help4yourfamily

Create the family you want to have

Caught in the Loop: Why People Repeat the Same Bad Choices Over and Over

train circle

train circle (Photo credit: bitmapr)

written by, Kate Oliver, LCSW-C

When I met Aaron, he was 10 years old and living with his parents who had adopted him after three failed placements.  Aaron’s parents were at a loss about what to do with him.  They were committed, loving parents who wanted to help him make better decisions; however, after living with them for over a year, Aaron continued to have bizarre behaviors that they did not understand.  In addition to continuing to steal from his parents any time he had the opportunity, his parents had just figured out that he had also been urinating into the vents in his room.  Aaron’s parents were at a loss as to how to help him change this behavior and they were terrified that it would continue to get worse.

Children who have experienced trauma can seem to continually engage in activities that can be baffling to parents.  I have had many a parent come in to my practice and describe a foster or adopted child who seems to seek attention in negative ways and to actually work to recreate the circumstances that were traumatizing to them in the first place.  From rooms that seem to get instantly messy immediately after cleaning them, to repetitive behaviors that pluck even the calmest parent’s nerves, these children can seem intent on turning their parents into a recreation of the child’s biological parent or earliest caregiver.  There is a name for this phenomenon.  It is called “traumatic reenactment.”  The best way to explain traumatic reenactment is to first understand how trauma works, and the ways we store it in the brain.

Think of your brain as a computer.  The files in your computer are stored in different areas.  There is a short term memory file that stores what you had for breakfast today and yesterday.  There is a long term memory file that stores the stories from your childhood.  There is the work file, the running “to do” list file, and many, many more.  Days that go as planned are pretty easy to file away.

But what happens on a day when something traumatic happens?  An easy definition of trauma is anything that impacts you in such a way that it causes you to feel as though your life is in serious danger, with the possibility of death, or that changes who you perceive yourself to be in a negative way.  To show how people typically store traumatic memories, let’s take the example of a car accident.  You do not wake up in the morning thinking this is probably going to be the day you are in a car accident.  If you really believed that, you would probably never get into the car.  But, there you are, driving down the road and someone sideswipes the car you are in.  No one is hurt, but there are a few moments of panic and your car is seriously damaged.  What do you do?  Well, of course, as an adult you make sure everyone in both cars is okay, call 911 to make sure no one is hurt, and then the insurance.  But what is happening with your memory filing system?  How are you filing this memory?  It sure does not go in the breakfast file!

What happens with trauma is that, until we file it, it acts like a virus on our computers.  If you have ever had a virus on your computer, you know what happens.  You go to get on the internet and think you are checking your email, only to find all kinds of unwanted images popping up on your computer.  Then, if and when you are able to get to your email, you may find out you sent a bunch of messages to people that were not even from you!  You never sent that!  This is how trauma works.  Until you file that traumatic memory you just got from the car accident, your brain is going to be working overtime to file it.  You will go to get in the car and up will pop the memory of the accident and maybe another accident you had a while back.  You will start to remember those terrifying moments when you were out of control and you did not know if you were going to live or die.

Healthy adults file traumatic memories as they verbally process the trauma.  Remember how you called the police?  You had to tell them what happened so they knew who to send.  You were processing the memory.  Remember when you had to call the insurance?  Same thing.  Did you sit in your car for a moment and do some sort of self-soothing like deep breathing to calm yourself down?  Maybe you got a hug or reassurance from someone.  Perhaps you reminded yourself that you have been in cars thousands of times and the vast majority of those times nothing bad happened.

If you did any of those things, you were processing and filing your memory.  Another part of filing trauma is finding a way to understand the event.  This includes thinking about whether you could have done something differently, how you got through it, and how you can avoid the same thing happening again.  Therapists call that mastering the situation.

Now, think about the child you have or have had in your home who has experienced trauma but did not have anyone to process it with and did not have anyone to soothe them, nor did they know how to self soothe, after all, who would they have learned soothing from?  The clinical term for the way this “virus” manifests is “traumatic reenactment.”  It goes like this.  A trauma occurs.  It is not filed appropriately because there is either no, or not enough, processing or soothing for the child.  The child tries to gain mastery (understanding) of the trauma by subconsciously putting themselves back into the same situation over and over again in an attempt to understand or “master” it.

Remember Aaron?  When Aaron lived with his birth parents he was repeatedly locked in his room for days at a time when his parents went on drug binges.  When his adoptive parents brought him in to see me he was lying and stealing constantly, then, they had recently discovered that when they sent him to his room for punishment, he had been urinating into the vents of their home.  What became clear was that this child had found a way to experience a traumatic reenactment with his adoptive parents.  He lied and stole, then got sent to his room for punishment.  While in his room, he had the emotional experience of feeling trapped again, just as he was trapped when he was very young.  In his mind, being sent to his room meant he was not allowed to come out even to go to the bathroom.  When he had to go, he did what he had before, went in the vents, so he did not have to be around a wet spot in his room.  His loving parents had responded in every way they could think of to change these behaviors, but it was not until they understood where the behaviors were coming from that they were able to adapt their responses to more accurately fix the underlying problems.

