When people have trouble paying attention, when they’re too emotional, or reactionary, or downright aggressive, what can we do to help them turn it around?
Perhaps too often, these behaviors are addressed with medication for ADHD or bipolar disorder.
But according to Bessel van der Kolk, MD, the problem (and the solution) may lie in knowing how to recognize the signs and symptoms of childhood trauma.
Bessel walks us through the major markers of this kind of trauma in this short video – check it out, it’s just 4 minutes.
Have you ever recognized any of these symptoms as potential childhood trauma? Please leave your thoughts in the comments below.
“Fear, flight, and freeze ” are the common responses to threat and trauma but submission and compliance are also responses that should be recognized, especially as those strategies can and do arise in patients’ relationships with their therapists . Persons with prenatal, perinatal and early developmental trauma usually will not have a conscious awareness of the trauma and cannot put into words the experience. The memory will persist unconsciously held in their bodies until they feel safety, acceptance, understanding and care from another. Sometimes, clients will have an awareness of a significant trauma but not reveal it to the therapist because they cannot really trust another and they take on the role of being the good, acceptable compliant patient. They seek help but may often not only feel guilt/shame, but also feel responsibility for the trauma they endured. Body-centered psychotherapies or body work in conjunction with talk therapy is most helpful in the healing processes of very early trauma. (The common practice in this country of the barbaric torture of unnecessary genital mutilation of newborn males in infancy is a relevant aspect of early trauma that needs to be recognized. The reluctance and norms against even speaking about circumcision are similar to those that surround the common practice of sexual abuse by priests as shown in the the recent movie “Spotlight”. Ronald Goldman’s book “Circumcision: The Hidden Trauma- How an American Cultural Practice Affects Infants and Ultimately Us All” should be recommended reading for every therapist I would also recommend methods of the Pesso-Boyden System Psychomotor (PBSP) and other body-centered therapies. The experiences of trainees in the body-centered healing methods contribute to healing and personal self-knowing within the therapist of the deep inner territory of terror, mistrust, dissociation, rage, shame and submission which are the enduring results of early trauma. That personal knowing on the part of the therapist is highly useful and perhaps essential in working with the vast numbers of clients patients having those issues.
I hope these perspectives might be useful in this discussion and am grateful for discussion opportunities and information that is disseminated in the presentations.
Thanks and best wishes to all.
Yes! I agree. After 20 years of detective work, I am finally able to notice when I am dissociating and ground myself. I believe the body work of Somatic Experiencing, along with mindfulness practice, are helping greatly with this.
FRIEND and FLOP (the stage beyond FREEZE) are also stages in the trauma response.
Thank you Ruth. I suffered no childhood trauma. My marriage eventually disintegrated, but was not physically or mentally destructive.
I do not ever feel unsafe or helpless. I live a good life with my children, grandchildren and friends. But it is lived with the awareness that I could not save my daughter. You have been made aware of her condition, her ability, creativity and the illness which destroyed her. I can continue with my life, but I could not save Anne Marie. That fact stays with me.
I have thought for a long time that there is a connection between childhood trauma and ADHD, eating disorders and the “isms” later on (workaholism, alcoholism), etc. So glad to see it coming out for discussion.
Thanks Ruth and all your specialists.
When we learn to love and protect our children society can eventually heal itself.
Childhood trauma survivor,
Val Heath
Absolutely!!
For many years I have argued about the misdiagnosis of ADHD in children. Yes , some children may have it but even those who do often come from disruptive homes and homes with a a great deal of anger in them and other emotional issues….and of course Trauma!!
The impact of trauma and the many symptoms which come as a result create development of mechanisms such as you have described in the video ; which then become coping skills which cause a new set of problems. If one is patient enough and engages with the client to help them understand when these behaviors developed you are more likely to get a better feeling for what the underlying issues are.
