Amani (age 16) sits in her geography lesson, doodling and staring out the window. She fidgets, and squirms in her seat. She just can’t seem to sit still. She bites her nails and fiddles with her hair clip. Miss Green has had enough. “Look Amani, how on earth are you going to pass your GCSEs. You just don’t concentrate on the work. Your mind is always some place else and just stop fidgeting!”
Unbeknown to Miss Green there is a neuroscientific and physiological explanation for why Amani is like this. This year her parents split up. It happened overnight. She was devastated. She had no idea they were even unhappy. Amani told her friends that her world crash-landed that day. She’s had to move to a new flat too. She has not been able to sleep since it all happened and feels extremely anxious most of the time.
The neurobiological fall-out of unprocessed trauma
When a child or teenager experiences a shocking event in their lives, and there is no emotionally available adult to help them think and discuss how they feel about it (known as processing), adverse neurobiological changes happen that make learning very difficult. Evidence-based research demonstrates that raw and painful emotions derail learning due to poor activation of the frontal lobes in the neocortex (see below), and high activation of the emotion centres in the old mammalian and reptilian parts of the brain (flight/flight/freeze behaviours). Frontal lobes are key to focused attention and concentration 1
Moreover, when we learn something, new synaptic connections form in the neocortex. The more complex and dense the synaptic connections in our frontal lobes, the more sophisticated our cognitive intelligence. 2 Stress from unprocessed painful life events block the forming of new synaptic connections in the neocortex, and suppress the strengthening of existing synaptic connections, thus derailing both the child’s ability to learn and the consolidation of what they have learnt.3
The Physiological fall-out of unprocessed trauma
The fact that Amani can’t sit still and is constantly squirming in her seat is the physiological fall-out of unprocessed trauma.
Stress physiology research shows that a shocking life event without social buffering (someone being there to help the child make sense of what has happened) can result in chronic arousal of the body’s autonomic nervous system 4. The means the release of too high levels of stress hormones: adrenaline, cortico-releasing factor ( CRF) and cortisol.
These dramatically affect mood, leading to anxiety, panic attacks, irritability, aggressiveness. The person is robbed of any moments of feeling relaxed or at ease ( vital for the ability to learn). The hyperarousal continues at night and this is why Amani can’t sleep. Moreover, in the teenage years the stress response systems in the brain are far more easily triggered than in middle childhood 5, so with an overlay of trauma, you get one stressed out teenager whose capacity to learn grinds to a halt. Schools have a duty of care to calm these teenagers down so they can learn again.
Amani of course doesn’t know about the physiological and neurological changes resulting from her shocking life event, because no one has told her. She just thinks there is something wrong with her brain and that it’s her fault. There are so many teenagers like Amani sitting in classrooms when their whole body-mind is geared for primitive fight/flight or freeze reactions and not for learning. And some of these teenagers will be having a panic attack whilst being told to sit still and behave.
The only thing that seems to help Amani feel even remotely normal is to listen to music. It’s true, listening to music triggers neurochemicals called opioids (anti-anxiety chemicals). 6. So, when she thinks Miss Green is not looking, Amani takes out her air-pods. Miss Green turns around unexpectedly, “Right! That’s it Amani. I have had enough. Off to isolation. You know those are not allowed in class.”
At home, mum has also noticed Amani’s restlessness and apparent ‘hyperactive behaviour’. She has just read an article about ADHD diagnoses at different stages of life, so she marches Amani to the doctors who refers her a psychiatrist. He agrees Amani has ADHD and possibly bipolar disorder due to her mood swings. He writes out a prescription for medication. How many teenagers like Amani, do we label and drug instead of hearing their stores?
