Safety First

Psychology , Trauma May 26, 2016 No Comments

Parenting a child who has been abused, neglected, and traumatised is no easy task. Children in care have many unmet needs and require more than your average, good enough parenting. Much thought needs to be given to missed experiences and pockets of development that have yet to be realised. Most of all, and before anything else can be achieved, a child needs to feel safe. By this I am talking about physical safety, where they start to feel safe in their own body and with those who surround them, as well as developing an internal, psychological safety. This is not an easy or quick process; it presents many hurdles and challenges to the child, the foster carers, the placement, and those who are involved in the wider network with the child. Change is crucial to every child’s development and recovery from trauma.

For a child to feel safe, there is a need to address the things that heighten their fear and anxiety. Children in care have come from homes where the very people who should have protected and nurtured them have caused them harm and/or neglected their needs. They are unfamiliar with safety and have learnt to be vigilant and watchful, suppress their needs and feelings, or behave in a way that is chaotic, disorganised, and dysregulated. These children are constantly in a heightened state of arousal, bracing themselves for the next fearful situation or person. They are highly reliant on their flight, fight, and fright responses because they have grown in an environment where safety is unfamiliar, and sometimes, non-existent.

Without wanting to go into too much detail, the flight, fight, and fright responses are ourfight fright dog cat bodies primitive survival modes. When we are expecting something bad to happen to us, our minds, our bodies, adrenaline kicks in and we do want is instinctive, whether it is running away, staying and toughing it out, or freezing to the spot with utter terror. For children who have had compromised beginnings, this state of red alert is a constant. Their baseline anxiety and the associated physiological responses (e.g. heart rate) are significantly higher or lower compared to those who haven’t had such parenting experiences. Children who have experienced trauma within the context of a parenting relationship have different physiological baselines and neurological connections, and their bodies respond accordingly because they have had to survive.

With this in mind, how do we help children in care feel safe? It’s a difficult task because they will bring to their placement(s) all their strategies and fears, but we may not know what they are. Part of helping a child feel safe is noting and tuning into those fears and the situations that trigger dysregulation. In my experience, if a child’s behaviour escalates, it’s an indicator that they feel unsafe or at the very least are struggling to manage a situation. It may appear illogical and need unpicking, with a specific focus on the child’s history and relationships. If we know the triggers we can help them regulate their feelings when they spike. By regulation I am talking about carers doing the regulation with them (co-regulation), showing them and teaching them how to feel safe in their own body (perhaps within the context of therapy if needed). I don’t mean showing them once or twice and then expecting the child to take it on board, I am talking about doing the same regulatory tasks every time, for months on end. It can be painfully slow. There is no harm in telling the child that you understand when and why they may find certain situations or interactions frightening (and I would specify). There is nothing wrong with thanking them for showing you they were finding something very hard. Give them a language for their feelings, tell them you get it, and tell them how you are going to help them. Let them know what to expect and stick to it. In time this will afford safety.

53e6d9fe-94a2-4354-bc6b-f331e8f40734

Given children in care rely on primitive responses and have limited ability to self-regulate, it is no surprise to learn their sensory processing can be affected. Trauma prevents stress being expressed and discharged from the body effectively, meaning it remains and lives physically within the body and may show itself in other forms (somatisation). Understanding how a traumatised child’s body processes sensory information is important – for example, are they sensory seeking or sensory inhibited? Within placements we always consider the child’s missed experiences, but consideration needs to be given to how the child manages and makes sense of their sensory environment. If a child is dysregulated in their senses, this will effect how they see and make sense of their world, and impact on their ability to interact and form secure attachments with their foster carers (Burnell & Vaughan, 2012).

Feeling safe isn’t just about considering the child’s responses to personal interactions. It relates to all areas of their life and the things we take for granted. Structure, routine, and consistency are so important, particularly early on in a placement. We know this and talk about it all the time but I don’t think we truly go into detail about what it may look like for children in care. Children in care are likely to have experienced disjointed parenting, played out through a total lack of, or inconsistent boundaries, irregular and unpredictable mealtimes or availability of food, no routine for markers in the day, such as the morning/getting ready for school, bedtime, and so on. Giving the child a very clear routine, telling them what it is and what to expect, helps the child learn they are with someone who is predictable. Being transparent about mealtimes, when they are, and making sure they happen when you say they do can go a long way. when it comes to bedtime, let them know the order of things and how you structure this part of the day. Part of this is letting someone know how your house works and what happens inside, and partly telling and showing them that you will look after them. For these children, routine is so important, it brings security and predictability, a foreign feeling when we think about the chaotic and disjointed experiences children in care are usually accustomed to. I hear many foster carers say how a child knows their routine and can’t understand why they can’t do it. Again, part of providing safety and security is allowing the child time to become accustomed to new routines. This can take months on end. If they are struggling, put a list up somewhere and do the routine with them every day. Be empathic and understanding; they will get there eventually. Yes it is time consuming, possible frustrating, but you are doing so much more than teaching a routine. You are showing that you are alongside them, that you understand they need you there to help them, that you won’t get cross or shame them when they make a mistake. It will help your relationship develop and will allow feelings of safety to grow.

Penny.

 

References:

Burnell, A., Vaughan, J., (2012) Family Futures Neuro-sequential Approach to the Assessment and Treatment of Traumatised Children: Neuro-Physiological Psychotherapy (NPP). 

Van der Kolk, B., (2014). The Body Keeps Score. UK: Penguin

 

 

 

 

 

 

 

plbedford

Leave a Reply

Your email address will not be published. Required fields are marked *