Developmental Trauma

by Corinne Gnepf, LCMHC, NCC

The previous articles in this series on trauma discussed what trauma is, how it affects the brain and the body, how it shapes our view of self and the world, and how it may impact our faith and trust in God. Today, we are turning to traumatic experiences that take place in the earlier years of life, and we will see how detrimental those can be to a child’s development and ability to live a healthy life. While some trauma does not come at the hand of another human being (for example natural disasters), the majority is caused by people (crime, rejection, abuse, etc.). Developmental trauma does have marks of human brokenness and sin all over it. “Relationships and interactions that shape our minds and brains when we are young … give substance and meaning to our entire lives” (van der Kolk 2014, p.166)

WHAT IS DEVELOPMENTAL TRAUMA?

danger, maltreatment, abuse, neglect, or disrupted caregiving systems that negatively impact a child’s development. When a child is exposed to repeated overwhelming stress, and the caregiver does not help to reduce this stress or even is the source of the stress him/herself, the child is likely to develop neurological, physiological, and behavioral adaptations to the trauma. These traumatized children may not develop PTSD (Post Traumatic Stress Disorder) but they are at risk for complex emotional, cognitive and physical illnesses that last throughout their lives[1].

Why would developmental trauma impact children in such a significant way that they may feel the effects of their adverse childhood experiences for the rest of their lives?

The first article in this series “TRAUMA 101” names three of the seven emotional systems in the brain-body system that are relevant for trauma. These are the fear system, the separation-distress system, and the seeking system. The first two of these play the dominant role in a child’s life. Every child does experience fear. But it makes a big difference whether a child experiences fear and then is taken care of (soothed, protected and experiences safety again) or not. Children who have spent their first formative years in a chaotic, harsh, abusive, or neglectful environment have lived through one traumatic experience stack on top of another. These experiences often come at the hand (figuratively and literally) of the people who are also responsible for the child’s safety and care. When the child’s physical and emotional needs are not met by their caregiver then they experience separation-distress. Whenever a child does not feel safe, the brain reacts with a release of neurochemicals that activate the body to react to danger. Frequent showers of these neurochemicals alter the brain structure and in turn, these changes to the brain have a significant impact on a child’s behavior. She may be more guarded, aggressive, quick-tempered, hypervigilant, and reactive. He may be overly sensitive to smells, noises, touch, or sounds, and react with big feelings or shuts down. These behaviors and reactions are not “bad”, they are the normal adaptation as a result of repeated danger without support and enough felt safety.

IN THE BRAIN & BODY

These kinds of behaviors make sense because of the “amygdala alarm” and an altered brain structure due to repeated harm, absence of felt safety, and/or neglect. The amygdala is located in the lower part of the brain, the limbic system, or the sensing brain. Here, our brain scans for danger about four times per second. Whenever the amygdala senses danger it activates the autonomic nervous system and the adrenal glands releases cortisol. Cortisol is responsible for activating the body’s fight/flight response. This is a normal response, and the body can break down the cortisol after a few hours as a part of the normal process.

However, for a child who is exposed to repeated harsh treatment, threats, or abuse, or who experiences neglect and the deprivation of food, safe physical touch, emotional connection, cortisol (and other neurochemicals) showers their system over and over, and stays in their bodies for days, weeks, or may never really return to a normal baseline. This has a detrimental impact on the brain because cortisol destroys neurons in the brain that are responsible for developing memory and thinking. Short-term memories my never make it to the long-term memory. This child will likely struggle with academic learning, remembering fact and life events, and the child may have difficulties to logically think through an issue, problem, or choice.

Another significant change to the brain as a result of developmental trauma is often an underdeveloped prefrontal cortex (PFC). The PFC controls body regulation, attuned communication with self and other, emotional balance, flexibility to respond in various ways, soothing fear, insight, empathy, morality, and intuition. These are all important social-emotional skills that are needed for a healthy and successful life. Children with developmental trauma are significantly impaired to develop these life skills. Developmental trauma is also linked to physical health issues, such as chronic illnesses caused by inflammation, as well as early death. What a sad and heavy reality it is that many children’s futures have been deeply shaped by other humans before the children even had a chance to decide what they wanted or not.

DEVELOPMENTAL TRAUMA’S IMPACT ON ATTACHMENT

Developmental trauma also impacts attachment, the bond between a child and her caregivers or parents. The attachment is the blueprint of relationships and how a person gets their needs met.  Foundations for the attachment are laid within the first two years of a child’s life, and then built on throughout childhood and adolescence. A securely attached child is comfortable in close and intimate relationships; he learns to adapt to new situation quicker when his caretaker is calm and confident, because this soothes the child’s stressed disposition.