Methylphenidate (ADHD medication) is a psycho-active drug with all sorts of side effects. Dr Lucy Johnstone (clinical psychologist) is one of the key founders of an internationally acclaimed movement in the British Psychological Society called the’ Power Threat Meaning Framework. It aims to educate people that they have alternatives to the psychiatric model of human distress. Johnstone says, “The psychiatric narrative robs you of your personal meaning’.7 So far no one has heard Amani’s story about the impact of her parents’ divorce.
Enter Mr. Jones
Mr. Jones, trained in trauma informed practice, is a newly appointed Deputy Head at Amani’s school. On his first day, he wanders around the school, making a point of visiting all the children in isolation. As soon as he sees Amani, he recognised the signs of hyperarousal.
Mr. Jones: Hey Amani – talk to me… I am here to listen to you. How come you are in isolation?
Amani: I don’t seem to be able to behave in class sir.
Mr. Jones: I don’t think young people, as thoughtful as you, would do what you did in class unless something is wrong, unless you were hurting inside. Will you help me to understand what you are feeling?
Amani: I hate school. I hate my life. I hate myself. Nothing’s right in my life. I want to be dead.
Mr. Jones: So, everything feels so horrible right now. And when you are feeling like that, I know it’s difficult to imagine a time that it will be different. Would I be right in thinking that things at home are difficult at the moment or is it a combination of home and school?
Amani told him about her parents’ separation ending with “I worry what’s going to happen to me in the future. I worry that if I go on like this, I might just end up working in MacDonald’s for 20 years or being on the dole.” Amani does not know the research on outcomes for children and teenagers who have experienced separation and divorce when they don’t have access to an emotionally available adult, but on a gut level she does know that research: Without psychological help these children are:
- 75 percent more likely to fail at school (far more so than having lost a parent through bereavement)
- 50 percent more likely have low self-esteem, and experience poor peer relationships
- Far more likely to end up without qualifications, claiming benefits, have health problems, behaviour problems, smoke, drink, suffer from anxiety/ depression 8
So, what did Mr. Jones do?
He gave Amani some vital psychoeducation about stress physiology in terms of her natural reaction to the shocking event she had experienced. It helped Amani enormously to stop feeling that her failure to learn was her fault. He also found her an emotionally available adult called Miss Stevens. She could to go Miss Stevens when the emotional pain got too much and she needed a hug or someone to talk to. Amani formed a real bond with Miss Stevens and told her she had saved her life!
At the end of that day Mr. Jones walked into the Head’s office. He was there for a long time.
Now the school helps teenagers like Amani, rather than sending them to isolation. Newly implemented interventions in the school included:
- Children who had experienced a traumatic incident and were clearly in a state of hyper-arousal were given a purple card. When they felt too aroused to be able to learn, they could show the purple card and were allowed to spend 5 minutes in the sensory room or in the meditation room (proven to calm the body down). Both facilities were staffed by a soothing adult. Remarkably no child abused the system.
- Staff were given basic counselling skills and learnt how to recognise energies and mood states that were trauma activated, sometimes manifesting in challenging behaviour, sometimes in poor concentration and failure to learn.
- The staff who were natural ‘emotional nurses’ (lovely warm empathetic presence) were trained to be emotionally available adults.
What happened to Amani?
With Miss Stevens, she grieved and raged about her parents’ divorce. She was no longer in a state of hyperarousal and so did well in her GCSEs. This is because we know that feeling deeply understood, listened to and empathised by an emotionally available adult bring stress hormones back to base rate. 9,10, 11
A year later Amani sat her mother down and told her that she had actually put the ADHD medication down the toilet. She told her about her terrible pain about the divorce. She also told her about Miss Stephens and about social buffering and how it brings down stress hormone levels naturally without resorting to psychoactive drugs (she reeled off the side effects of the drug in case her mother was in any doubt). She said, quoting Mr Jones, “You see mum, there is an alternative to psychiatric diagnosis and drugs, its hearing someone’s story.” Her mother listened to her psychological informed daughter with awe and huge pride and apologised profusely for not helping her with her painful feelings about the divorce.
