Jessica’s Story: Responding To Children Who Have Suffered Traumatic Loss

A child’s behaviour can spiral out of control in the aftermath of losing a loved relative or parents separating. Putting these children into detention or suspending them, is the opposite of how a school should respond. Dr Margot Sunderland describes what happened to Jessica

I have heard the following narrative so many times. It goes like this. There is a really good student, good attainment and good behaviour. The student then experiences a traumatic loss, for example parents separating, a loved relative dying. The child’s behaviour and attainment rapidly declines. Too many times, they end up in the isolation room or detention. Many are permanently excluded.

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      string(415) "In the first of her new Beyond the Classroom series, Dr Margot Sunderland offers practical guidance for non-specialist teachers and school staff responding to children in distress who ‘behave their trauma’. In this first guidance we meet ‘Sarah’, who struggles with anxiety and Dr Sunderland explores the need to view children’s behaviour within the context of their home lives."
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      string(5691) "Panic attacks, heart palpitations, somatisation, phobias, social anxiety, worry, catastrophising…It’s not a way to live life to the fullest. You feel vulnerable, frightened, unprotected and helpless. Fear can be a lot easier to handle, as it’s more clear-cut. Once the ‘scary thing’ disappears, we feel okay again. But anxiety goes on and on continuously, regardless of whether the fearful incident has ended or not. This is because with states of anxiety, the brain triggers high levels of stress hormones, which colour our perception with a sense of threat, danger and deep unease. As Sarah, one particularly anxious 15-year girl, told me, “I have never known one moment of calm in my life.”How do children and teenagers commonly try to cope with feeling anxiousThey act! By controlling, avoiding or both.Controlling includes behaviours like controlling food intake, purging, checking things (e.g. taps and plugs) carrying out rituals, self-harming.Avoiding means avoiding situations that evoke feelings of threat and danger, for example not going out to social gatherings, parties where there are lots of people or missing school (phobias or social phobias).In order to heal, anxious children and teenagers need to stop ‘acting’ on their outer world and start thinking and feeling about their inner world, namely the underlying feelings fueling their anxiety. This is because anxiety is always a symptom, never a cause.For many children and teenagers, the cause of anxiety is something very frightening that happened in their lives, which left them feeling profoundly unsafe in the world. Common examples include being bullied or shamed at school, parents splitting up, a parent leaving the family home, a frightening teacher or parent, multiple school moves, or living with a parent with addiction issues. For others the underlying feelings of fear, grief, shame etc. originate from living with parents who themselves are anxious. Research shows that it is nearly impossible not to develop an anxiety problem with a parent who is themselves anxious.How do you transform ‘unbearable feelings’ into ‘thinkable thoughts’Research shows that the best way to alleviate anxiety as opposed to just trying to ‘manage anxiety’ is to address the feelings experienced at the time of the painful life event. That said, it is never possible to do this alone, only in the presence of an emotionally available adult, one who can listen and empathise and help the child/ teenager to make sense of the traumatic event. This is because the feelings about it are often deemed by the child/teenager as too dangerous to feel on their own (e.g. fear of the strength of their grief, fear of shame, fear of going mad, fear of the strength of their rage) which is why anxiety developed in the first place. As Freud said, “anxiety protects us from fear.”But here’s the rub. Firstly, teenagers need to know how unaddressed trauma can fuel anxiety because most of them have no idea. Anxious teenagers are often extremely aware and super eloquent about their symptoms: panic attacks, psychosomatic symptoms (after endless ‘all clears’ from doctors,) phobias, obsessions, heart palpitations – but not about the cause of those symptoms. However, with supportive curious enquiry from an adult trained to listen, many will accurately and easily recall the life events that changed everything for them, and left them feeling fundamentally unsafe in the world.Underlying any anxiety is an impaired ability to meaningfully think about feelings. In other words, anxiety is fuelled by wordless sensations, known by some as ‘unstoried emotions’. With help from the trained adult to make sense of the original ‘trauma’ the anxious child can find relief by putting painful feelings into words. As observed by Heather Geddes, these ‘unbearable feelings’ can transform into ‘thinkable thoughts’, meaning that a traumatic memory can evolve from a haunting nightmare into an integrated part of our life story.Explaining the causes of anxiety to older children and teenagers… And why it’s vital to talk to an adult trained to listenAnxiety is not related to ‘bad’ genes or a chemical imbalance in the brainFor many people, anxiety is ‘fearing in the present what happened in the past’The traumatic event will typically have happened at a time when your younger child self had few or no coping skills to deal with the event, and no one was there to help soothe you or help you make sense of what was happening. So the feeling of threat and danger fully immersed, which is why it’s left you feeling so unsafe and frightened nowIn moments of anxiety our minds can trigger back to a time when we felt utterly powerless and utterly vulnerableIn the grips of anxietyYou have stress systems in your brain. 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Special Needs

