This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Monday, November 17, 2014

Books and Methods Review - Traumatic Brain Injury - Brain Damage

Traumatic brain Injury linked to ptsd and suicide. http://www.navytimes.com/news/2013/02/gannett-mild-tbis-linked-troop-ptsd-suicide-020613/

Bear - left parietal and left temporal
Kitty - left temporal

Both my children have brain injuries (called Cerebral Dysrhythmia - the cause and time of injury is unknown - could be birth defects, could be from abuse).  The temporal lobe is definitely damaged in both, Bear also has damage in the parietal lobe.  I always thought it explained a lot, and I bet more than a few of "our kids" have these issues.  I always include the brain injuries when mentioning their issues to people who need to know, because I think it helps people understand that this is PERMANENT not something that therapy or medication is going to "fix."

Damage to the parietal lobe can also lead to Anosognosia - "impaired awareness of illness." Affects approximately 50 percent of individuals with schizophrenia and 40 percent of individuals with bipolar disorder.may not recognize that they are ill. Instead, they believe their delusions are real (e.g., the woman across the street is being paid by the CIA to spy on him) and that their hallucinations are real (e.g., the voices are instructions being sent by the President). Impaired awareness of illness is the same thing as lack of insight. The term used by neurologists is “anosognosia,” which comes from the Greek word for disease (nosos) and knowledge (gnosis). It literally means "to not know a disease." This is more than just denial!

We are often told that brain damage can be "fixed," and I believe that to a certain extent that is true, but at some point we have to acknowledge that some of it isn't going to get better or we'll be blaming ourselves (or allowing others to blame us) for our child not healing.

Some analogies:

The Newborn Kitten - Kittens eyes stay closed for awhile after they are born.  Scientists did a study in which they didn't allow kittens eyes to open when they normally would. When they finally allowed the kittens' normal, healthy eyes to open, the kittens were completely blind. The part of the brain that processed vision did not form. The kittens will never be able to see.

Amputated Limb - If a human being has a limb removed and replaced with a prosthetic limb, then the brain can be trained to use the remaining muscles in a different way that allows movement of the new limb.

So the question is, if a person has brain damage or an injury, can they "heal"?  Can they retrain their brain to work in a new way that circumvents the damage (like teaching a person with dyslexia "tricks" to make it easier to read) or is it permanent?

I assume the answer is that it depends.  On the age of the person, on the cause and extent of the damage, on when and what quality of intervention/ therapy was used, and on the motivation of the "injured" person to heal...

There is evidence that in addition to brain damage and the way the brain forms in utero, a lot of what happens to a child as an infant can also cause brain damage.  I've written a couple of posts reviewing Piaget's child development and Katharine Leslie's take on Cause and Effect and Object Permanence and how it effects children of trauma, but here's a couple of key points:

Cause and Effect - Children with attachment disorders and FASD (Fetal Alcohol Spectrum Disorders) often have problems with cause and effect. This may start with the caregiver not meeting the child's physical needs (ex. not changing them when they're wet or feeding when they're hungry). The child doesn't learn that if I cry then someone will come make it better. Instead they might learn that if I cry then someone will hit me, or if I cry then no one will come anyway... this makes behavior management difficult - both self-regulation and parent discipline. If I steal a cell phone, then I will get in trouble. If I yell at my sister now, then she will be scared of me - even 5 minutes (or 5 years) from now.

Object Permanence - We all know that young infants have no ability to understand object permanence. For example, if you hide a rattle under a blanket they don't look for it, it's gone. For them, out of sight out of mind is really true. At about 8-9 months though they "get it." They start to look under the blanket. We often help them develop this ability by playing peekaboo with them. "Wheeere's Mommy? Here I am!"

Now imagine the child who's infancy is not the norm. Who never "gets" this concept. So what? Maybe they never put their toys away because if you can't see them they don't exist. Might not even be so bad because when they are put into foster care they "forget" about all the things left behind... but it's not just things the child doesn't remember. It's people.


You can't attach to someone who isn't there the second they step out of sight. Mommy doesn't exist anymore.

There's a weird movie with Adam Sandler and Drew Barrymore called 50 First Dates. Because of a car accident that damaged her short term memory Drew's character is unable to remember anything that's happened in her life the day before. Adam meets her and courts her anew every single day. They introduce a character called "10 Second Tom." He can only rememember things for 10 seconds. Drew is able to fall in love with Adam because she has the ability to create attachments. Tom would be unable to attach to anyone.


Even though I'm here and not going anywhere, my kids' ability to attach is severely damaged, and for Bear, maybe permanently. Katharine assures us that even a child/person older than 8 who's brain is pretty much hardwired now, can learn these skills and abilities (or approximations of them), but just like learning a foreign language, the older you are the less perfectly you'll be able to learn it and the the more effort it takes (think of people who learn to speak English as a second language as a child versus as an adult).

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