Post Traumatic Stress Disorder – PTSD
By Rick Delaney, Ph.D.
Childhood Anxiety Disorders
Many foster children suffer from anxiety disorders such as panic disorder, obsessive-compulsive disorder, specific phobias, social phobia, generalized anxiety disorder, and post-traumatic stress disorder. Of all the anxiety disorders seen in foster children, anecdotally post traumatic stress disorder appears most frequently. But what, you might ask, is PTSD? Post Traumatic Stress Disorder (PTSD) is a disorder that has a serious impact on how the child’s brain func¬tions. PTSD appears after the experience of a significant trauma which inflicts or threatens to inflict harm on the child or teenager. Terror or fear and a sense of helplessness are involved.
Traumatic events can include physi¬cal or sexual abuse, or such incidents as being kidnapped or witnessing the death of a parent. One research study reported that almost two thirds of foster children who had been sexually abused displayed PTSD symptoms. These symptoms can include: intrusive memories, withdrawal and/or numbing, and on-going signs of elevated arousal. Here’s how Martha and Bob Mayer described their foster son’s problems:
Timothy, an 11-year-old foster child, had never spoken of his past history with anyone. But, he seemed jumpy, distractible, preoccupied and shut-down emotionally at times, and withdrawn from others. He rarely showed any emo¬tion, except for fright. He often could not drop off to sleep because he was afraid of the dark. We would regularly find him awake at night, and he would tell us he’d had a nightmare again. When he played with some of his toy people, he always tied them up with string or bound them with tape. Timothy seemed alarmed by any males wearing beards. And, if you entered a room where he was playing, Timothy would jump out of his skin with fear. Odd things would set him off. He was removing his sweatshirt by pulling it over his head, and it got stuck. He freaked like he was trapped and started scream¬ing. This really shocked me. He started screaming angrily at me. It’s like he has some sort of flashbacks or something.
The foster parents did not know it until much later, but Timothy had been physi¬cally and sexually abused in very per¬verted and twisted ways involving being restrained, tied up, and left in the dark. This foster child seemed to re-experience the event over and over again. His play, his recurring nightmares, his obvious distress when confined seemed symp¬tomatic of the abuse and resulting PTSD. Even his withdrawal from others, preoc¬cupation (and concentration problems) and startle response pointed to PTSD as well.
Why Do Kids Act This Way?
All children and adolescents deal with stress and mildly traumatic events which can impact them both emotionally and physically. Normally, their response to these events is short-lived and they bounce back quickly without long-last¬ing effects. However, when the stress or trauma is serious, severe or catastrophic, PTSD may result. Here are some events or catastrophes which can cause PTSD:
- Sexual and physical abuse
- Automobile accidents
- Receiving a diagnosis of a life threat¬ening illness
- Suffering through a severely painful surgery or procedure
- Exposure to domestic violence in the home
- Surviving an “act of God”, such as, flood, fire, earthquake or hurricane
- Living in a war zone
- Surviving a terrorist attack
- Rape
Exposure to these kinds of trauma can increase levels of three brain hor¬mones – cortisol, serotonin, and nor-adrenaline – which may impair brain development and actually change how the brain works. Children who live in a constant state of fear in, say, dan¬gerous, abusive families, also live in a state of chronic stress. This can result in a variety of developmental delays as well as problems with controlling emotions such as anger and fear. In general the brain chemistry can be changed by trauma so that the child might be ultra tuned-in to signs of danger and aggression.
Can Anything Be Done About It? Yes!
With the responsiveness and avail¬ability of parents and professionals, foster children and teenagers with PTSD can be helped to overcome or deal with the effects of the traumatic incident(s) and move on with their lives happily and productively. But, how can you as a foster parent specifi¬cally help in the healing process?
Here are some suggestions:
Early Intervention:
the sooner the child receives professional help the better the outcome may be. Talk with your caseworker about secur¬ing care for your traumatized foster child. If there is doubt about what has happened inquire about hav¬ing the child evaluated by a mental health professional.
A Sense of Safety:
Exposure to trauma leaves the foster child or adolescent feeling powerless, help¬less and victimized. Not surpris-ingly they feel vulnerable and unprotected. It is essential for the foster parent to help the child feel safe. Some children have never felt safe in their life.
Providing A Secure Haven:
If and when the child reveals what has happened to him/her and expresses feelings about it, foster parents should try to remain calm and sup¬portive to the child or teenager.
A Feeling of Mastery:
Older foster children with PTSD may be helped by opportunities to talk about what they experienced or survived. Some children report the trauma to foster parents before telling any¬one else in their lives. Allowing the child to recount graphically what happened, though, may be some¬what traumatic for you as a foster parent. The foster parent may need to talk with the caseworker and the child’s therapist about how much to encourage the child to divulge and process.
Reassuring the Child:
Foster parents should reassure the child that their on-going struggles following the trauma are not a sign of weakness. It’s important that children and teenagers who have been victims of physical and sexual abuse are reas-sured that the victimization was not their fault.
Psychotherapy for the Child:
Some¬times foster children have problems with depression, anxiety, or other emotional problems related to the trauma. Various forms of psycho¬therapy which permit and encour¬age the child to express feelings and memories about the event may be helpful. Trauma-focused cognitive behavior therapy has been shown to help children and adolescents with PTSD.
Medication:
Medication may also be useful to deal with agitation, anxiety, or depression.
Note: To learn more about ADHD and other issues important to foster, kinship and adoptive parents,
please view our course at FosterParentCollege.com.