Having worked in Child Welfare for over 30 years, I have seen changes come and go quickly. Unfortunately some of these approaches did more harm than good.
For example, there was a time when Autism was blamed on “bad parenting” or child neglect and there was once a popular type of therapy for children with “attachment problems” that involved the forced holding (some would say torture) of the child. As often happens with untested theories, things have a way of eventually righting themselves.
We now know that Autism is a complicated disorder that is not caused by neglect (or vaccines, for that matter) but rather is heavily influenced by genetic factors. We also have learned that forced holding of children can re-traumatize them and in doing so, actually impede treatment.
Trauma Informed Care: Time Tested
One change that has stood the test of time is the strength based philosophy that Trauma Informed Care teaches us. When I attended graduate school in the 1980s the thinking at the time was that the human brain was simply not up to the challenge of managing traumatic experiences, such as child maltreatment.
The theory was that when something traumatizing happened to a person, their brain suffered damage or pathology that contributed to their behavior or mental health problems, and in the case of children, their brains experienced a developmental delay that contributed to unmanageable behaviors. This was essentially a pathology or deficit theory of human growth and change, and not a very optimistic one at that.
This theory failed to explain how people have overcome seemingly insurmountable losses and challenges and have gone on to live rich, satisfying lives.
The Art of Adaptation
I met Rosemary while I was in graduate school, and she changed my thinking for good. Rosemary lost her vision at the age of 14 and at a time when medical science was not sufficiently advanced to help her. Since then, she went on to get married, raise 8 wonderful children and become an accomplished writer and gourmet cook. I know because I married one of her children.
One of the first things I noticed about Rosemary was that she was able to tell who was entering a room by the sound of their footsteps, and she could “read” facial expressions by the sound of a person’s voice. Perhaps most astonishing is that she does not consider herself as unique or gifted in any way. She says that she simply adapted to the circumstances in which she found herself. Her adaptations are her strengths.
The 1990s and beyond have seen a new influx of researchers and teachers, such as Dr. Bruce Perry, Dr. Martin Teacher, and Dr. Bessel van der Kolk, to name a few. They were not satisfied with the deficit theories and wanted to dig deeper.
One of their major discoveries was that the human brain develops in a use dependent fashion. That is, it organizes itself and makes connections between its cells in a way that is consistent with how it is used. For example, a person who can only recognize people by the sound of their footsteps, and does this often enough, will develop a brain that is organized in such a way that the person becomes very good at picking out footsteps.
How about children who are living in environments that are unpredictable or threatening, where they are forced to use their brains to stay safe and alive? Might the things that they need to do repeatedly – such as stay in a high state of alert and keep “their heads on a swivel” at all times—cause their brains to develop in such a way that they do this all of the time, even when it is not necessary? The evidence was showing us that the answer is an emphatic “yes!” The science of adaptation was born.
The Science of Adaptation
The science behind Trauma Informed Care tells us that all of a person’s behaviors “made sense” at one time or another. That is, the behaviors developed for a reason, and even though that reason is no longer present, (for example, the person is no longer in the threatening or dangerous environment) the behavior is likely to continue. That’s because through repeated experiences, their brains developed ways to be certain that they would always stay safe from threat.
Being in a constant state of alert and being able to see threat anywhere were necessary and smart adaptations, not pathologies or deficits. If a blind person’s adaptations can be perceived as admirable signs of strength, maybe other adaptations formerly labeled as “problems” can be seen in a new light.
When 9-year old Jason was placed in foster care, his foster mother noticed that that he would hide food items in his room, sometimes half eaten. No matter how often she cleaned Jason’s room and assured him that food would always be available in her home, the behavior continued.
The deficit model told us that starvation caused this “undesirable behavior.” The Trauma Informed Strength Model tells us that Jason’s brain actually has made a remarkable adaptation—he has developed the brain connections to avoid starvation and receive the comfort of satiety. This realization causes a shift in how we perceive Jason’s behavior. Hording food is not the work of a “damaged” person. Far from it. It is the work of an individual whose brain has been able to adapt to the need.
As social workers, therapists and caregivers, one of the most rewarding realizations is that where there is the ability to adapt, there is great hope for healing. In Jason’s case, with enough of the corrective experience of knowing that he will be cared for, and that there will always be “enough,” new adaptations can be created. They may take time, but they will happen.
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