Monday, April 7, 2014

Paying Attention to What Hurts

A four year old, asked why her drug addicted mother left her at the hospital, says, "I think I cried too much."  A fourteen year old, also born exposed to methamphetamine, says, "I think it was because I was a boy."  That is the case for eight girls left behind by a mother who fled to Mexico with a son. To the last one, the adopted children with whom I work feel there is something deeply wrong with them.  And their sometimes strange and dangerous behaviors often have their parents believing it is true.

Attachment and trauma-informed care asks us to think about it in a different way.  These young survivors of physical, emotional, and sexual abuse; neglect, abandonment, and multiple placements have developed some interesting coping skills to deal with painful emotions and fear of closeness.  Their parents are also coping with these difficult behaviors; lying, stealing, aggression, manipulation, defiance, tantrums, and control battles.  The parents and children are both saying, "Make it stop!"

In her article for the March/April 2014 edition of Social Work Today, "Mindfulness, Women, and Child Abuse: Turning Toward What's Difficult", Char Wilkins, LCSW, faculty member at the University of California San Diego Center for Mindfulness writes about techniques for adults.  It dovetails nicely with the principles of Acceptance and Commitment Therapy promoted by Russ Harris, M.D.  The focus is on accepting and being present with unwanted feelings without resistance.

It is very difficult for parents to watch their children suffer.  In my experience it is even more difficult for parents to experience sadness, anxiety, and shame with their children.  Like their children, parents (like all people) avoid, deny, and distance themselves from troublesome thoughts, feelings, and sensations.  Yet these are the fears that drive the unwanted behaviors.  If a parent cannot tolerate these feelings, what is a child to do on her own?  Parent and child are running, from each other.

Yet, while it is not the entire treatment, focus on these unpleasant feelings can make them less powerful.  Without pushing or pulling, they can be regulated.  "Fear is here," as Wilkins writes.  As in Post Traumatic Stress Disorder it turns on the fight/flight response and releases the stress hormones cortisol and adrenaline.  But with practice, the chemicals dissipate, the extreme reactions slow, the brain's emotional amygdala is quieted and the thinking cortex begins to make decisions toward self care.  The keys here are presence and silence.  I have participated and watched as parents have demonstrated with their breathing, posture, and touch that they can be trusted with their child's heavy burdens.  The bodies relax, the expressions soften, safety returns, and the relationship grows stronger.