When a baby or toddler experiences that her needs are not, or only conditionally or intermittently, met, she learns that the caregiver is not dependable. She does not feel safe, the overwhelming stress of unmet needs leads to dysregulation. As these experiences continue and stack up, she develops an insecure attachment. There are three insecure attachment styles: avoidant, ambivalent, or disorganized.

DIFFERENT ATTACHMENT STYLES & TRAUMA

The avoidant attachment style’s hallmarks are discomfort or avoidance of intimacy and vulnerability, suppressing feelings, shutting down when emotions are intense. Independence and self-sufficiency are high because these children have learned that their big people are not sufficiently meeting their needs.

The ambivalent attachment style is characterized by an emotional instability due to the craving for intimacy mixed with intense fear of rejection or abandonment. These children are looking for constant reassurance that they are still okay, and they do what they can to earn attention and favor. They tend to be clingy, because they needed to stay close to get their needs somewhat met. It is hard for them to trust people.

The disorganized attachment style is the most severe of the insecure ones. These children’s behavior is rapidly changing between anxiously clinging to and pushing away the caretaker. These children are emotionally instable, unpredictable, and distrust relationships deeply.

FOSTER CARE & ADOPTION & TRAUMA

Children who have lived in foster care, in institutions or orphanages, usually have developmental trauma and insecure attachment. Adoptive parents, foster parents or care takers often struggle with the child’s intense behaviors and may not know or understand why the child cannot behave like other children. The brain and nervous system have been primed with too many scary and overwhelming experiences, and as we discussed earlier, the brain has adapted to be more reactive in order to protect the child from (perceived) danger. The survival brain is in charge, and with it, the body responses and behaviors that go with the survival brain- everything is about the moment. In the moment of reacting to a perceived threat, the child cannot quickly detect and respond to soothing and regulating attempts because the social brain is locked away. The reaction is about survival. These children are traumatized and they are victims; they are not bad children. Their big behaviors are normal physiological and emotional response to the previous experiences in their lives.

IN CROSS-CULTURAL WORK

As a cross-cultural worker you are likely in contact with children, teenagers or adults who have developmental trauma. Whether you adopted a child, work in a care center or an orphanage, run a ministry for at risk youth, are involved with refugee children, do prison ministry, or teach at a school for marginalized children, etc., you know people who have developmental trauma. It is everywhere. The effects of it are severe.

These individuals need help, support and hope that things can change, that someone in their life now can provide safe and stable relationships that stand their testing. They deserve people who come alongside them, who work to understand the impact of developmental trauma, and who commit to stay long-term, because short-term relationships do not revert developmental trauma. If you have adopted a child or are about to, inform yourself about developmental trauma. If you and your adopted child are struggling, please get help as soon as possible. Whether you are parenting a foster or adopted child, or are teaching, working in health care or social work, Trust-Based Relational Intervention® (TBRI®) principles have shown good outcomes to reduce the trauma and help children to healthier attachment and lives. TBRI is an attachment-based, trauma-informed, and evidence-based caregiving model designed to support children from “hard places” (abuse, neglect, trauma). It aims to heal brain chemistry and build trust, rather than just manage behavior, through three main principles: Connecting, Empowering, and Correcting. Let us work as adults toward being safe people for children. They depend on us.

If you are wondering whether developmental trauma is part of your story, we encourage you to reach out to a mental health professional who is trauma trained, and explore your story together, in person. Healing from developmental trauma is a long journey, one that will take years. Some of the essential work in therapy will be around attunement, because attunement gets significantly obstructed in early childhood when the caretaker does not attune to the child and provide healthy stimuli, care, warmth, and predictability.  Other elements of therapy work will include experiencing felt safety within the counseling relationship, self-regulation, integration of the trauma into the life story. (This article could be useful: https://www.psychologytoday.com/us/blog/expressive-trauma-integration/201904/adults-suffering-developmental-trauma)

Resources:

• Adverse Childhood Experiences (ACE): https://www.verywellmind.com/what-are-aces-adverse-childhood-experiences-5219030
• TBRI: Trust Based Relational Interventions: https://child.tcu.edu/tbri/
• The Connected Child. Bringing hope and healing to your adoptive family. Purvis, Karen B., Cross, David R., and Sunshine, Wendy Lyons (2007).
• The Connected Parent. Real-life strategies for building trust and attachment. Purvis, Karen B., and Qualls, Lisa (2020).
• Twenty Things Adopted Kids Wish Their Adoptive Parents Knew. Eldridge, Sherrie (1999).
• When The Body Keeps the Score. (Specifically, chapter 10 ‘Developmental Trauma: The Hidden Epidemic’.) Van der Kolk, Bessel (2014).

[1] Source: https://www.camh.ca/en/science-and-research/institutes-and-centres/cundill-centre-for-child-and-youth-depression/childhood-trauma-toolkit/developmental-trauma-aces/what-is-developmental-trauma-aces