PTSD: Jackie Meyer

The drawing that you see is from an eight year old boy who has

been in a SAFE foster home since he was three. We will call him

Dan. I had asked him to draw a picture of his family. I assumed he

was going to draw his foster family with whom he loves and feels

safe. He drew his biological family with mom out of the picture, his

siblings crying from pain and he is shaking because he is about to

be hit.

Dan is suffering from complex post traumatic stress. It is different

from other types of traumatic stress in that it is early, chronic

maltreatment within a care giving relationship.

Dan’s abuse was so early; it started before he was born. He had a

mom who was being severely beaten while she was pregnant. His

life was in danger and he knew it at an implicit level while he was

still in the womb.

Chronic maltreatment was ever present for the first three years of

Dan's life. He did not know if he would have food while parents ate

steak. He was often severely beaten for what normal kids do, like

lose a shoe. The people, who were supposed to protect him, hurt

him.

CPTSD affects brain development. Dan, like the other children we

get into foster care, has a physically damaged brain. These children

have learning lags that are not always the result of a lack of

intelligence. They have no cause and effect thinking. Dan stood in

the school lunch room and loudly yelled at the lunch lady because

his class did not wait for him to put his colors away before going to

lunch. He used every vulgar word his bio dad taught him in front of

everyone. It did not occur to him that it was his slowness that

caused the problem.

These kids appear to be on hyper alert all of the time. They are

primed for the next bad thing to happen. It is the same feeling that

we get when we see the police car lights in our rear view mirror.

Only their feeling never ends. Dan has difficulty laughing because

the neurons for fun have been hijacked by rage and fear.

CPTSD affects the children’s ability to attach. Since it was the care

giver who hurt them, why would they want to connect to someone

else who they think will want to hurt them. As a result they behave

in ways that push the adults in their life away even it means getting

punished.

Kids who suffered from this kind of trauma get sick a lot more or at

least claim to be sick. Their sympathetic nervous system is out of

control. Being on hyper alert takes its toll on the body. Dan has to

have allergy shots on a regular basis

Because of the brain damage these kids often can not control their

emotions. The child may not be oppositional when he throws the

tantrum in Wal-mart. He may be just out of control. “It may be a

matter of can’t verses won’t.” They may use negative behavior to

make themselves feel better. The pain from cutting is a whole lot

easier to handle then remembering my father taking a gun to my

mom’s head. Getting in trouble for lying is a whole lot better than

taking the chance of getting beaten if I tell the truth.

Kids do not know for sure that foster parents or other caregivers

are not going to beat them. Dan was kicked out of school several

times in Kindergarten. One time he was so angry over some minor

thing that he hit the teacher. Dan was afraid and had no skills to

handle his big feeling. The school did not like this so much. They

were afraid that he would hurt the other kids. It was difficult for the

school to understand that he was not just being defiant. But they

did agree to a safety plan for Dan and the other children.

Bad memories may surface at any time. The child’s feelings of

terror are so overwhelming they may dissociate. This could

happen in school. He may just sit and stare and not cause any

problems. However, he has just missed class time. Dan was always

being accused of not getting his work done on time. The teacher

would often encourage Dan to do his work, but because his body

was feeling the emotions from abuse that happened years before he

could not do it.

Behavior control is a big issue with these severely traumatized kids.

One usually thinks about aggressive impulsive behavior. However,

excessive compliance is also a behavior issue. This is the kid that

every teacher and foster parent loves. He is doing helpful things

way beyond normal expectation. People have always abused him

before so he is going to do everything he can to prevent it. What

caregivers do not understand is that this child is extremely afraid.

He can be living in terror.

Foster parents often tell me that they can not get their child

interested in anything. CPTSD often does not allow the brain to

process new information. Everything is funneled through old

patterns. If he was always put down for trying he is not going to try

now.

Kids with CPTSD suffer huge amounts of shame. These kids feel like

pond scum. Telling a child how valuable he is will do no good. All

preschool children believe they cause everything that happens to

them. Therefore these children believe that they caused the

maltreatment that happened to them. They made mom go to jail.

They made dad beat them. They are often stuck at this early

developmental age and continue to believe this.

The good news is that kids can be helped. We must work with them

at their level.

Think of Maslow’s hierarchy.

Kids need to feel safe first:
Treatment is phased based. They must feel safe first. Remember
Dan had been in foster care for five years and never felt safe.
Treatment must always be done with in the family setting because
only the caregiver can help him feel safe.
The foster parents literally redo the child’s early life. They put a
new narrative into his brain so that this time he feels safe. Like with
small children, the foster parent must set clear boundaries and give
lots of nurturing. As the child feels safe his brain will heal. He will
be able to do the things that other kids his age do. Until then a 16
year old that is functioning like a 10 year old should not drive.
The foster parent needs to help the child control his feelings. Two
year olds throw tantrums and often can not control them. Because
of CPTSD, a 16 year old may not be able to control his tantrums
either. The parent must calm the teen until his brain heals and he
can calm himself.
As the parent helps the child eliminate his shame, the child begins
to use his thinking part of his brain and not just react with
emotions. The child can now make clear and wise choices. He no
longer suffers from Complex Post Traumatic Stress.
To some this may seem impossible. Mary Dozier has done much
research on this and her conclusions show that it is the foster
parents that make the difference. This is true of Dan. Dan’s
teachers report he is doing above average work. There have been
NO violent out burst. Dan is on his way to becoming a productive
young man.
Never forget how much influence you have as a foster parent.