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!

Saturday, March 9, 2019

Continuous Traumatic Stress (CTS)

Image result for abused parent

We call ourselves Trauma Mamas (and Trauma Papas).  We live with our abusers and care for them on a daily basis. Unlike other battered women, we are not encouraged to leave. Instead, we are told we have to stay. We're told that we *should* devote all of our time and energy to this child. 
{Fighting the *shoulds* - Prioritizing Yourself, Your Family, and Your Child - In That Order!}

Our house often feels like a war zone. The stress feels like it never ends and even becomes our new normal. It affects our bodies, our minds, our relationships.

{Not coincidentally, our kids with Chronic Post-Traumatic Stress Disorder (C-PTSD) often perceive chaos as normal and their bodies can become "addicted" to the stress hormones, to such an extent that they attempt to recreate the chaos in their everyday life with us. Why Doesn't My Child Feel Safe?}

Continuous Traumatic Stress

It's not Post-Traumatic Stress Disorder if you're still living it.
Back in the 1980s, mental health professionals dealing with victims of political repression in South Africa found that the usual treatment for PTSD provided little help for people living in fear that the victimization could happen again at any time. 
CTS - Not a Disorder
People experiencing continuous stressful environments might be formally diagnosed with C-PTSD* or DTD**. 
Although many people experiencing these kinds of repeated traumas will have enough resilience to avoid developing full-blown trauma symptoms, coping with CTS often depends on how or where the trauma takes place. This includes war zones where the threat of physical attack remains very real and a state of “permanent emergency” exists. 
When the Trauma Doesn't End How can people learn to live with chronic traumatic stress? by Romeo Vitelli Ph.D. Posted May 29, 2013  
I think we can safely include parents of children with severe trauma, aggression, violent tendencies, and other disorders among those dealing with CTS on a daily basis.

CTS in Parents/ Caregivers

The following article refers to Post-Traumatic Stress Disorder,  but I believe you'll agree that the more accurate term is Continuous Traumatic Stress. "Post" implies that the traumatic event(s) are over.

PTSD in Parents of Kids with RAD

Many foster and adoptive families of Reactive Attachment Disordered children live in a home that has become a battleground. In the beginning, the daily struggles were expected, after all, we knew that problems would occur. Initially, stress can be so subtle that we lose sight of a war which others do not realize is occurring. We honestly believe that we can work through the problems.
Outbursts, rages, and strife become a way of life. An emotionally unhealthy way of life. We set aside our own needs and focus on the needs of our children. But what does it cost us? {Handling Rages}
In war, the battle lines are drawn; an antagonism exists between two enemies. In our homes, we are not drawing battle lines; we are not prepared for war. We are prepared for parenting. Consequently, the ongoing stress can result in disastrous affects on our well-being literally causing our emotional and physical health to deteriorate.
The primary symptoms of Post Traumatic Stress Disorder include:
  • Avoidance -- refusing to recognize the thoughts and feelings associated with the trauma, this further includes avoiding activities, individuals, and places associated with the trauma.
  • Intense distress -- when certain cues or "triggers" set off memories of the traumatic event. You may have trouble concentrating, along with feelings of irritability, and frustration over trivial events that never bothered you in the past.
  • Nightmares and flashbacks -- insomnia or oversleeping may occur. You may exhibit symptoms such as heightened alertness and startle easily.
  • A loss of interest in your life -- detaching yourself from loved ones. Losing all hope for the future and a lack of loving feelings.
Secondary symptoms of Post Traumatic Stress Disorder can include:
  • The realization that you are no longer the person you once were. Relationships have changed by alienating yourself from loved ones. Loneliness and a feeling of helplessness prevail in your daily life.
  • Depression, which can lead to a negative self-image, lowered self-esteem, along with feeling out of control of your life and environment. You may become a workaholic and physical problems may develop.
  • You become overly cautious and insecure. Angry outbursts may occur putting stress on significant relationships.

Stress - Fight-or-Flight  
Your body perceives stress like an attack (think of our ancestors being attacked by a tiger) and reacts with an instinctual fight or flight response. This feeling prompts your adrenal glands to release a surge of hormones, including adrenaline and cortisol.

To fight the "tiger," adrenaline increases your heart rate, elevates your blood pressure, and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream, enhances your brain's use of glucose and increases the availability of substances that repair tissues.

Image result for stress tiger
Cortisol also curbs functions that would be nonessential or detrimental in a fight-or-flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system, and growth processes. This complex natural alarm system also communicates with regions of your brain that control mood, motivation, and fear.

When the natural stress response goes haywire
The body's stress-response system is usually self-limiting. Once a perceived threat has passed, hormone levels return to normal. As adrenaline and cortisol levels drop, your heart rate and blood pressure return to baseline levels and other systems resume their regular activities.

