Behaviour

Sam’s Story – Managing Challenging Behaviour

In this second guidance, Dr Margot Sunderland relates the story of ‘Sam’ – a sobering tale about a teenager struggling to come to terms with his traumatic past

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 mother

Sam, 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 likely

Scenario 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. At Trauma Informed Schools UK, we have consistently found parents to be grateful that someone is finally hearing their story, and appreciative that the questions are simply about supporting their child better.

Mr Timpson was aware of the physical abuse Sam had suffered and had also been trained to recognise trauma triggers. As a result of this proficiency and knowledge, Mr Timpson stopped the bus and guided Sam out into a nearby field. Mr Timpson knew that he needed first to emotionally regulate Sam – aka, to stop the amygdala in Sam’s brain sending danger alerts out. When a hyperaroused child is calmed by a soothing adult, neuroscientists refer to this process as the amygdala “going quiet”.

There are lots of ways to emotionally regulate children and teenagers: all evidence based (neuroscience and physiological studies). Mr Timpson used empathy, understanding and a soothing voice. All of these are proven to calm the amygdala (Morelli et al 2014 and Seltzer et al 2010)

He said “Sam, something triggered you when that mouthguard hit your head, didn’t it? Let’s sit here for a while until you feel safe again and if you want to talk about what happened I’m right here to listen.”

Eventually, Sam calmed down. They talked about the horse in the next field, before Sam rejoined the bus. The rest of the school trip went by without any problems.

In his trauma informed schools training, Mr Timpson learnt the importance of calming the body down first before the teenager engages in any conversation or reflection on what happened. Later in the term, Sam asks to talk to Mr Timpson and tells him he is worried about his Mum.

He also tells Mr Timpson about the terror he felt at the hands of his Mum’s partners. With Mr Timpson’s assistance, Mum receives counselling for the first time in her life. Once she discusses her traumatic childhood in a safe setting, she’s able to change her pattern of unhealthy relationships and is no longer drawn to men who are repeats of her past. For the first time Sam and Mum have a calm safe time together.

Unacknowledged trauma is like a wound that never heals and may start to bleed again at any time ( Alice Miller)

Reflection

‘Zero tolerance’ approaches to discipline in school – such as the use of detention, isolation rooms and permanent exclusions, entirely overlook the reality for so many troubled children of traumatic life events. 70 percent of excluded children in the UK have special education needs of disability and many of these children/teenagers will also have unresolved trauma. (BBC Parliament Accountability Jan 19 2019).

Research shows that the brains of traumatised children change in the same way as soldiers returning home from war. The shocking events for both the children and soldiers can cause physical changes to the brain. And yet, through the use of permanent exclusions, we isolate thousands of traumatised children due to their challenging behaviour which manifests as a result of over-active stress response systems. (McCrory, et al 2011)

Take away messages

  • Research shows that two out of three teachers worry that if they have a conversation with a teenager who self-harms, they will make matters worse for that teenager (Talking Self Harm Report, 2015). This feeling of ‘narrative incompetence’ leaves far too many children and young people seeking alternative sources of help e.g. internet sites which tell them to ‘cut deeper’ or simply ‘end it now’.

When teenagers come to talk to teachers about difficult things at home, suitably trained staff can often provide vital, life-changing conversations. Trauma informed training for staff includes giving accurate empathic responses and ‘finding the words to say it’. With appropriate training, school staff no longer need to be frightened of addressing mild to moderate mental health problems. They no longer need to see mental ill-health as some kind of scary brain disease (which it really isn’t) but rather painful life experience that heed to be acknowledged, talked about and made sense of.

  • From our training in over 500 schools in regions across the UK and seeing the moving results achieved by staff we have trained, we entirely endorse the research findings of the Government Green Paper, ‘Transforming Children and Young People’s Mental Health Provision’ (December 2017), which states:

‘There is evidence that appropriately-trained and supported staff such as teachers, school nurses, counsellors and teaching assistants can achieve results comparable to those achieved by trained therapists in delivering a number of interventions addressing mild to moderate mental health problems (such as anxiety, conduct disorder, substance use disorders and post-traumatic stress disorder)’.

  • Behaviour should always be considered as a possible communication and not simply seen as a deficit or naughtiness in the child.
  • We need to protect traumatised children/teenagers by ensuring they have a calm safe base at school at least once a day with a trusted adult, where they can emotionally regulate/emotionally refuel

Dr Margot Sunderland is Co-Director of Trauma Informed Schools UK

www.traumainformedschools.co.uk

References

  • Geisler, F. C. M., Kubiak, T., Siewert, K., & Weber, H. (2013). Cardiac vagal tone is associated with social engagement and self-regulation. Biological Psychology, 93, 279–286.
  • Langley-Obaugh, C. (2020). How Stress Can Lead To Emotional Trauma – Christine Langley-Obaugh. [online] NotSalmon.: https://www.notsalmon.com/2015/04/04/how-stress-can-lead-to-emotional-trauma/
  • Miller A (1998). “Thou Shalt Not Be Aware: Society’s Betrayal of the Child”, p.226, Macmillan
  • McCrory, E, De Brito, S.A. Sebastian, C, Bird, G, Kelly, P, Viding, E (2011) Heightened neural reactivity to threat in child victims of family violence Current Biology Vol 21 issue 23 December 2011
  • McCrory, E, https://www.ucl.ac.uk/pals/news/2016/feb/research-professor-eamon-mccrory-finds-children-exposed-trauma-show-same-pattern
  • Morelli, SA, Torre, JB, Eisenberger, NI. (2014) The neural bases of feeling understood and not understood. Soc Cogn Affect Neurosci. 2014 Dec; 9, 12,:1890-6.
  • Seltzer, LJ, Ziegler, TE, Pollak, SD. (2010) Social vocalizations can release oxytocin in humans. ‘Proc Biol Sci’. 2010 Sep 7;277,1694,:2661-6.
  • Solms, M Neuro-Psychoanalysis – Where Mind Meets Brain www.youtube.com/watch?v=FZ4HsiavUCg
  • The Education Committee 8 Accounbality hearing with minister for Education Damian Hinds https://www.parliamentlive.tv/Event/Index/31092729-0e14-4344-aee9-e49fb41e4fd6( BBC Parliament Accountability Jan 19 2019

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