What is PTSD?

Bear is starting with a new therapist who wants to start working with his PTSD. Bear doesn't know what PTSD is (or attachment or trauma or values!) so the therapist recommended we all read something on it so we could all get on the same page. The problem was I couldn't find something written for kids - especially at Bear's reading level (about 5th grade). So I adapted this one from Attachment Trauma Network (http://www.radzebra.org/WhatIsPTSD.htm)

What is Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder?

Many adopted children are diagnosed with Post-Traumatic Stress Disorder, or PTSD. A child might get PTSD if something happens to them that causes them great pain (emotional or physical). This trauma might include adults not always taking care of the child’s basic needs (food, changing diapers, hugs and attention...), an adult hurting the child, the child being taken from his or her family (even if the child was not safe that child will still miss them), the child being left with many people, or having to move a lot.

Some of the ways children and teens might act if they have PTSD:

1. Extreme emotional reactions. This is how the child reacts to things - sometimes acting in ways that don’t match what is going on.

2. Angry outbursts. This could be yelling, hitting, crying, cursing…

3. Obsessive repetitive play. Being unable to think about anything else, just doing the same thing over and over. What the child is doing might be like upsetting things that have happened in his or her past.

4. Sleep Disturbances. The child has trouble with how and when he or she sleeps.

5. Unusual or excessive fears. Being afraid of almost everything, or of things that don’t scare most kids.



Other children might have Complex Post Traumatic Stress Disorder, or C-PTSD. Children with C-PTSD had trauma in their lives regularly and without anyone taking care of them all of the time.

Some of the ways children and teens might act if they have C-PTSD:

1 Attachment – Many traumatized children do not accept discipline, get in other people’s personal space, distrust others, and lack friends.

2 Biology – Many traumatized children stiffen when touched, do not feel pain, exaggerate small pains, and take longer than others to learn how to ride a bike, skate or perform other movements requiring both sides of the body working well together. Often the chemicals in the body do not work like they should, including hormones - which can make a teen cranky, angry, and maybe violent. There might also be sleep problems, early puberty, depression, and other problems. Many children also have ongoing stomach issues (like gas or diarrhea).

3 Affect or emotional regulation – Many children show strong emotions all the time and have a hard time calming down. They might easily explode into a violent rage over the smallest things (for example, the word “no” or even, “Let’s talk about this later.”; cry for an hour over a trivial remark; worry for days about an imagined insult. Many children can’t tell others what they feel; when asked what they feel, they say they “don’t know.” Some children are “too good,” pretending they are always happy. Some children don’t seem to understand most of their feelings, except anger. These children often feel depressed, numb and/or think about suicide all the time.

4 Dissociation –Many children repeatedly dissociate (disconnect, day dream or distract themself) when confronted with trauma triggers (things that make them think about awful things from the past), such as an adult’s angry voice or facial expression, a parent leaving the child with a sitter or at daycare, the sight (or even the thought) of babies, or diapers, or dolls, or a child car seat belt. Dissociation may not always be obvious to someone who is not trained to see it. Some children use television viewing or sleeping as a way of dissociating. When dissociated the child may not remember what happened or not think about it having happened to them.

5 Behavioral control – Many children fire before they aim - they do things before they think about how their actions might affect others or even themselves. They interrupt, butt into line, grab, push, or say the first thing that pops into their heads. Some children self-harm in large or small ways (cutting, hitting) or engage in destructive attempts to self-soothe (calm themselves), such as picking skin, rocking, head banging, chewing on their lips, masturbating. Many children are aggressive, particularly with parents but not only with parents. They hit, pinch, kick, bite, and throw large objects. Many children suffer from nightmares, night terrors, bruxism (tooth grinding), restless leg, and night waking. Some children turn to drugs and alcohol. Some children suffer from eating disorders even as infants and toddlers; many more develop eating disorders as they mature. Older children are prone to drug and alcohol abuse. Many children refuse to do as they are asked to do. Others show a false front and deny their own wishes and feelings in an effort not to rock the boat. Finally, many children live out the type of trauma they have suffered, either in their play, or simply in their day-to-day contacts with others.

6 Cognition – Many children cannot focus or pay attention when they are supposed to pay attention and they cannot plan tasks well or get organized. Some children seem dulled-down and are not curious about their world. Many children do not totally understand the idea of “object permanence.” If they can’t see someone, they don’t know or believe on a deep level that she is still there (obviously this can effect attaching to or caring for another person, like an adoptive parent.) Many children don’t understand the idea of cause and effect, especially involving his or herself; they do not grasp that if they hit someone, that person will not want to be their friend. Many children suffer from learning disabilities. Many children show delayed development of language skills. Many children can’t handle bright light or medium-loud noise (yet scream themselves). They may find it terrifying (or unusually thrilling) to spin, swing, or hang upside down. Many children struggle to complete puzzles or read maps or learn how to tell time.

7 Self-concept –Many children doubt their own reality; they chatter nonsense constantly partly as a way of helping themselves believe that they exist. Many children believe they are bad, unworthy, wrong, or at fault for every negative thing that has ever happened to them. Some children imagine they are fat when they are not, or believe they are much smaller or less powerful than they are. Many children cannot see where they leave off and others begin, and as a result, they constantly invade others’ personal space, either literally (waving a book two centimeters from someone else’s nose, clinging to a parent at an inappropriate or even dangerous moment, such as when the parent is standing at the stove) or metaphorically, with constant demands for attention. Some children can’t believe they could ever do anything to feel better about themselves, and some children fear that they are “damaged goods,” “trash,” “garbage,” or “unfixable” and that if they show their bad sides, their adoptive parents may send them back to the orphanage or to another foster home.

Adapted and abridged from Attachment and Trauma Network
http://www.radzebra.org/WhatIsPTSD.htm