I am thrilled to see you bringing this to light and sharing!! Thank you!! Traci
My daughter was diagnosed with ADHD at age 5. When she was 4 her dad was murdered. Even though she was small, im sure her trauma is the root cause of her issues. She is now 11. We underwent 4 years of therapy and everyday is a struggle. I made the decision to no longer medicate her about a year ago. We are going to start Biofeedback soon. Medication is not the answer. I believe she will be fine. People want to make things more complicated than they really are. God has a special life purpose for victims of trauma and once you find what that us.. Your food.. Its all good!
I’m glad you decided to be proactive in your daughter’s treatment. It is quite disturbing to see the number of tender young lives that are “dulled” and controlled by medication. Instead of being so quick to prescribe chemical remedies for “behavioural issues there should be much more support to help parents teach their children self-regulation and other healthier ways to direct their energies. This, and ruling out PTSD should be the first line of treatment before resorting to pills.
Absolutely agree. Being too fast to diagnose a client with PTSD when ADHD symptoms have been seen in early years, doesn’t mean that medication has to be part of the treatment as a solution. Self-regulation, behavior, mood managing and environmental response can be well managed when supervised.
Very interesting… may even apply to any developmental issues as adults from difficulties in relationships at home, outside the home and in the workplace. Again appreciate the valuable insights being shared about ways to recognize a problem and choose an appropriate solution.
I appreciated Dr. Van der Kolk comments.
From a psychodynamic perspective on development, it is always essential for me to get as close to the whole picture of the client’s life as possible. With children, I even include the previous generation so as to understand familial dynamics. With this approach, it is easier to uncover any history of trauma, even intergenerational trauma.
I have dealt with and am currently dealing with depression, anxiety and other dependency issues related, I believe, to my upbringing. My responsibility was to make everyone happy at the expense of my own feelings. Objectification seems to be the word that sums it up best. What s responsibility for a young child. I cannot let it go. Following my own conscience create greats stress and the fear of not being loved.
Be careful removing from meds. It’s a double edge sword.
Get a second opinion. I could see the frustration. Who wants kids so young taking all these medicines. Then to learn she may out grow the shot comings.
I agree with Anthony. All psych meds are potentially addictive (including the amphetamines sold as ADHD medication), and in susceptible people, can trigger a host of symptoms, including withdrawal psychosis, suicidal and homicidal ideation, increased anxiety and worsening depression, just to name a few.
These drugs have not been approved for paediatric populations, and their widespread use seems to be a result of pharmaceutical industry fraud and undue influence on medical education, corruption in the licensing procedures of the FDA, and the current inability of many to accept that healing from trauma takes time (in the hands of skilled therapists), and to perhaps deal with their own fears about the safety of their loved ones due to mental health issues. I have nothing but empathy and compassion for the latter. It can be terrifying when a family member is mentally unwell.
I am not saying all drugs are bad, but for those who cannot metabolise them (either due to polypharmacy or lack of genes in the CYP450 family), the use of drugs can be catastrophic, delaying or destroying any chance of recovery. Also, all psych medications, taken over the long-term, cause cognitive decline. Patients are generally not warned of this before they begin taking them. If drugs are used, I wish doctors would use them as a short-term intervention, not a long-term band-aid. The following website is a mine of information, maintained and updated by a growing cohort of pharmaceutical drug casualties: survivingantidepressants.org
Hello Esteemed Ruth and Bessel,
Would you be willing to allow Fetal Alcohol Spectrum Disorders to enter the conversation? We know: 70% of Canada’s foster kids are dealing with the brain damage of FASD; at least 5% of the populations of developed nations would be diagnosed with FASD; and the symptoms cluster around AD/HD, executive functioning, affect regulation and adaptive behavior. The common dxs are AD/HD, bipolar, RAD and of course ODD.
The science is unequivocal but split off from the fields of trauma, attachment, learning and delinquency–so far.
For example, Bruce Perry and others (including you?) have mentioned the smaller brains of children who have experienced trauma and neglect…without checking to see if these kiddos had smaller brains at birth, and alcohol exposure.
Now that the DSM V actually HAS prenatal alcohol exposure as an example of neurodevelopmental disorder (315.8), I wonder if it would be more compelling to consider. Maybe that doesn’t make a difference.
Please let me know if I can be of further help.