Take away messages
- School staff can do so much to emotionally regulate stressed out children and teenagers who are reeling from a shock that turned their life upside down. To quote Herman, “The core experiences of psychological trauma are disempowerment and disconnection from others. Recovery therefore is based upon …empowerment and the creation of new connections. Recovery can only take place within the context of relationships it cannot happen in isolation” (12)
- School staff need to be trained to recognised post traumatic symptoms so they do not mistake them for poor concentration bad behaviour or ADHD.
- Leaving students and pupils in a state of hyperarousal resulting from trauma is tantamount to emotional neglect. We owe it to them to provide evidence- based interventions proven to calm the body down, so they can start to learn again.
1. Restak, R. (2001) The secret life of the brain. Washington, D.C: Dana Press.
2. Jacobs, B., Schall, M., and Scheibel, A. (1993) A quantitative dendritic analysis of wernicke’s area in humans. II. Gender, hemispheric, and environmental factors. The Journal of Comparative Neurology, 327(1), pp. 97-111.
3. Dinse, H., Kattenstroth, J., Lenz, M., Tegenthoff, M., and Wolf, O. (2017) The stress hormone cortisol blocks perceptual learning in humans. Psychoneuroendocrinology, 77, pp. 63-67.
4. Tyng, C., Amin, H., Saad, M., and Malik, A. (2017) The Influences of Emotion on Learning and Memory. Frontiers in Psychology, 8.
Chen, Y., Dube, C., Rice, C., and Baram, T. (2008) Rapid Loss of Dendritic Spines after Stress Involves Derangement of Spine Dynamics by Corticotropin-Releasing Hormone. Journal of Neuroscience, 28(11), pp. 2903-2911.
Doom, J. and Gunnar, M. (2013) Stress physiology and developmental psychopathology: Past, present, and future. Development and Psychopathology, 25(4pt2), pp. 1359-1373.
5. Somerville, L., Jones, R., and Casey, B. (2010) A time of change: Behavioral and neural correlates of adolescent sensitivity to appetitive and aversive environmental cues. Brain and Cognition, 72(1), pp. 124-133.
Gunnar, M., Wewerka, S., Frenn, K., Long, J., and Griggs, C. (2009) Developmental changes in hypothalamus–pituitary–adrenal activity over the transition to adolescence: Normative changes and associations with puberty. Development and Psychopathology, 21(1), pp. 69-85.
6. Bernatzky, G., Presch, M., Anderson, M., and Panksepp, J. (2011) Emotional foundations of music as a non-pharmacological pain management tool in modern medicine. Neuroscience & Biobehavioral Reviews, 35(9), pp. 1989-1999.
7. Power Threat Meaning Framework | BPS (2020) [Online]. 2020. Available at: <https://www.bps.org.uk/power-threat-meaning-framework>
8. Fractured Families: Why stability matters (2013) Centre for Social Justice [Online]. 2013. Available at: <https://www.centreforsocialjustice.org.uk/library/fractured-families-stability-matters>
9. Gunnar, M. (2017) Social Buffering of Stress in Development: A Career Perspective. Perspectives on Psychological Science, 12(3), pp. 355-373.
10. Morelli, S., Torre, J., and Eisenberger, N. (2014) The neural bases of feeling understood and not understood. Social Cognitive and Affective Neuroscience, 9(12), pp. 1890-1896.
11. Gottman, J., Katz, L., and Hooven, C. (1996) Parental meta-emotion philosophy and the emotional life of families: Theoretical models and preliminary data. Journal of Family Psychology, 10(3), pp. 243-268.
Kiema, H., Rantanen, A., Laukka, S., Siipo, A., and Soini, H. (2014) The Connection between Skilled Counseling and Client’s Heart Rate Variability. Procedia – Social and Behavioral Sciences, 159, pp. 802-807.
12. Herman, J. (1997) Trauma and recovery. New York: Basic Books.