But when stressors are always present and you constantly feel under attack, that fight-or-flight reaction stays turned on.

The long-term activation of the stress-response system — and the subsequent overexposure to cortisol and other stress hormones — can disrupt almost all your body's processes. Stress Management - Mayo Clinic 

"[C]hronic stress can be debilitating and overwhelming. It can affect both our physical and psychological well-being by causing a variety of problems including anxiety, insomnia, muscle pain, high blood pressure, and a weakened immune system. 
Research shows that stress can contribute to the development of major illnesses, such as heart disease, depression, and obesity. The consequences of chronic stress are serious." Chronic Stress- American Psychological Association

*Complex PTSD (C-PTSD)
Though CTS is not considered a disorder in itself, a new diagnosis has been suggested to take continuous traumatic stress into account:  Complex PTSD (C-PTSD).   
Judith Herman, author of Trauma and Recovery (1992), suggested people dealing with child physical abuse, intimate partner violence, women trapped in sexual slavery and other people experiencing long-term stress often showed symptoms very different from people experiencing single-event traumas. As a result, they can often become passive and withdrawn (due to learned helplessness), or develop highly unstable personalities. This could lead to dangerous repetitive behaviours such as becoming involved with violent partners,  repeated self-harm attempts, or chronic substance abuse. 
Though not part of the new DSM-5, suggested C-PTSD symptoms in adults include:
  •         Difficulties regulating emotions, including symptoms such as persistent sadness, suicidal thoughts, explosive anger, or covert anger
  •         Variations in consciousness, such as forgetting traumatic events (i.e., psychogenic amnesia), reliving traumatic events, or having episodes of dissociation (during which one feels detached from one's mental processes or body).
  •         Changes in self-perception, such as a chronic and pervasive sense of helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
  •         Varied changes in their perception of the perpetrator, such as attributing total power to the perpetrator or becoming preoccupied with their relationship to the perpetrator, including a preoccupation with revenge.
  •         Alterations in relations with others, including isolation, distrust, or a repeated search for a rescuer.
  •         Loss of, or changes in, one's system of meanings, which may include a loss of sustaining faith or a sense of hopelessness and despair.
**Developmental Trauma Disorder (DTD)
Since C-PTSD does not adequately reflect the kind of developmental impact seen in children, clinicians have suggested an alternative diagnosis, Developmental Trauma Disorder (DTD).
Symptoms for children are similar but also include:
  • behavioural problems,
  • poor impulse control,
  • pathological self-soothing (through dysfunctional coping mechanism such as self-cutting), and
  • sleep problems.  
When the Trauma Doesn't End How can people learn to live with chronic traumatic stress? by Romeo Vitelli Ph.D. Posted May 29, 2013

Treatment of CTS
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Living with CTS 
So what do classic PTSD symptoms such as flashbacks, nightmares, hypervigilance and the startle response mean for people who are afraid of being re-victimized? People experiencing CTS are usually more preoccupied with the possibility of future traumatic events than by what happened to them in the past. 
For them, staying vigilant is a healthy way of responding to what they must face although they need to learn to tell the difference between realistic vs. imagined threats to their safety. 
When the Trauma Doesn't End How can people learn to live with chronic traumatic stress? by Romeo Vitelli Ph.D. Posted May 29, 2013

Caregiver Fatigue/ Compassion Fatigue

The demands of caregiving can be overwhelming, especially if you feel you have little control over the situation or you’re in over your head. If the stress of caregiving is left unchecked, it can take a toll on your health, relationships, and state of mind—eventually leading to burnout.
When you’re burned out, it’s tough to do anything, let alone look after someone else. That’s why taking care of yourself isn’t a luxury—it’s a necessity.

Caregiver stress and burnout: What you need to know
Caring for a loved one can be very rewarding, but it also involves many stressors. Caregiver stress can be particularly damaging since it is typically a chronic, long-term challenge.

If you don’t get the physical and emotional support you need, the stress of caregiving leaves you vulnerable to a wide range of problems, including depression, anxiety, and burnout. And when you get to that point, both you and the people you’re caring for suffer. That’s why managing the stress levels in your life is just as important as making sure your family member gets to his doctor’s appointment or takes her medication on time.

Common signs and symptoms of caregiver burnout
  • You have much less energy than you once had
  • It seems like you catch every cold or flu that’s going around
  • You’re constantly exhausted, even after sleeping or taking a break
  • You neglect your own needs, either because you’re too busy or you don’t care anymore
  • Your life revolves around caregiving, but it gives you little satisfaction
  • You have trouble relaxing, even when help is available
  • You’re increasingly impatient and irritable with the person you’re caring for
  • You feel helpless and hopeless

Helping Ourselves - Recovering from CTS and Burnout 

There will always be times when we feel defeated. Like we just can't take one more step. We want to run away.  We want to drop kick this kid.  I have heard so many people say, "I am DONE!  I can't take anymore!"  