I could die happy if you two
sorry, that comment got sent too fast. I meant to delete the last line…
kp
I completely agree with Dr. van der Kolk. I have made these observations for years in children and adults. Trauma so often gets overlooked during assesments.
I’m so glad we are starting to acknowledge this. I see it constantly with the recovering people I work with. Most particularly I’m glad Dr. Van der Kolk mentioned the self soothing. If the drugs and alcohol aren’t there as he mentioned there is spending, sex, food, co-dependency etc.
Feel like I could write a dissertation on this topic.
Just take one small issue and examine how a mother who smokes while pregnant does effect her baby’s psychological and physical life thereafter.
Smoking causes the baby’s brain to be stunted because it causes hypoxia (depleated oxygen) in the amniotic fluid…and smoke contains 4000 chemicals (including cyanide).
Depending on when she smokes, i.e….before she’s pregnant, when she conceives, during the embryonic stage, during the fetal stage, during which trimester….all (is my guess) would make a difference…but still smoking has an effect….
Thinking aloud though, what emotional effects and what physical and brain development issues would show up?
This link is the first article that comes up on a Google search… Still birth, prematurity, lead poisoning, blood sugar problems, diabetes.
Smoking brings down sperm count and injures the DNA the sperm that remain.
But also, a smoking mother is setting a MODEL up, or behavioral example of how to *do your life*… A perspective lens on things. A set of avoidance tactics of how to manage one’s stress. There is potential there for the baby to have a craving for the same poison.
Addiction or not, underweight babies ARE more prone to brain bleeds, less brain development, fewer neural pathways,…and if they do not get skin to skin/breastfeeding…cerebral palsy, delayed motor development feeding problems, blindness, deafness, ADD ADHD, and ASD
(Jill Bergman’s *Hold Your Prem*) p. 122-123. Apparently smoking is related to SIDS too (Sudden Infant Death Syndrome).
If you go ahead and imagine what hypoxia is like in the womb…what does it feel like to have to hold your breath on and off… due to somebody else’s control- what do you feel?. That translates to resentment, dodging behaviors, always being ready to be on guard, troubles breathing-like asthma. There is a difficulty feeling free-enough to take a full breath of fresh air. This is NOT a lovely outlook, or premonition of what wonders life has offer.
Thanks for your comments Elena, I really enjoy the way you have woven together a bigger picture.
I see this kind of misunderstanding all the time in my practice. In particular, I see a pattern where early childhood neglect and abuse leads to a diagnosis of borderline personality disorder and all of the stigma associated with that — not to mention the implication that the problem is an intractable part of their personality. It adds insult to injury in the worst possible way. And in light of the experiences of severe trauma we are able to uncover in therapy, all of the ‘borderline’ symptoms make sense as an understandable reaction to the trauma, not something inherently wrong with the client.
I feel so strongly about this, so thanks for bringing it up!
Thanks Leslie for such a succinct and insightful comment! Yes – these are ‘understandable reactions to trauma’ – and call for compassion, not stigmatising diagnoses. Your clients are very fortunate to have
you. I hope I find a counsellor with similar perceptiveness… 🙂
Our childhoods and the first relationships we have with our caregivers are so impactful. If from an early age we are not nurtured and loved and ‘taught’ by modelling how to understand and manage our emotions how can we be expected to do this as adults for ourselves.
I work with sand tray with many adults to enable them to reach a much earlier phase of their life often prior to their ability to verbalise. This brings up early traumas and I feel we need to be respectful of this rather than pathologize and medicate.
Thank you – these insights helped me understand for the first time why my mother suffers from these symptoms; she suffered emotional abuse and neglect throughout her childhood and had her home destroyed by bombing during World War Two. It has also thrown light in retrospect on a client’s behaviour that I had assumed, along with her psychiatrist, was due to a personality disorder. Hindsight is a wonderful thing!
Childhood trauma is usually the first possibility I consider when people come to therapy. With couples, I always do a family history of both persons.
What can we do for adults who display this behavior? Can it be assessed that their erratic behavior is from a childhood trauma that has never been addressed? Could these adults lash out at others, get into other people’s businews to the point of it being obsessive?, and not partake in substance abuse?
