Patterns in Trauma Anxiety

February 29, 2016

 

Over the years I’ve often felt I missed my calling. I should have been a sociologist, an anthropologist or some type of clinical therapy researcher. I have a tendency to make connections and put things together. These are things that it seems others don’t usually make the connections on. However, I’m always saying, “Well what changed before you saw this?” and then digging to find that needle in the haystack.
 

In the last ten years I’ve recognized several patterns with trauma children. I’m going to talk about a few of them here. There are certainly more than what will be covered in this post, but I’m starting with these.
 

It doesn’t surprise me in the least that in today’s fast paced American culture that, children in particular, are quickly referred to a psychiatrist by their primary care physician; then labeled and sent on their way with prescriptions for ADD, ADHD, Anxiety, Depression, and/or countless other mental health issues. It saddens me, frustrates me, aggravates me, and angers me, but in no way surprises me. I call it the “minute rice mentality.”
 

If you take a look around and think back across the decades, you’ll see we no longer live in a culture of community and stability. We live in an ever changing and ever growing, always on the go culture, where we don’t have time to be ill, nervous, sick, depressed, anxious, or ‘off our game’. It’s damn the torpedoes and full speed ahead. This lifestyle and mentality takes a toll on adults, so imagine the impact on a child who is already affected by trauma.
 

Children come out of orphanages and foster care into hopefully loving and stable homes, but may have absolutely no idea what loving and stable mean. They may have a lot of anxiety, but they don’t understand it. They don’t know how to verbalize it, so they act out. Some adults exhibit these behaviors as well without even realizing it.
 

I know a lot of adults who talk incessantly to fill an awkward silence. This is a pretty common behavior in children who are verbal and have anxiety around bedtime or any other separation. They don’t understand or aren’t comfortable expressing their fears, so they think of a hundred and one things they need to share and analyze right then and there. This can be extremely challenging when they’re supposed to be going to sleep or you’re trying to separate to go to work.
 

The most common anxiety behavior/issue I see is sleep challenges. Being awake and active enables one to push down and ignore the trauma at least a little bit. When one is now required to be still, then the brain can kick in, and that’s not always a good thing. Physiologically, often times, cortisol levels (which have been high all day) rise in the evenings in children who have experienced trauma and are under a lot of stress. This can make it that much more challenging to relax and get to sleep.
 

Self-harm is another thing I see children (and adults) with anxiety exhibit in various stages. This can be everything from picking at their skin to the extremes of cutting and more. The more severe this level of anxiety has reached, the more necessary it is to bring in multiple sources to help deal with it. A child (or adult) who is purposely self-harming has anxiety that has reached so deep as to undermine their self-confidence and needs to be monitored closely and the need addressed from multiple approaches.
 

Another behavior commonly observed in a trauma child is negative self-talk where they will put themselves down when they make mistakes, or make statements like “you don’t like/love me, why would you?” They feel so unlovable they feel the need to prove it. In cases of verbal abuse, they will frequently repeat the statements they’ve heard directed at them over time. If they’re not actively verbalizing negative self-talk, they may act out when they receive praise or recognition for a job well done. It just doesn’t fit with the picture they have of themselves, and they can’t reconcile the praise they receive with how they feel. This is one of the reasons the sticker charts that teachers are so fond off are such a trigger for trauma children. It activates that emotional memory of not being good enough and/or being verbally abused.
 

Some years ago I was attending an Education symposium for Deaf and Hard of Hearing Children. One of the speakers used this analogy that was so profound, and I’ve shared repeatedly because it is so easy to understand. Imagine an 8oz Pyrex measuring cup (the clear glass kind used to measure liquids). Now imagine that every day each person is given 8 oz. of “reserves” to deal with day-to-day life. Are you with me so far? If that child has anxiety, 6 oz. or 3/4 cup of those reserves will be used up just contending with the anxiety. That leaves the child with only 2 oz. or 1/4 cup to process all the normal day-to-day things that come up in life. Is it any wonder that a child with anxiety has trouble paying attention in school? Can’t focus for more than a few minutes at a time? Has a messy desk or cubby area? Their minds are constantly in motion dealing with the anxiety. I’ve used this reference before but remember the emotions in the movie Inside Out when they’re fighting over the control board (aka Amygdala)? Fear, Disgust, and Anger all battling to control the board; can you see the face of anxiety in there?
 

Remember how quickly the Anger character was ready to take over the control board. We hear a lot about Fight or Flight and I would rather call it Rage or Run. The “Fight” in a trauma affected child looks unlike anything a person who hasn’t experienced trauma could ever imagine. In my twenty plus years of working with preschoolers I have never seen a “fit” “meltdown” or “conniption” that could compare to what a child affected by trauma can produce. That high level of cortisol that they’re producing really comes out in the heat of the moment.
 

This is perhaps the one thing that aggravates me so much with the minute rice medicine approach. Emotional Trauma is a very complex beast and it is not something that can be addressed in a MASH style fashion, where you triage, treat, and send them back to the front as soon as possible. It needs the Dr. Welby approach, if you will. For those who don’t remember that TV show, he was the doctor who came in and got to know you, knew your family, knew your history and really made an effort to see the whole picture before making recommendations.
 

We need more physicians who are willing to think outside the box. Physicians who are going to be more like Dr. Welby and look at the big picture and explore areas of complimentary alternative medicine. Physicians who will prescribe alternative therapies that may include Kripalu yoga, certified clinical aromatherapy, licensed acupuncture, therapeutic massage, equine therapy, art therapy, nutritional counseling, cooking therapy, music therapy, and so many more available options before rushing to the prescribe and street them philosophy.
 

We as parents and survivors living with trauma must demand that the physicians we see operate under this open minded outside the box philosophy. If we don’t insist that they take us seriously and hold them accountable then we’ll never see change within the medical establishment. Look at how powerful the autism community is and rightly so because they are unified. Adoptive and foster parents who are parenting children with trauma and adult survivors of early childhood trauma need to be just as insistent and unified to bring about effective change to the approach modern medicine takes in treating trauma.

©2016 Cynthia Tamlyn-CCA

 

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