it - nor for that matter are parents. So we encourage parents to talk about it and what we would call the calm before or the calm after the storm. So reflecting on - I know that the such and such is going to be really difficult for you, how can I help you with that? And then perhaps afterwards - and it could be an hour after, it could be a day afterwards - and I saw that it was really difficult for you yesterday when x, y or z happened - how can we help you when that happens again tomorrow? So there is a time that we need to think about how to talk to children about how to do things differently, and I think often that’s one of the difficult things because we all do it - why did you do that? And she’ll obviously say - ‘I don’t know and it wasn’t me anyway.’ And they don’t know. And parents are not really in a place at that point I think to have the empathy - because they’re just managing the feelings and they’re feelings. So that’s one of the big jobs that we have with parents is how to talk to children in a way that - at a time I guess, when parents are in thinking mode and when children can be helped to be in thinking mode.

EG I’m also aware that it can be really helpful when we’re talking about serotonin - we’re talking about the sort of neurobiology - neuroscience of all of this that can actually be really helpful for both the children, young people and their parents to understand the way the brain works actually. And that, as you’re saying, when children are in a calm state, and parents too, is the time to be engaging with them in reflection. Because that’s when they’re brain ready to do that. But explaining the impact of trauma on brain and body can be helpful for children and young people and parents, can’t it?

CG Well I think it reduces the child’s feeling that I’m a bad kid, which most of these children - however much they want to say ‘it wasn’t my fault, it was all your fault. If you hadn’t asked me to do the dishes, then this wouldn’t have happened.’ They actually inside feel terrible and I don’t know many aggressive children who actually want to be aggressive, even although their body language is telling you that. Inside that is not what they want - they want to be able to manage, but they just don’t know how. In fact I think we had a child who asked his foster parents ‘please tell me’ - his social worker ‘please tell me how to behave.’

KW That’s right, yeah. We did, we had a wee boy that said, yeah ‘can you tell me how to behave.’ And it wasn’t’ that he didn’t want to, it was that - can’t do, not won’t to.

EG And I guess the other thing to remember is that going right back to the beginning in some senses is that babies are born relational. And so although that external behaviour can be very violent and scary, underneath there is a need for a relationship and it’s to remember that.

CG And I think one of the things that Karen has done is - that we use a lot at Adapt - is to prepare our fantastic poster, calling a Calming Poster.

KW Yeah, and that’s just about other strategies and helping them to manage their feelings and their anger. We used to call it an Anger Poster, but we changed it to Calming Poster cos it is about helping them calm down rather than…

EG And to teach new behaviours as you said Karen.

KW Teach new behaviours.

CG And it’s on the poster - lovely - Karen has made it all lovely coloured and beautiful so that parents can look at it and children can look at it at those points in time whenever they’re brain just can’t figure it out.

KW And it’s about helping them to practise - we use the word practise a lot for parents and for children, you know because their children need to practise new ways in managing their behaviour.

EG And where would people who were looking for that poster for example - where could they find that?

KW I don’t think it’s on the website, but I mean it’s something that we could certainly put on the website. Well we give it to parents or we can adapt it for each child - just putting their name on it and different things that will work for them. Cos different things work for different children.

EG So it could go on your website.

CG We’ll put that on our website for parents. But what we would say is you need to look at it and adjust it to what would work for you because parents are the experts in their children and in them and while I might say go out for a cycle, that might… because I like cycling - it might not work for all parents or all children. And so children and parents need to work that out. And in actual fact it works really well if children and parents can sit down and work it out between themselves, in the calm before or the calm after. So that children are actually buying in to some of the strategies. What I think’s important is that parent’s don’t expect children - although they’ve bought into it - to actually be able to do it, when they hit in that point where they’ve lost the plot. Because they have to practise - we all fell of our bike quite a few times before we were able to cycle - so therefore parents need to be prepared to practise the strategies for the child until the child is able to practise it themselves.

EG And I guess in doing so I sometimes say to parents and to residential workers actually that what they’re doing in doing all of what we’ve described is they’re actually healing brains. They’re helping brains to recover. And that can take quite a long time. It’s not going to happen - Karen’s nodding her head and saying it’s not going to happen…

KW It’s not going to happen overnight, it’s a long…we say it’s not a quick fix

EG Take years - no, takes patience.

CG And I think one of the really, really important things is that parents’ get as much and the fullest information about their children’s history and revisit it with someone who can actually help to interpret the child’s behaviour. I think Karen said earlier on that children’s behaviour is their language - it’s the language that they’re using to let us know what’s going on inside for them. The dictionary is the child’s story and so therefore if parents don’t have the child’s story then they’re not able to interpret the child’s behaviour. And sometimes parents need help to do that, as we all if we’re learning a new language - we go to language school to learn a new language. Then sometimes they need people to help them to understand what the child’s actual language is by interpreting the dictionary, and helping them to interpret the dictionary.

KW And that’s often our starting point, isn’t it? Well can I do a full history - but it’s OK reading the history. But I think it’s to try and help, like you say, parents interpret that for them, what that means for the child.

EG I’m wondering then if you have some final thoughts?

KW Well I guess one of our parents - I think’s on the website - she kind of said that it helped to come from a place of love when parenting her child and that’s what developmental re-parenting helped her to kind of realise. That if she comes from a place of love and she’s responding, then it’s really helpful. But I guess when you’re living with aggression and violence on a daily basis that’s a bit harder to do. So my final thought would be if you can try to come from a place of love and understand that underneath that behaviour’s a hurt child.

EG Thank you Karen, and Christine.

CG I would just reiterate what Karen says, but to emphasise that parents won’t always get it right. Parents need empathy and support - just like we’re asking children to practise different ways of being, we’re asking parents to practise different ways of being. And often that’s not a way of being that they see their friends or they’ve been brought up with. So we all make mistakes - making mistakes is a fantastic way of learning - that we don’t have to be perfect to be good enough. And it reflects for our children the fact that they don’t have to be perfect to be good enough either. They need to begin to come from a place of love of themselves.

EG So Thank You Karen and Christine.

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