Is there any research for this group?
I have seen adult women who experienced severe trauma in early childhood being misdiagnosed with schizophrenia, Bipolar, BPD, ED, ADHD, and other self harming behaviors of suicide, self mutilation, DID, and SUD.
I currently I am working with a client who has been committed to a psychiatric hospital for four months. Her early trauma is known, but she has been diagnosed with PTSD and is being treated with Ritalin. Her symptoms are obvious to me, a lowly counselor who has studied childhood trauma, but evidently not to her psychiatrist.
In fact I was at a presentation of ACE and consequences to a group of psychiatrists and they were all fascinated, as if this were a new concept. I know Freud has been somewhat discredited but he wrote about these phenomena.
This lack in education amazes and appalls me.
Suzanne,
There are so many therapies in the psyche arena. Psychiatrist sometimes are in a different league.
It’s amazing how problems are resolved with so many options to pick from
I would expect doctors to be up on their game. It’s must be difficult because there are so many meds that they could give out, then they’ll tell you we have to try this and that one. They are in the dark.
Just as in Freud’s day, there continues to be a tendency to “look away” from childhood or developmental trauma. It is easier to label behaviors ADHD or even Borderline PD(!) than for parents, and some professionals, to look deeply into the core signicance of children’s so-called acting-out behaviors.
The unfortunate, insurance-driven emphasis on symptomatology, & on cause and effect, today leads many down this garden path. A former supervisor of mine often said, l the map is not the territory.
If we truly embrace a relational-constructivist perspective in conjunction with an attachment-style focus, we would be listening for interpersonal relating styles. We’d be asking What? Where? When? How?, that is, asking about the relational details in a person’s narrative, rather than focusing on the Why?
I remain impressed by the seminal writings of Alice Miller MD. For the purposes of this discussion , in particular, her book, Thou Shall Not Be Aware, addresses the professionals’ collusion with overlooking &/or encouraging patients to forgive & forget developmental traumas.
I am most grateful to trauma pioneers, like van der Kolk, & Fonagy for their work in keeping our professioal eyes wide open.
I meant helpful!! Sorry!
Thank you for sharing this clip… Very helpful?
Thank you for providing these healing resources. A book that’s helped me heal from childhood trauma is “Complex Post Traumatic Stress Disorder – From Surviving to Thriving, a Guide and Map for Healing from Childhood Trauma” by Pete Walker. Pete has walked through his own healing process and therefore a reliable voice for showing me the way. I tend to trust therapists and friends who’ve done their own healing and know what healing really involves.
I work with adoptive families and present the pre-adoptive parent education (25 hours) for my agency. We have been trying to teach our parents about developmental trauma for some time so that they have some awareness before they bring their child home. As internationally adopted children have often been through many transitions, caregivers, trauma, neglect, etc., our parents need this understanding so that they can advocate for their child in school, doctor’s office and therapist’s office, as well as the community and even extended family. This subject is really my “soapbox” and although this information was not necessarily new to me, I am thankful that there are discussions about it. I am now being contacted by past-adoptees who are adults. Back when they were adopted, the theory was to just love the child and all would be well. Due to that philosophy, parents did not know that this wonderful adopted child experienced a different brain developmental trajectory than biological kids and kids who did not experience their first years (plus utero) bathed in stress hormones. Any information to the public, parents, teachers regarding developmental trauma will provide parents and caregivers a new way to consider the needs of these children and adults.
Thank you!
More please!
Dr Kim,
Thank u sooo much after spending a couple decades in many 12step programs, something wasn’t being ‘fixed’ I found a gifted SE Practioner who valued do reserve cultures and was sensitive to the impact of transgenerational traumas. I am in the last year of becoming an SEP. My darma is to help African Americans, particularly adoptive children resolve the effects of overwhelming events in their nervous systems. We in the US are observing horrors because of the cultural crime of slavery and I as an African American female SEP student would appreciate if Ruth and contributors would discuss and even just mention the slavery that took place in the United States (like they have mentioned the holocost) and how it impacts People today. People are harming themselves and one another.