I have soooo felt this way myself.  First of all, remember that YOU ARE NOT ALONE!! 

But My Child Needs Me! Giving Until There's Nothing Left
By the time most women reach out, I think we have hit rock bottom. 

 Like most moms, especially moms of special-needs children, I gave and gave and gave until there was nothing left. No reserves. Nothing. I was completely empty. That's hard to come back from.

A woman on one of my support groups was talking about feeling overwhelmed to the point that she found herself having no patience for her child and yelling at him all the time.  She was no longer able to be a therapeutic parent like she used to be.  In my response to her, I realized that things really have changed for me over the years, and I don't think it's just because Bear is out of the house and Kitty is stable.  I really am in a better place emotionally.

I totally get it.  When my kids first got here, I was empathetic, calm and patient with them- maybe TOO patient.  I stuffed things down, let it roll off my back, and GAVE and GAVE and GAVE... until there was nothing left.  I was so burned out and overwhelmed that we were all miserable.  

Here are some things I did to get ME back:

I know it sounds stupid, but I needed "permission," encouragement, and constant reminders to take care of myself.

Parenting a child with attachment issues is incredibly draining and we need extra support to deal with that. But it felt so wrong to prioritize my self over the needs of everyone else.

Society tells us that as women, we should be nurturing and prioritize our family. We should always put ourself and our needs last.
People who work with our child tell us we should prioritize that child. That we should do more for the child. 

They are all WRONG! 

What you HAVE TO do is prioritize yourself over the needs of the family! 

All those well-meaning people who say you SHOULD (or should not) be doing something have no idea what living 24/7 with a child with an attachment disorder is like. 

Even those who have experience working with special needs children don't know YOUR child and how your child is with YOU - plus they work at most an 8-hour shift with your child, then they get to go home!  Also, none of them take into account your other children or your marriage, let alone your needs as the caregiver of your family.  Their priority is the one child, not your family as a whole.

I also needed "permission to prioritize myself and the rest of the family over the needs of one child. Yes, my job as a parent is to help this child, but not at the expense of my marriage and the other children. Prioritizing Yourself, Your Family, and Your Child - In That Order!

Putting Yourself First
Remember what they say when you're on an airplane that is in trouble -- put the oxygen mask on YOURSELF first.  If you are not taking care of yourself, then you can't help anyone else.  

You have to find what works for you.

This is definitely easier if you have support, but you have to prioritize your needs, even if it's just something little, like keeping the best piece of whatever you're serving for dinner for yourself. 
If you give and give and give without getting much, if anything, back, then there is nothing left for anyone!

I knew I could not help anyone on empty. I had to find ways to refill my cup before I could even think about the rest of my family. It sounded impossible. 

Self-care? Who has time for that?

The answer: Without it, you're out of time (and emotional reserves). It's the only thing you have time for until your tank is no longer empty.

Go out of your way to do things just for you. Things that remind you of who you are outside of being a parent. I don't mean go to the gym once a week. This is not a New Year's Resolution kind of thing. I mean put the kids to bed early every night (we called it "room time") and have some adult time. Plop the kids in front of a video with a PB&J on a paper plate and do something that fills you up. {Getting Respite, Planning a Retreat }


For me, that meant getting my Love Language needs met. I'm a "Words of Affirmation" girl. I found ways to get people to praise my work. I blogged. I mentored. I hung out with people who "got it" and were encouraging me. I tried not to expect that affirmation from my husband and children. I knew they were too overwhelmed and drained to fill my love tank. {Five Love Languages}


I know you're going to ignore this, but GET SOME SLEEP!  DRINK LOTS OF WATER!  Eat Right!  Exercise!  All 4 are important, but they are in order of priority.  Please do everything you can to take care of yourself.  No one else can.

FYI, exercise does not have to be joining a gym or running 2 miles a day. It can be blasting your favorite tunes and dance like no one's watching, break out the hula hoop, take the dog for a walk... kids can join in if they want to.

Find people who "get it."  Real life, online... just find them, and share!! Remember, "YOU ARE NOT ALONE!"

ASK FOR HELP!!!  and ACCEPT it!!  

When someone has a baby or has been hospitalized, people come over and help out.  They bring food for several days or even weeks.  They clean, go shopping, mow the yard, take care of the kids...  just because we haven't been to a hospital, doesn't mean that we aren't living like survivors of some catastrophic illness or major life event.  When people say, "Can I help?"  Say YES!  You need help.  You deserve help.  Ask for it.  Accept it.  Please!


