Complex Trauma and Its Effect on Child Development – Arthur Becker-Weidman Ph.D

See below for a full transcript of the talk from Arthur Becker-Weidman you can watch here: https://youtu.be/nKj3cgGht4c.

Learn more about his work here: http://www.center4familydevelop.com

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Chronic early maltreatment that occurs within a caregiving relationship. This is a clinical construct, not a DSM IV diagnosis. But I do think it is much more useful than the DSM IV diagnosis because it captures the pervasive effects of early maltreatment. PTSD only captures a narrow slice of behaviour, that rarely captures the behaviours demonstrated by many children in our child welfare system.

Complex trauma causes impairment in seven domains of development:

  • Attachment
    • Traumatized children often feel that the world is uncertain and unpredictable. They can become socially isolated and can have difficulty relating to and empathizing with other. The fact that trauma occurs within the caregiving relationship is so powerful because the caregiving relationship is where you are inclined to run when there is a problem, but in this case the caregiving relationship is the problem, which leaves the child nowhere to go, and no way to resolve the distress. The source of threat is the attachment figure. You want to get close and get away at the same time.
  • Biology
    • Traumatized children may experience problems with movement and sensation, including hypersensitivity to physical contact and insensitivity to pain. They may exhibit unexplained physical symptoms and increased medical problems.
  • Emotional/Mood regulation
    • Children exposed to trauma have difficulty regulating their moods. You learn to regulate your moods through your relationship to your early primary caregivers. They also have difficulty describing their feelings and internal states. With a young child, you regulate their emotions for them, because they cannot do it themselves, gradually they develop ability to do it with you, and then eventually develop capacity to do it themselves. Trauma disrupts that process and interferes with the child’s capacity to develop the ability to control their moods.
  • Behavioral regulation
    • Traumatized children can exhibit poor impulse control, self-destructive behaviour, and aggression towards others.
  • Dissociation
    • Dissociation is one of the hallmark feature of complex trauma. One of the ways the mind copes with overwhelming stress or trauma is to split off or dissociate the emotional component with the episodic component. What happens is, we repeat the event again and again and it decreases in intensity. When the episodic and emotional memories are split, this split continues, and no integration can occur, there is perpetual dissociation.
  • Cognition
    • These kids have difficulty completing tasks and focusing. We see a range of cognitive difficulties because their capacity to take in information and move information from working memory to short term memory to short term memory to long term memory is impaired because, when our experience chronic early maltreatment in a caregiving relationship your stress response system is always active, which is antithetical to taking in new information and learning.
  • Self-Concept
    • Traumatized children frequently suffer from disturbed body language, low self-esteem, shame and guilt. They come to understand themselves as unloved, unlovable, throw away kids.

Frequent behaviour associated with complex trauma include affect dysregulation, attention/concentration issues, negative self-image, lack of impulse control, aggression.

Children in the foster care system come to us having experienced a range of traumatic experiences that profoundly impact their development and functioning. Exposure to drug and alcohol use and abuse. There is no safe level to pre-natal alcohol exposure.

  • Half of young children placed in foster care had been exposed to cocaine prenatally.
  • Half of the infants had been drug exposed and had HIV exposure 30x the community rate. Also accompanied by growth failure, immunization delays, and a host more difficulties.
  • 50-95% of children entering into foster care have significant mental health problems, but these are not addressed at intake. They get a good physical screening but not a good mental health screening.

 

Maltreatment and the developing brain

Maltreatment during early childhood can cause vital regions of the brain to develop improperly, leading to a variety of physical. Emotional, cognitive and mental health problems. This explains why these things that happened to kids when they were 2,3,4 still affect the child now they are 10 – regardless of the quality of care they now receive. When children experience complex trauma, normal parenting approaches are not necessarily effective, because these kids come with a very different history to the children you would have raised from birth. These events have a profound effect on the functioning and structure of the brain, and that is where behavior comes from (the brain and various synapses and how they are connected). Much of brain development occurs postnatally. A colt can walk around and nurse, within half an hour of being born. Takes a human infant a lot longer to reach similar maturity because our brain is so large. For example, the limbic system, the part of the brain where emotions are regulated, the amygdala (fight/flight/freeze), then the prefrontal cortex (seat of most executive functions – planning, judgement), then the orbital frontal cortex (switching area). These connections don’t necessarily develop until the end of the first year into the start of the second year. Our species is so adaptive is the way our brain works in these intensive developmental periods. What happens is a huge number of synapses get created, and then depending on experience certain connection get strengthened, and at the end of the growth period, whatever connections aren’t strengthen or used are pruned away. So, these early experiences profoundly affect in this one example your ability your prefrontal cortex to regulate your emotions. Because if the connections that develop are impaired, then your capacity to regulate your emotional response will be impaired.

Epigentics speaks to the interaction between environment and genes. It’s not nurture or nature, it’s both. Environmental factors affect gene expression which affects protein production which affects a variety of things.

Children who have experienced complex trauma have significantly worse life-time health outcomes. Specifically they are at risk, as adults, of developing personality disorders, including Antisocial personality disorder, narcissistic personality disorder, borderline personality disorder and psychopathic personality disorder.

 

How does complex trauma impact child development?

It has a significant impact on developmental delays, leads to a difficulty in identifying feelings, impairs other domains, and contributes to fear and shame based behaviours (lies-shame, stealing.

Their developmental age is often much younger than their chronological age, which is difficult. Many times parent shave trouble relating to a child at an age different to their chronological age. Problem solving difficulties will be impaired. Ability to defer gratification will also be compromised.

In testing thee children often exhibit a significant lack of motivation, test poorly on standardized tests and display a lack of motivation which can be misdiagnosed as ADHD, ODD, or Mental Retardation.