Thanks for the reminder. It is an important area to explore. I have just started seeing a new client (2 sessions), well educated and very articulate but has anxiety management problem. I think I would do her dis-service if I neglect to explore her perception regarding the slavery history and how it has impacted her mind and body.
I have a daughter I adopted at 3 mos. of age (international adoption). Desperately looking for an experienced clinician to help her (she is now 20). Has been diagnosed with ADHD, anxiety and now has an eating disorder. Been to several psychiatrists, psychologists and therapists. Any help would be deeply appreciated.
I have recognized this for the last thrity years and integrated this knowledge in my private practice. However, today this is still not common knowledge and old paradigm that the distracted behaviors are ADD or ADHD or Bipolar are still being diagnosed by other professionals, school systems and parents. Which makes it difficult for children especailly to truly get what they need and not what they need (psychotropic medications that I believe are further impacting their normal developmental processes and creating a differnt type of re-traumatization). Thanks for your efforts to get the word out because it is so desperately needed if we are not going to create generations of confused people thinking they can’t live productive lives.
Very interesting subject and great conversation. Thank you.
Having worked with individuals for many years, I perfectly agree with what Dr. Bessel van der Kolk says about trauma. Trauma is insidious, chronically affecting people in so many different ways. His book gives insights that are essential for being able to understand the causal issues of an individual’s trauma and how to work with them to alleviate symptoms.
No words of gratefulness for this video. It really touch me very much,,, and thanks to all the people that made their comments, there is so much to learn about all this. And thank you Ruth, for allowing all of us to increase our knowledge, our understanding and insight about ourselves and the world that surrounds us.
Everyone should read an der Kolks’s the Body Keeps the Score: it should be a required text in any graduate program related to counselling and psychotherapy.
I have been in Adult Children of Alcoholics for several years. I have 30 years of sobriety and still have problems with relationships and I have given up on them. I am 60 years old and I gained 100 pounds when my daughter died. I have had some DVD’S on a Summit for tapping. I am afraid to use them because I may fall apart. I can no longer afford a therapist and I cant\’t remember anything from my childhood. Do you think that watching these DVD’s will help? Thank you so much . I do take Adderall to help me focus because I can’t seem to get anything done unless I am under a deadline or some kind of outside pressure.
I know these symptoms all too well from myself and my clients. Fortunately I can say, that even with hereditated trauma symptomatic from a mother with PTSD it’s possible to start a joyful living and re-invent yourself, not longer as victim, but as protagonist on the drivers-seat of your life.
I had help and I searched for many years for the most effective methods to overcome this massive interference. Tapping helps, but in your case I’d look for a trained practitioner on trauma.
For treating effectively a trauma and to eliminate the related stress – high cortisol level – it’s not necessary to remember details. Your body sensations speak the truth and can lead the therapeutic process.
Actually I work mainly with the Trauma Buster Technique of Rehana Webster (Tapping + NLP) and had so extraordinary results, often with 1 single session, that it brings me to tears of gratefulness, seeing that women raped as 5-years-old, diagnosed as bipolar, and with chronic pain and dizziness 6 months after the treatment starts to work regularly again after 8 years of invalidity pension.
Christine, I think if you take a chance on those DVDs you might find that though a lot of emotion is likely to come up, if you continue, keep going with the tapping even while the great emotion is engulfing you, that you may really feel some relief afterwards. Just don’t stop tapping UNTIL you feel
Some relief.
Excellent reminder that our histories matter. So many clients repress these memories or don’t want to deal with them. Others have no conscious memory of the trauma….especially true of birth trauma. As clinicians we need more information on how to work with this, and to help those children (and their parents) who suffer as a result.
very interesting since I’m recovering from severe depression with suicidal ideation. I’m 51 years of age, lost my own mum from suicide when i was 3 years of age (she was abused by her own brother and my dad was very very authoritarian, might he be a bit abusive as well), at 14 years of age i was abused by my own brother and finally I’ve left my husband due to psychological, economic, isolation and physical abuse. He left me (signing for a contract at 2500 kms from here with my 2 children (18 + 16) just 19 days after having got a pulmonary embolism. got a severe depression (2 weeks in respite house + 1 month in psy ward) where no one (except 2 friends have visited me. He left the kids 6 weeks alone and I could only sleep 90 minutes a night for 6 months. Finally he mimcked my tears and when i begged him to stop belittling me he answered me : oh you are praying to the mecca.
