After hearing the horrendous news last week about the hundreds of children in council care in Nottinghamshire who were exposed to sexual abuse by predatory foster carers and residential care staff for decades due to repeated failures to learn from mistakes, Dr Tian Dayton has written a blog for us which is partially excerpted from The Soulful Journey of Recovery. (Dayton, Nov.2019,HCI)

A blog by Tian Dayton PhD.

It is heartbreaking to hear what has been happening for years in Nottinghamshire. However, it is not new. It happens too often in too many places and at the hands of adults who are the designated protectors of children. Power corrupts and power over the lives of children appear, unfortunately to be no different.

“Trauma can occur any time that we encountered an experience that overwhelmed our capacity to cope with what’s going on,” says Daniel A. Seigel, MD, Executive Director of the Mindsight Institute. “So if we’re an adult and we have trauma it’s going to have one kind of impact. But if we’re a young child and we experience trauma, especially in relationship to those we depend on, our caregivers, then the trauma takes on a different kind of impact. That kind of betrayal by our caregivers, leads to all kinds of ways [in which] the developing brain for example, doesn’t develop the kind of integrative circuits that it otherwise would. So developmental trauma, which means abuse, neglect or both early in life, has been shown to result in impairments in the growth of the fibers of the brain that take differentiated areas, like the left and the right or widely separated memory systems. The brain, in other words, compartmentalizes pain, and doesn’t create a kind of relational coherence”.

This lack of relational coherence can evidence itself in anything from depression to violence as these children grow up. Simply put, the parts of their brain that monitor their behavior are not necessarily connecting well with their impulsive urges to act out, implode or explode.

Dr. Bessel van der Kolk, who was on the initial task force to create a diagnosis for PTSD to put into the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), refers to how the poli- tics of establishing the diagnosis took attention off of some of the most basic manifestations of PTSD. “The impact of pervasive trauma in our society continues to be largely ignored. We know today that one out of eight kids in the U.S. has been a victim of maltreatment, and that half of all kids in the world are exposed to extreme violence. The Adverse Childhood Experiences studies have demonstrated that early exposure to family violence and emotional abuse is the largest and costliest public health issue in America. As a society, we mobilize against threats like ISIS, but most American kids are not the victims of foreign terrorists; they’re the victims of the social conditions in which they mature.”

When we say “social conditions,” we are referring to the family and the community that a child matures in. What kind of parenting did they receive? How solid was their family structure? Did they have extended family, a safe neighborhood, and decent schools? What was

But the sad truth is that the first system that has failed these children is the family system, their parents and grandparents. When the parents who brought a child into this world fail in their duty to protect and nurture, the child is put at a kind of risk that leaves them very vulnerable. Nature wired parents to be the people who care the most with an inborn need to bond and stay close. When this system fails, heartbreak follows. The child is heartbroken from the start. And when the next systems put in place fail, too, we are looking at a lifetime of potential pain.

The Adverse Childhood Experiences (ACE) study, led by Robert F. Anda, MD, MS of the CDC; Vincent Feletti, MD; and David W. Brown, DSc, MScPH, MSc, in 2006 is one of the largest studies ever conducted on the relationship between trauma in childhood and long-term effects on health and well-being. It draws an irrefutable connection between childhood trauma and health problems, both physical and mental, later in life. The study included more than 17,000 health maintenance organization (HMO) members who underwent a comprehensive physical examination that provided detailed information about their childhood experiences of abuse, neglect, and family dysfunction.

Anda talks about why trauma in childhood has such long-term impact whether it be family or caregiver trauma.

“For an epidemic of influenza, a hurricane, earthquake, or tornado, the worst is quickly over; treatment and recovery efforts can begin. In contrast, the chronic disaster that results from ACEs is insidious and constantly rolling out from generation to generation. If the effects of toxic stress are not understood, so that children can receive some sort of understanding and support from home, school and community, these children simply vanish from view...and randomly reappear—as if they are new entities—in all of your service systems later in childhood, adolescence and adulthood as clients with behavioral, learning, social, criminal, and chronic health problems. (Anda, Felitti, et al., 2006)

When childhood needs are not well met, it becomes not only expensive but incredibly difficult for public health institutions to intervene and fix the problem. How children were raised creates the foundation for who they will become.

Anda feels that society has bought into some myths concerning adverse childhood experiences, such as, “ACEs are rare, that they happen somewhere else, that they are perpetrated by monsters, that some, or maybe most, children can escape unscathed, or if not that they can be rescued and healed by emergency response systems.” If we leave it up to our public health systems to treat kids or adults who are already in trouble, we will make the job infinitely more difficult. We need to look at parenting styles, family composition, educational systems, and the environment at home and in the neighborhood.

We need to find ways to support families before they fall apart. And to incentivize women and families not to bring children into the world that they cannot care for. In America we routinely pay farmers not to grow certain crops, but we would shutter at the idea of paying young women to stay in school rather than have children before they are in a position to care for them. Rather we patch it up on the back end giving money after the child is born and often even more money if the child is placed within the extended family system.

People with high ACE scores, who experienced the cumulative effect of growing up with a cluster of adverse childhood experiences, tend to be those who fell into the healthcare and penal systems in adulthood. The ACE study suggests their childhood stress was more than their brain/body could process (Anda, Felitti, et al., 2006). According to Dr. Anda, growing up with ACEs causes pain and also carries a higher risk for other issues, including having risky sexual behavior; STDs; contracting HIV from injected drug use; suffering from pulmonary disease; smoking-related lung disease; autoimmune disease; poor adolescent health; teen pregnancy; and mental health issues. Or, on the relationship front, ACEs can lead to revictimization, instability of relationships, and possibly poor performance in school or in the workforce. These are the kids that get sick more often, who get into trouble, and who are “at risk.”

The risk begins at home. When home fails the child is thrown into foster care systems that all too often continue to traumatize them and the child in these systems has no one familiar to turn to, they come in separated from those they love. And the people who are hurting them, their parents and foster caregivers, are those they are supposed to go to for understanding and support. This is trauma for the developing child.