Not only avoiding toxic people as much as possible but actively surrounding myself with people who "get it." This is why I admin the group Parenting Attachment Challenged Children. It is a safe, positive place


Therapy - for ME!  I needed to talk to someone whose primary goal was helping ME deal with my life. I found a therapist who specialized in trauma.


It is not shameful, and it doesn't have to be forever, but a LOT of therapeutic parents I know (including myself) take medication to help with the anxiety and depression that come from parenting kids with trauma/ attachment issues.


Forgive yourself for not being the "perfect parent" (which doesn't exist!) that could heal/fix your child.  Give yourself time to grieve the child that you wanted (one who could love you back, heal with your help, be RRHAFTBALL... 


Do silly, fun stuff with the kids. Do silly, fun stuff just to entertain yourself! Here're some ideas 99 Ways to Drive Your Child Sane and Brighten Up a Boring Day!


Even if it's for the most minute of successes.  Have you seen that Wendy's commercial about a little girl who lost her baseball game, but they celebrate because she didn't get hit by a ball?! 
  • I didn't smack my child when she screamed in my face for the millionth time (Get a mani/pedi - even if you do it yourself).  
  • My kids ate dinner, fast food in front of the TV counts!  (Go on an ice cream "date" with one of my healthy children).
  • No blood was spilled in the last hour! (Take a hot bath with a trashy novel and a glass of wine after the kids go to bed).
  • Behavior Bingo - Behavior Bingo is something I heard about from somewhere on the web. As a way to cope with her children's behaviors, this mom started pretending that whenever her child did something annoying (like pitch a fit, or paint with poo, or call her a $%#*... she would sometimes act really excited like she'd gotten to put a marker on her imaginary bingo board. She didn't tell her kids what she was doing or why. Every now and then she would yell out, "Bingo!" She usually thanked the child for the behavior (again without telling the child why), and rewarded herself in some way (got an ice cream or a margarita or whatever). She said it made her feel better and confused the heck out of the child(ren). lol
    Image result for adulting award 
  • ... 


  • How to Have Good Dreams 
  • Deep breathing - slow, deep, even breaths from the diaphragm, rather than short, shallow breaths from the chest. Can try counting - especially if trying to go to sleep
- Get comfortable and relax muscles.- Inhale deeply and hold it.- Exhale and repeat.- Try adding stretching.
  • 4-7-8 Breath. I use this quick and simple breathing every night. It works!
  • EFT Emotional Freedom Techniques (aka Tapping).  This can be a full tapping routine or just something simple like a side hand chop.
  • Mantra (can be used with tapping) - Choose a positive, calming word or phrase. Repeat it over and over to yourself silently to prevent distracting thoughts from entering and calm yourself.
  • Exercises that cross the mid-brain (like Brain Gym).  Sometimes I use a tapping-type technique - like patting my left knee and then the right, over and over. I've also crossed my arms over my chest and alternately tapped the backs of my upper arms in a subtle way that others probably won't even notice.
  • EMDR is a therapy that works in similar ways (crossing the mid-brain).  
  • Exercise - Going for a walk or run, yoga, jumping on a trampoline to clear the mind and reduce stress.
  • Distraction/ Redirection - Find a different activity or something to focus on that distracts from an event that is causing stress.  Lots of ideas in this post about the Attachment Challenge.
- Read a book or magazine.- Listen to relaxing music or watch a video.- Do a crossword puzzle, or play an electronic game.- Make cookies.- Play with playdoh- Try lying down and taking a nap.- Go somewhere in your imagination.- Cocooning (create a cozy, womb-like area with books and soft toys). 


Prioritize Your Relationship with Your Significant Other
With any luck, this person will be around long after your kids are out of the home.  Respite, date night, at least 5 minutes a day of time together where you DON'T talk about your kids.  I also found it helped to have 10 minutes a day to talk about the kids, and schedules and how your day went...

Prioritize Your Relationship with Your Other Kids
Spend extra time with your other kids.  Go on "dates" with them.  Find times to chat.  Treat them to a little extra mommy time.  The squeaky wheel gets the oil and that means often the other kids can get shoved to the side.  Plus it helps you by getting some time with your child(ren) that is capable of having a relationship with you.

My Top 10ish Things I Couldn't Do This Without

Stop Walking on Eggshells - A book that really helped me set boundaries for living with RAD/ Borderline Personality Disorder/ Older Teens

Finding the Joy 

This is one of the hardest things I've ever done and one of the most important. I wasn't ready for it until my "love tank" was a little more full. I highly recommend this post to you when you're ready!

You Have Not Failed

I did have to accept the fact that one of my children was not able to heal. While I was recovering from the PTSD caused by him living with us, I would often start feeling guilty about my failure to "fix" him. I have reread this post a thousand times to help me combat this feeling. It works for me.

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