Anyway I’m safe after 6 or 9 suicide ideas. all is ok right now .
Of course . So glad Bessel that you are speaking out about this. So many kids are clearly misdiagnosed and treated with medications at the symptom level,rather than there being any attempt to understand the underlying etiology The issues that have led to the child’s difficulty with self regulation is constantly being missed with these kids. Small t developmental trauma needs to become much more of a focus for our attention. The role of parental stress and how it affects the developing child also needs to be much more understood.
I’m glad that someone is recognizing this aspect of PTSD since it can be subtle and sneaky for adults who have repressed the memories of the trauma(s) for self-protection (myself included). I find myself in his hijacking cycle way too often and I honestly know in my heart that I don’t want to be there, but my compass keep pointing me back!
I’m going to share this with my therapist, though I’m pretty sure she already agrees with this model. For adults of past abuse- just because we can’t remember every detail doesn’t mean the effects aren’t as damaging (a past therapist told me that since I was unable to tell her details of my past abuse, I must not have been abused… Really? She also told me to sleep with my husband whenever he wanted sex… Just what a victim wants to hear! I left RIGHT after that- set me back big time.). We work with what we have to get through the days. Targeted therapy helps so much. Lessens the hijacking cycles, etc… Thank you to all the Therapist who continue to learn and expand their minds.
Enjoyed this video, thank you. So many individuals have days and days hijacked by emotions they don’t understand. When upset, they can’t just pop back, rather things seem to get worse. Identifying traumatic experiences is difficult because we are all so different. Many traumatic experiences are minimized by others, making trust a huge issue.
I wanted to say that this point is so important. I am often working with adolescents who for a year don’t reveal underlying trauma, rather demonstrate anxiety, self harm, or school phobia. Finally though opportunity of expressing self in non verbal ways the story unfolds and words begin to emerge which helps make sense of the person’s behavior. With Adults this is quite important, as society may not be as forgiving of certain behaviors exhibited by a person who has an underlying trauma that has never been voiced. This only adds to the adult’s difficulties and reinforces that the world is a bad place. Assessment is key, being able to ask questions in a sensitive manner and at the same time, not telling the person what might be underlying is important. I believe when the person feels safe in the context of a therapeutic relationship and we provide an atmosphere that provides permission and ability to tolerate hearing about trauma, that is when the person can truly share such intimate and frightening information.
All the time! So happy to see you doing more education on this!
There is another very important condition being overlooked on this story and on this website as well.
I hope everyone becomes a whole lot more informed and aware of the signs and symptoms of FASD!!!
Thank you. Yes, I have childhood trauma of molestation, witnessing violence in adults, adults who exercised reckless behavior, adults with alcoholism and inconsistent nurturing, love and bonding (essentially nonexistent) or at the very least, dysfunctional.
Today, I suffer with PTSD from child hood trauma. I stress, finger nail bite and have 2 picked relationships over the past 12 years that are distant, passive aggressive or narcissistic. I find myself in positions of serving them for approval on multiple levels only to be shut out, or even kicked out when they are triggered. I was always the one to say sorry and go back. I finally stopped this cycle after 5 yrs in my last emotionally abusive relationship; however, its in a small community and we know a lot of the people…and people ask questions. It keeps me hijacked and in these extreme emotions, obsessing about the relationship, things that I’m hearing that aren’t fair, things I should have said, things I still should say… it goes on and on. I find I’m in relationships that appear to be low-grade to med-grade bullying…I’m always serving them on some level whether it’s helping with their jobs, problems, etc. I need help.
Check out Melanie Tonia Evans, very insightful & humane recovery process.