Sarah's Story: Helping Children And Teenagers Who Live With Anxiety

14 Apr 2020

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      string(5708) "Adolescence: what an amazing stage of life, with all its dramatic hormonal changes, transforming that sweet little kid into a teenager who knows their own mind, becomes their own person and finds their own direction. If all goes well, transition to adulthood means the teenager fully engages with their drive and creativity, discovers their sexuality in the context of a loving relationship and develops enhanced levels of social and emotional intelligence.But if things go wrong and teenagers experience traumatic life events with no one to help them make sense of what’s happened, they can find themselves living with the torment of shame, anxiety, depression, low self-esteem, peer pressure, identity crises, and relationship breakdowns. Many will try to alleviate unbearable psychological pain with alcohol, drugs, self- harm and/or anti-social behaviour. But it doesn’t have to be this way.There is a mass of research including the social buffering studies showing that the presence of just one emotionally available adult in a teenager’s life vastly reduces the risk of their transition into adulthood being tormented or difficult. For many teenagers this will be a teacher, preferably one who is suitably trained in trauma informed practice. The following case study bears this out.Abused motherSam, aged 14, was a proud member of the school’s rugby club. The teenagers in the club had worked incredibly hard so were promised a trip to the beach as a reward.Sam came from a very troubled background – his mother (a single parent) had been a victim of childhood abuse, and never received counselling to help her process what had happened.The problem is that unprocessed trauma doesn’t just happily sit still in the mind. Research shows that traumatic memories show no hope of fading until they are worked through in the present. Failure to process traumatic memories can result in triggering flashbacks and debilitating mental health problems.Unfortunately, this was the case with Sam’s mum, who repeatedly partnered physically abusive men who harmed her just like her father had done when she was a little girl. Some of her boyfriends ended up hurting Sam too, with one particular man taking to beating Sam around the head, sometimes with a shoe.The beach day arrived and the club bounded onto the minibus, excited by the trip. Also with them was Mr Timpson, a teacher. Sam’s friend started joking around and playfully threw a rugby mouthguard at Sam. Sam went bananas and began screaming, shouting and lashing out.In effect, Sam was experiencing a trauma trigger. Trauma triggers take place when something in our current moment reminds us of a trauma in the past. The smallest of sensations, like a faint smell or light touch, can send the mind into ‘threat mode’. In Sam’s case, the mouthguard hitting his head triggered the memory of the abuse he had suffered at the hands of his mother’s boyfriend.In a trauma trigger, part of the brain called the “amygdala” goes on red alert, telling the mind that the trauma is happening again. The amygdala (see pink spot in photo below) fails to distinguish between memory and real life, which is why traumatised children are at risk of seeing minor stressors as major emergencies.Trauma is not an event itself, but an emotional response to an overwhelmingly painful and stressful event where there was no-one there to help you with what was happening at the time (Margot Sunderland)I will now describe two possible responses to Sam’s outburst. Remarkably, the second scenario actually happened. In many schools, where staff are not trained in trauma informed practice, response one would have been far more likelyScenario One (fiction)After Sam’s outburst, Mr Timpson shouts “If you are going to act like a hooligan you can go back to school right now”. Mr. Timpson asks the driver to return to the school, where Sam is put in detention.He is devastated, as the incident confirms to the critic in his head that he is intrinsically a bad person. The psychological pain is awful and he knows he will be cutting himself to numb the pain when he gets home.Across our schools there are many children like Sam who receive a punishment without the possibility of traumatic life experiences being taken into account. They may also be given a psychiatric label such as ADHD, ‘conduct disorder ‘or ‘intermittent explosive disorder’.To impose diagnostic labels on children like Sam without ever hearing their story is both an abuse of power and a failure of psychological safeguarding. As Professor Mark Solms says, “If we just see behaviour or think in terms of diagnoses – with no reference to the context of [the child’s] life we do terrible violence to the facts of what has happened to him.”Scenario Two (fact)In reality, Sam was lucky to attend a ‘trauma informed school” (TIS). In trauma informed schools teaching staff are taught to recognise trauma triggers amongst children who can go from zero to extreme arousal in seconds. For children with unresolved trauma, minor stressors (like a mouthguard being thrown) become major emergencies.In many trauma informed schools, a member of staff who has a good relationship with a parent carries out an interview to ask them if they are willing to speak about any painful life experience, trauma or loss they know the child has suffered.They are reassured that this is kept confidential, and that the information will only go to key staff directly involved with the child. 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ADHD

