Saturday, June 23, 2018

Chapter 2: For your own good

Wow.. this chapter is saturated in heavy trauma and complex brain physiology that was difficult to process each in its own way, but both abstract and fairly new in their relevant fields. We follow the shocking story of Sandy who witnessed and experienced atrocities at an extremely undeveloped age.

When Perry described the details of those unspeakable acts my immediate response was, ‘Oh, how resilient she must be.’ However, assuming that her resiliency is a presumable response to her trauma; it is in some way doing her a huge disservice. Why? When I make an assumption that she is automatically resilient I negate or overlook the underlying consequences of the trauma. If I assume that just because she is a child, that she can easily bounce back, then I don't take into consideration the real bio-physical responses of her trauma are usually misinterpreted and/or labeled as ADHD or ODD. I would fail to consider that this child is walking, breathing, and eating, yet could be living and reliving memories of pain and agony that I can't even begin to understand. Although I may not see that this child is suffering, we can't automatically assume that she (or other kids who have experienced trauma) are resilient based on the simple fact that they are kids. What we observe as visible functioning does not paint the whole picture. In many ways it is like the definition of health as defined by the World Health Organization, “a state of complete physical, mental and social well-being and not merely the absence of illness” (as cited in Allen, 2016, p. 70). Resiliency is not just necessarily the absence of devastating observable behaviors, but rather a state of equanimity between the different facets of their well-being. With this definition, would you or I be comfortable calling a student resilient without really understanding the depths of their mind?

We as practitioners may have capitalized on this word because we just assume that kids will be okay, as mentioned by a criminal investigator on page 38, "Children are resilient. They will be fine" (Perry & Szalavitz, 2006). In using this word, we are creating expectations for children that they will be okay. What if they aren't? And if they aren't, what shall we do? It is undeniable that youth are strong, capable, flexible, creative, humorous, adventurous, yet they are not adults and they do not possess adult brains. Therefore, the authors do a great job at helping us understand the science of the brain to breakdown how the malleable and susceptible brain of a youth is not meant to withstand these trauma experiences and when they do, labeling them as resilient does nothing to support their young brains; empowering them does. 

Giving youth power is giving them control, just as Dr. Perry described in his sessions with Sandy. Upon hearing of this, I kept getting lost in my thoughts and experiences with one particular student client. Without sharing very many details, he would go into these dissociative states and had frequent interpersonal conflicts with students and teachers. When he came to see me at school, I knew that I had to give him control in our sessions together. I would often hear his teachers and administration call him manipulative, which is a word that I causes me to feel some type of way, because I knew that he was acting (or reacting) that way to meet a need. “After all, one of the defining elements of a traumatic experience- particularly one that is so traumatic that one dissociates because there is no other way to escape from it –is a complete loss of control and a sense of utter powerlessness. As a result regaining control an important aspect of coping with traumatic stress” (Perry & Szalavitz, 2006, p. 52). The authors explanation put many things in perspective about student’s behavior and was a huge sense of relief because it essentially validated all of the work I was already doing. Using this direct quote will give me direct evidence that I can share with school staff about why I do what I do and why students do what they do and why they need control.


2 comments:

  1. I had to re-read certain parts of this chapter because if I didn't pay close attention to the neurobiology parts, it went right over my head. I think this neurobio stuff plays a huge part in how we assign children with the trait of being resilient. Before having a better understanding of how trauma impacts the brain, I would easily call children resilient and move on. Children are incredibly vulnerable because they are at the height of brain development, and they are flexible, so if we can intervene early, there is a better prognosis of decreasing traumatic stress symptoms. I love your quote about resiliency - "Resiliency is not just necessarily the absence of devastating observable behaviors, but rather a state of equanimity between the different facets of their well-being." Resiliency is about getting back to equilibrium. Would we initially call Sandy resilient? In some ways, I think it is purely amazing that she was still functioning after experiencing such a horrifying event. Her brain was doing the best it could to try and protect her, but it was so severely stressed. Sandy was clearly not fine - she was in a state of hyperarousal, as her resting heart rate was high and she was demonstrating hypervigilant behaviors. Her behaviors were directly a result of that trauma. Thank goodness for someone like Perry who could advocate for Sandy, provide her with a safe and secure relationship, give her control, and let her process her experience through play. Having a non directive approach was absolutely key in working with Sandy. She ran the playroom in the church and was able to regain that sense of power that is so important for our clients.

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  2. Hi Ada! I enjoyed reading your post. You make a great point when you admit that you first assumed that Sandy must be “resilient” to have survived her ordeal and still display some semblance of sanity after the fact. But then recognize that below the surface, Sandy is dealing with, and will be dealing with, profound psychological, emotional and bio-physical damage that to the full extent may never be resolved or managed. It’s a recognition that’s affirming and empathetic to Sandy’s challenge and struggle yet to come. I also liked how you included the quotes referencing how resiliency is not just an “absence of illness” but the “state of equanimity between different facets of their well-being.” This definition of resiliency gives the clinician and the client a truer standard for biopsychosocial health.
    I was also appreciative of how you included the idea of “control” in your post. I was amazed at Perry’s intuitive decision to allow Sandy to “control” the initial sessions while reading the chapter. It’s also great to read how you were able to give your student a sense of control in your work with him. I’ll keep that quote in mind for any future encounters where students display a sense of hopelessness about their circumstance in life.

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