Wow. .this Dr. Hit the nail on the head. I could relate to the low self esteem and interactions between people. Once hurt, the trauma rises above and recalls the past hurts.
Once my father would indicate that he would kill us like a goat.
So even to this day I get frightened with knifes.
Dad committed suicide. He has so much disappointment in his life. He endured forty years of trauma from a house fire. This left him depressed and unable to function as a human. So agitated.
As someone who has experienced childhood trauma, I want to offer a resounding “Yes!” to these questions. Although I appeared to be very high functioning throughout childhood and early adulthood, I finally sought help at age 25 when I realized that I could no longer fight my demons on my own. Throughout the years, I have been diagnosed with alcoholism, addiction, an eating disorder, bipolar disorder, major recurrent depression, narcolepsy, hypersomnia, dysthymia, anxiety and atypical psychosis. Other diagnoses such as BPD, OCD and ADHD have been suggested. I have a history of self-harm, suicidal ideation, and relationship issues, particularly with men.
At age 45, after years of insisting my childhood was perfect, disturbing memories finally began to emerge. One year later, I am allowing this incredibly painful process to unfold, in the hopes that I can salvage my future. I never believed that my past should affect my present, but it did, regardless of what I thought. As the traumatic memories emerge, I am experiencing greater difficulties with concentration, focus, completing tasks, and feeling grounded in reality.
I am so grateful to the people who are doing research in thus area, educating the public, and offering help to those of us who need it. I hope to join your ranks one day soon.
Thank you for this post. Up until about 10 years ago, I saw many children and adolescents for assessment of possible ADHD. Among nearly all of these clients, developmental histories and family circumstances could not be ruled out as contributors to their behavioral and emotional management problems. In fact, outright abuse, neglect, or chaotic environments are equally plausible explanations. My decision was to stop accepting these types of assessment referrals out of my fear of doing them more harm. Probably not the best solution but the only one open to me at the time given the mandates and expectations of family, school, and strict mental health systems. I no longer make this particular diagnosis among young adults where there is a history of abuse or other index trauma events. A trauma-informed assessment and treatment approach seems to produce the best outcomes.
Childhood trauma and ‘the wounded child have commonalities. They both agree on the the roots of substance abuse and high risk behaviors. The signs of childhood trauma or the symptoms of it are devastating. The adult can’t process information as adults do. Retreating to self isolation, lack of concentration leads to other issues.
I have all of the symptoms. I’ve been diagnosed with everything but ADHD or ADD. I do indentify with dwelling, and being hijacked. I struggle with medications that affect my thinking. Before given the proper diagnoses, preferred medications become the cause. Getting to the root of the trauma may be difficult. However, the symptoms are all there.
I recognise these symptoms from people with traumatic childhoods caused by parents in distress because of mental illness and alcohol addiction – how some individuals were regarded as inept in school by teachers because they exhibited a lack of grasping certain things. They couldn’t give a simple answer because they were worried they would leave something out and be punished. So they froze, their voice sometimes didn’t work even if they could answer. One person was opening their mouth to speak and nothing came out. They tried a couple more times, but felt struck dumb, literally. It went away quite quickly and they felt foolish and embarrassed.
The individuals concerned felt certain learning processes were impossible to manage even though they were obviously very intelligent (and could reason things out), but became almost intellectually/number blind, when expected to explain these things formally, in writing. This was more than a lack of confidence, or attainment. It have been panic.
One person said that in their early years they zoned out in class a lot and got told off. They were not bored, just disconnected and focuses on something on the classroom wall for a long time. Later it was like knowing an apple was on a tree, but suddenly being unable to express it the way they were instructed to by their teachers. Things like chemistry, maths and foreign processes were pure hell for them because they understood things quickly, but lost it half way through because they suddenly could not hear some of what was being said (like the volume had been reduced), or, at the last moment. Like walking in on half a conversation. This person could see logic, but could not translate it. They couldn’t retain and recall any slightly complicated calculation process. They elected to create their own at one point with some success, but were unsupported in this by their teacher who later told them that maths wasn’t their thing. This upset them because they desperately wanted it to be.
Very glad to see this video.