In therapy, Aaron processed the trauma, learned how to soothe himself and to be soothed by his parents.  It really did not take long for the vents to become dry again so his parents could focus on new ways to address other issues related to his early abuse and neglect.  For traumatized children, I strongly recommend counseling, with a therapist that specializes in trauma, as a resource to help them process traumatic memories to improve behaviors and help parents find a way to adapt parenting styles in ways that are most beneficial to the child.

January 15, 2013 Posted by | attachment disorder, child development, discipline, help for parents | , , , , , , , , , , , , , , , , , , | 4 Comments

Finding a therapist for a traumatized and/or attachment disordered child

Some elementary school counselors use books an...

Some elementary school counselors use books and other media to help their counseling (Photo credit: Wikipedia)

As therapist who specializes in both trauma and attachment disorders, I can tell you it is important if you are searching for a therapist for one or both of these issues, that you find the right therapist for your child.  Doing so will save you a lot of money and aggravation and is more likely to speed the healing time for your child.  To start, look at my post on  finding the right therapist for you or your child (you can find the link at the bottom of this post).  With these particular children, and probably people with other specialized issues as well, there are further steps you would want to take to ensure that you have the right person.  I see the steps for this particular issue as follows:

1.  Figure out if your child has “only” trauma, or has trauma with attachment related issues.  Here is the distinction, a child with trauma without attachment disturbance usually experienced a one time occurence, or something that happened over a relatively short period of time and was quickly identified.  Trauma with attachment related issues is trauma that also impacts a child’s ability to bond with their caregivers in a healthy way, for example abuse or neglect by a primary caregiver or ongoing abuse or neglect that a child did not disclose.  If you feel as though your child’s trust in adults to provide care for them has been altered significantly, you will want to see someone with knowledge of attachment related issues.  To clarify this distinction, a teenager carrying on a short-term, secret relationship with a much older adult that they thought was younger or who was tricked into a situation where they kept a secret because they were breaking the rules when they were traumatized does not fall into this category of attachment disturbance.  It is within reason to anticipate that teenagers will try to stretch or break the rules and it does not signify a break in a child’s core ability to trust that their parents will care for them.  A teenager whose step sibling was abusing them for an extended period of time whenever their sibling came to stay at the home does fall under the category of possible attachment disturbance.  The difference is the primary caregivers were around at the time of the trauma and did not know to stop it, while in the first example, the teen was doing an activity it would be reasonable to assume is developmentally expected but someone took advantage of them inappropriately.  When in doubt, I would see someone who specializes in both trauma and attachment.   If you find that there is an attachment related issue for your child’s situation, I would always make sure to take the child to a therapist that understands attachment because in order to work on attachment disorders or disturbance, you must know about trauma since the two go hand in hand.

2.  Once you have determined whether you are looking for a therapist with trauma training or whether you need someone with an attachment and trauma focus, follow the steps from my first post on finding a therapist and ask these additional questions.

  • What is your training in attachment and trauma?
  • What recent trainings have you attended or conducted that relate to attachment and/or trauma?
  • How do you conduct your sessions?

The answers to these questions, if you are talking to the correct therapist, should indicate that the person stays actively engaged in seeking training for attachment and trauma related issues.  Additionally, an attachment specialist will indicate to you that you will be in the room for most, if not all, of the time that your child is in therapy with them.  Attachment oriented therapy is significantly different in that a therapist focuses much more on your relationship with your child rather than their relationship with your child.  In traditional therapy including therapy for singular trauma, you would take your child to see the therapist, you might check in with the therapist at the beginning or the end, then your child would see the therapist alone for the majority of the session.

While traditional therapy is effective with many children, for children with attachment disturbance, it can actually damage a child’s relationship with their parent.  I have seen this happen, since a child with attachment disturbance has a tendency to reject caregivers, and, while they are alone with a therapist they may talk to their therapist about how terrible and difficult their parents are.  The therapist and child will bond over this and the therapist shakes their head in disbelief, meanwhile they may be overlooking a parent who is really trying their hardest to meet the child’s needs while reinforcing for the child that the caregivers in their lives are, in fact, inadequate.  Remember, children with attachment disturbance see adults as unsafe on some level and tend to fit them into these categories.  A skilled attachment therapist will spot when a child is doing this and help them to retrain their system of trust by teaching them how to find trustworthy adults and by training the adults in their lives to be trustworthy in the way the child needs them to be.  To learn more about attachment disturbance you can see my post linked below “What is attachment disorder?”

**A note to providers- I understand that you have seen parents who are, in fact, inadequate.  For this post, I am assuming that a parent who cares enough to read this post is adequate because they are involved and caring enough to research this issue.

Stay tuned for my post on getting specialized treatment for your child- the things insurance companies won’t tell you that can help you get your child’s treatment paid for.

April 16, 2012 Posted by | attachment, attachment disorder, health insurance, help for parents, thinking about therapy? | , , , , , , | 8 Comments

   

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