Over time, if the therapist remains involved, some children will become less amenable to the rewards. The therapist may give up or the parents may become angry about being blamed. Treatment is discontinued. Each will blame the other for the failure. This process is the migration of the child’s belief system (“I am bad”) into the treatment. Some refer to this process technically as “the parallel process” or “isomorphism” with the child’s original family. As the child’s belief system of “I am bad” transfers to others, the therapist views the parents as “bad” and may also feel personally inadequate to correct the family’s problems. Parents and therapists encounter failure.
Under these circumstances, the child will not heal and the family could be destroyed. Families on the Downward Spiral (see figure 1) may have the child removed from the home. Some children are moved to another foster or adoptive home. Others are housed in shelters, children’s homes, residential treatment facilities or juvenile detention centers. The process is emotionally and financially costly to the child, family and society.
Figure 1: A spiral that results from families reacting to a child’s behavior.
The Trauma Lens Paradigm Shift The Trauma Lens Paradigm Shift
I tried to keep Allan close by so that I could keep him safe. But he would slip away. One day he came into the house after playing outside. My sister and I were visiting together in the living room. Allan could not stand still while talking to us. He kept shaking his leg. My sister, a nurse, was always concerned about Allan’s health. As she investigated his ailment, a live bird fell out of his pants. He gathered up the bird and freed it outside. His grandfather witnessed a similar incident wherein Allan hid baby rabbits he’d captured in the field.
My quest for answers continued. I searched through training documents given to us when applying for the foster care license. With six hours of training, they should have covered noncompliant behaviors. I found nothing. I searched through stacks of files the agencies provided about Allan’s early years: court documents, foster care placement reports, psychological evaluations and school reports. Hours of reading provided detailed information about Allan’s abuse, neglect, abandonment and his multiple diagnoses. A new world emerged for me with unfamiliar mental health terms and diagnoses.
As I read more, Allan’s behaviors started making sense. His trapping skills were learned from a dad who earned extra money from trapping alligators to sell and trade. He learned to hide from the police when the authorities were attempting to arrest his father for his drug use and dealing. His chaotic lifestyle did not lend itself to good hygiene or healthy meals. He learned to scavenge through the neighborhood for food. He did not live with his mother, making “mom” experiences unfamiliar.
I could now make more sense of Allan’s strange behavior—why he was responding to me so differently from my biological children. But my search for new parenting skills was futile. The problem was that this was 1994 and no resources existed. I was determined nevertheless to find answers on how to parent this child.
The following year, while searching through the vast number of books at the largest library in the area, I found a new book, The Discipline Book, by William Sears, MD, and Martha Sears, RN. It differentiated the “connected” from the “unconnected” child. Their description of the unconnected child sounded like Allan. I then called the director of the volunteer agency and asked whether they were teaching new parents to attach to their infants. How would you teach a parent to attach to a nine-year-old child? The director had no answers. Some may think that the answer is obvious—it should be just like the myriad of ways you attach to your birth children.
But my experience was different. The things I could do for my birth children seemed to make Allan’s behavior worse. Days flowed into weeks, weeks into months and nothing improved. The Downward Spiral continued. Allan began to sneak out of his bedroom at night and raid the kitchen for the foods he was allowed in limited quantity during the day. He would eat ice cream straight from the carton. I began to lose sleep, worried about his safety overnight. When we installed a motion detector at his bedroom door, he began to entertain himself by setting it off “by accident.”
Finally, while Christmas shopping in December of 1996, I found the greatest present I could have received. On a rack of sale books outside a store I found a book entitled Adopting the Hurt Child by Gregory Keck and Regina Kupecky. The authors gave a description of Reactive Attachment Disorder. There in the cold of December, I couldn’t stop reading the book. Our life started to make sense. The authors clearly understood children like Allan—here were some answers to my quest. I had no illusions that the road ahead would be easy. But now my despair was assuaged with hope.
—Faye Hall
Predicting treatment success begins by assessing two factors: the family’s engagement in treatment and their faith in the treatment professionals. Our new model offers a third factor: Treatment success for children with a history of early trauma and attachment disruptions rests on the parent’s paradigm shift of viewing the child and his or her disruptive behaviors through the “trauma lens” and accepting and using a different parenting model.
Imagine the impact of parents and professionals educated in trauma, child development and attachment before the child is placed in the home. Parental expectations will be aligned with the child’s capacity for healthy relationships. The parents and professionals will be equipped with effective interventions to support restructuring internal belief systems, emotional maturation and opportunities for attachment. Parents will have support and encouragement from trained professionals. The child will be encompassed by treatment consistency while developing relationships that heal. Treatment will be difficult but energized with new hope.
Even after a child is placed in the home and the family is coping with disruptive behaviors, hope is not lost. An educated treatment team can help the family repair damaged relationships and spur new connections through trauma psychoeducation and healing interventions. It may take more time, but these parents will truly understand that trauma impairs a child’s development, decision-making skills and the ability to form healthy and reciprocal relationships. Underlying parental issues, attitudes and personal characteristics may prevent the paradigm shift, thus hindering success. When these barriers are identified and addressed, they can be diminished, if not fully removed, by the parents and the treatment team.
FLAWED ELEMENTS OF FAMILIAR PARENTING STYLES
1. All Human Beings with Problems Respond to Behavioral Interventions.
The current therapeutic culture strongly emphasizes behaviorism and assumes that human beings can universally learn via rewards and consequences. If one rewards good behavior, good behavior will ensue and continue. If one “consequences” poor behavior, the poor behavior will stop. If the modification plan fails, then one assumes the reward was not good enough or the consequence not severe enough. An underlying principle is that all behavior is a choice. Behavioral approaches foster the delusion that parents can address every problematic behavior effectively. They also assume that early trauma does not impede the child’s ability to choose good behavior. Finally, behavioral environments are often overly structured, with little time and energy for nurturing relationships.
Brandon’s Family
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