The Body Keeps the Score in a nutshell

Bessel Van der Kolk’s The Body Keeps the Score is the most comprehensive resource on trauma to date. He focuses on all types of trauma inflicted at many ages, so I thought I would boil down some of the essential points that apply to children who are fostered or adopted and most importantly, how to help them. Sorry this is long but the book is 356 pages!

Two background points:

(1) children are designed to be under their parents’ protective care and when separated from or abused by them or others, they are extremely vulnerable to trauma — much more so and in different ways than adults.

(2) when faced with danger, functional humans do three things in this order (Van der Kolk, p. 80): First, they reach out to their social supports; if social supports are ineffective or unavailable, they go into fight or flight; and if they feel trapped, they freeze or collapse. Many parents of children who have suffered trauma realize that their kids don’t use the most important strategy available to social beings. They don’t rely on social support specifically because they have been betrayed by adults (see point #1). Therefore they skip right to fighting, fleeing, freezing or collapsing, which makes them very difficult to parent!

Here are some things that work:

1. A relationship with a caring adult is ESSENTIAL. Parenting a child who feels that “You will find out how rotten and disgusting I am and dump me as soon as you really get to know me.” (p. 211) is a challenge but possible! Although a child’s behavior may be appalling, somehow the parent must find a way to fall in love so that they can reconstruct the child’s inner map of feeling safe and treasured. Sometimes allowing a child in your care to develop a safe, trusting relationship with a dog or horse can be a good first step. Playing together (simple things like a ball toss) or singing together can help develop attunement/connection to each other. Firm, reassuring touch (that feels safe to the child) is therapeutic. Most parents need help from a therapist with experience in attachment.
2. Children need to integrate their histories into the arc of their lives as well as have misperceptions corrected for them (No, your adoptive parents didn’t steal you. Yes, you were a lovable baby. It wasn’t your fault you were abused.) Communicating fully is the opposite of being traumatized. (p. 235) Part of what is traumatic is dealing with difficult and shameful memories, thoughts and feelings alone. It can be both organizing and reassuring for children to know their story, speak their fears and be validated and accepted by adults. Again, most parents should seek professional help with this.
3. Neurofeedback is a very promising practice which “simply stabilizes the brain and increases resiliency, allowing us to develop more choices in how to respond.” (pp. 314–15) This is a welcome relief for children whose brains are “hyperalert for danger and organized [by their early experiences] for fight or flight.” (p. 310) I think the best neurofeedback for children with trauma is being done by Arleta James at Adoption and Attachment Therapy Partners in Ohio. After an initial training session in Ohio, parents can buy the equipment and do it at home with supervision.
4. Theatre can be a transformative experience. Van Der Kolk explains it this way: Traumatized people are terrified to feel deeply. They are afraid to experience their emotions, because emotions lead to loss of control. In contrast, theatre is about embodying emotions, giving voice to them, becoming rhythmically engaged, taking on and embodying different roles. (p. 335) One of my kids writes about her curative theatre experience in this post.

One thing that can help but is not a solution is medication. Drugs can help dampen big emotions and regulate behavior but don’t fix trauma or teach self-regulation.

Thank you to Dr. Lia Amakawa and Emma Gerstenzang for helpful edits.

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