Sam’s Story – Managing Challenging Behaviour

26 May 2020

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      string(5676) "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 relationshipsFar more likely to end up without qualifications, claiming benefits, have health problems, behaviour problems, smoke, drink, suffer from anxiety/ depression 8So, 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, 11A 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 messagesSchool 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.References1. 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."
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Special Needs

Amani’s Story: Supporting Children of Divorcing Parents

28 Aug 2020

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That includes researchers using the kinds of maths that bewildered us when they tried to explain it. They were describing the same sensations as the ten-year-olds, who often said things like “frustrated” and “angry” too. It turns out that ten-year-olds and top mathematicians are not as different as you might think.In fact, we discovered that top mathematicians get stuck all the time. Some of them said that maths is exactly that: getting stuck and worrying away at a problem, sometimes for years. That, and getting used to making mistakes. But here’s the thing, when we showed children in schools some of the things the mathematicians had said, they were amazed. They almost didn’t believe us.What we were grappling with was a set of myths about maths. These myths sneakily suggest that if you are stuck, you must have reached your ‘mathematical ceiling’. Whether your ‘ceiling’ is times-tables, fractions, x and y, integration, or vectors in seven-dimensional space, if you’re not getting it, you’ve probably reached your limit. This myth and the other, even more dangerous one, that maths is more of a boy thing than a girl thing, are part of a wider narrative, which many of us unconsciously accept:People are either clever or they’re not.If you make mistakes or find something difficult, that means you’re not clever.Only clever people can do maths and science (especially maths).By that logic, if you find some maths difficult, it makes sense to give up. Especially if you’re a girl. Only 22% of A Level mathematics candidates are girls – despite girls doing slightly better than boys at GCSE. It seems likely the maths-is-for-boys myth is an added push, encouraging girls even more than boys into giving up if they get stuck.The thing is, there’s increasing evidence that this isn’t the right narrative about how learning and maths work. “A mathematician is not someone who finds mathematics easy. A mathematician is someone who never quits.” Dr Nira Chamberlain, Senior Modelling Consultant (professional mathematician)Brains continually developProfessor Jo Boaler, now at Stanford University, wrote The Elephant in the Classroom, which describes groups of ‘under achieving’ children who, given the right context and problems that stretched them in the right ways, engaged deeply with mathematics. Boaler draws on the work of psychologist Carol Dweck, who has popularised the idea of a ‘growth mindset’: if you believe you are capable of getting cleverer, you are more likely to improve your abilities. 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We visited schools, and ran family workshops. We spent ages looking for problems that were fun to struggle with in a dramatic situation. We realised 2D coordinates were useful: definitely mathematical, but physically fun. Robots came into it early. They’re so literal-minded: you have to talk to them in precise, logical, mathematical ways. We could make our robots dance using coordinates! We discovered a useful contrast: how the human brain is different from a robot’s. We talked to neuroscientists and roboticists, psychologists and engineers. We learned that we use many parts of our brains to do maths – we have to train our brains over years. There are bits of your brain that get bigger and more connected as you do more maths – all through your life, not just in childhood. 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Arts-Based Learning

“We’re stuck!” Creating an interactive theatrical mathematical adventure

9 May 2018