You comments strikes hard. In school I felt the way. Unable to speak up. Be afraid that I would get punished. Then bully started and that really hit my confidence. Raised to be kind and loving towards people. Adolescence was traumatic.
The positives are hi here, and trying to do my best. Sometimes my expectations trump my wellness.
Am learning to deal with my struggles.
A very interesting take on diagnosis of early childhood trauma. However, I do not think that these symptoms (all or individually) will be manifested in everyone who suffered early childhood trauma. I strongly suspect that the ability to focus in on one thing to the exclusion of everything else happening around a person is also a symptom, although this ability to focus can be acquired for other reasons as well. And the depth of the focusing ability, may have to be quantified so that it can be understood in a variety of pathologic vs healthy lives. Such a person will get a “high” from that focus and not from drugs, alcohol, etc. So van der Kolk does offer some very good insights but they are just the tip of the iceberg that needs to be investigated.
As an adult who had deep trauma in utro and for the first 5 months of life, I still live with the symptoms of hyperviguliance, fear of persecution, hyper sensitivity, dyslexia and keeping myself alone as it feels safer.
With all the work I have done over the years and my many training, that residue of deep hard wiring seem impossiable to upgrade. It amazes me that having had a very close relationship with my mum who adopted me, it still have not over ridden the original pain, the wiring that I set up preverbally, as it is a pure emotion, while I can comfort myself to a point, some triggers have me consumed in the abbys, and days weeks are lost. I can be a lonely path. In the near future, I want to do some work on focusing on adoption and the effects long term. Right now I feel I have to find and live the missing peice of me before I do. Excuse the spelling spell check was not playing. Thank you for sharing your work.
AD/HD symptoms indeed are similar to those of PTSD: difficulty regulating attention, emotions, and performance of intended actions. Both are serious conditions, the symptoms of which permeate the life of the individual: a confused sense of self with shame predominating, a lack of consistency in productivity, excessive effortfulness and/or hypervigilance, explosive and/overly compliant behavior, difficulty regulating sleep which then exacerbates symptoms, challenges in educational and vocational life (sometimes hidden), and, when externally successful in life, a sense of being an imposter and fears of being exposed as not competent.
Complicating the accurate diagnosis of ADHD vs PTSD is the reality that many children experience trauma 1. within their families when biological parents, who are 1 out 4 likely to also have ADHD, have difficulty with their own emotional regulation and explosive interactions between parent and child escalate out of control and 2. In their fulltime job as students where their challenges are often misunderstood as willful disobedience, where humiliation occurs much too frequently, where the confusion of their competence is damaged by failures or struggles to complete work. ADHD combined with trauma resulting in symptoms of PTSD is not frequently enough recognized and both treated.
Thank you. I very much agree. I tend to look for these three signs consistently to attend to potential childhood/development trauma. I was also reading the recent book by Phil Mollon Psychotherapy for Adults with ADHD and Autism which outlines very subtle features of these conditions which are also sometimes overlooked and misdiagnosed. There is an overlap between the two and it is important to consider both with an open mind.
I recognize the problems that are meentioned in a lot of my clients as a psychotherapist. What you also see is a vey normal good functioning mental part of the person. So too well adjustment could also be a sign.
Yes I am One of that mix. I have Aspergers , ADHD, Eating disorder and PTSD my PTSD comes from a cocktail ( not been understood all the years and my many adjustments to cope ,to be, to fiting in and realy diligently sought to getting the same feelings and coping like the other people around me.. And also my mothers stressfull life when she was pregrent with me and my early month of life was also stressfull ( it whas like the world I came out to was not geared to deal with the vulnerable nervous system and the different system and not wrongly just different with in me). I have sufflered many defeats and been incorrectly made many times when diagnoses as borderline and Anorexia and treatments they gave me , did not helped but even made me more bad. As an very unhappy adult , I have gotten a lot of answers by reading and exploring the problem areas. I have not yet found the solution and treatment actually in my search , I reached to this debate. I will read the book mentioned Phychotherapy for adults with ADHD and Autism by Phil Mollon , maybe there some answers I hope so.