Challenges In Adoptions of Traumatized Children

 

 

As promised in the previous post, the video above is a recording of my virtual presentation from June 3, 2020, titled: “Does He Even Know How To Be loved?” Challenges in Adoptions of Traumatized Children.”

The hour-long presentation was requested by and offered through Haruv USA, which provides professional development and training on trauma-related topics, to professionals and interested individuals. The presentation is available on YouTube.

Feel free to leave comments or ask questions. Please note that comments are public, so if you want to ask questions more confidentially, please use the contact Na’ama Yehuda page.

 

 

השלכות של התעללות והזנחה על שפה ותקשורת של ילדים

The impact of neglect and abuse on language and communication in children – a video presentation (in Hebrew)

אפשר לצפות פה בוידאו המלא של ההרצאה שלי מיוני 2, 2020, בנושא “השלכות של התעללות והזנחה על שפה ותקשורת של ילדים” – ההרצאה היא בעברית (ללא כיתוביות תרגום לאנגלית בשלב זה), וניתנה במסגרת “חרוב מהספה” של מכון חרוב בירושלים

שאלות, הערות, והארות? אפשר להשאיר פה בתגובות לפוסט, אבל חשוב לזכור שתגובות לפוסטים באתר פתוחות לציבור, כך שאם יש שאלה או הערה יותר פרטית, רצוי לפנות דרך דף הקישור

The video above is a recording of my virtual presentation from June 2, 2020, about the “Impact of Neglect and Abuse on Language and Communication in Children.” The hour-long presentation is in Hebrew (no English Subtitles at present). It was requested and offered through Jerusalem’s The Haruv Institute‘s “Haruv From The Couch” initiative, which provides virtual professional development and training on trauma-related topics, to professionals and interested individuals. The presentation is available on YouTube.

For the English speakers among you, I am hoping to post a video of another presentation (on a different but related topic), this time in English, in the coming days. That presentation was requested by Haruv USA and was recorded on June 3rd, 2020. I am waiting for it to be made available. So be on the lookout for another video post!

Feel free to leave comments or ask questions. Please note that comments are public, so if you want to ask questions more confidentially, please use the contact Na’ama Yehuda page.

 

It Ain’t TMI, Little Guy

outhouse-door-1544645_1920

Photo: Pixabay

 

“My face gets all red,” he noted.

“Oh?” I didn’t know where he was going with this little tidbit of self-disclosure, but oftentimes neutral responses worked the best for those.

“Yeah,” he nodded. His hands continued to manipulate a small figurine: twisting, bending, spinning the head around.

I offered a box with a some accessories: a chair, a bike, a car, a bath, a bed, a backpack.

He raised his eyes without really looking at me, and returned his attention to the object in his hands. He wasn’t exactly aggressive as he was persistent. I found myself wondering when he’ll realize the head could come off.

“My face gets all red,” he repeated. “I watched.”

“Hmm?” I responded.

“Yeah.” He looked up, this time meeting my eyes in part-challenge, part-fascination. “In the mirror. Did you know I have ropes in my neck?”

He touched the sides of his neck, then grimaced and twisted his face and torso into a representation of intense muscle tension. Strain or fury or struggle or all.

“See?” he grunted.

The veins in his neck bulged and a small tributary pulsed at his temple, sprouting a delicate delta underneath the almost transparent skin.

“Yes, I do see.”

“It’s what happens every time,” he sighed as he relaxed his face and shoulders. Fierceness gone. Vulnerable.

“It’s what happens, when?” I had some inkling as to what he was describing but I wasn’t fully sure … and not assuming was often the right thing to do, anyhow. Especially with children who’d had so little opportunity to question or discuss or explain or inquire or straighten worries out. This little guy had had almost none, and for a boy who talked with almost no one, it was progress that he could speak about himself at all.

His eyes sought mine and the rising pink in his cheeks competed with the retreating redness from his earlier maneuver. He bent the figurine to sitting position, to a stand, to sitting again.

“When I go,” he muttered. “You know, when I … um … have to, uh, push the poo out.”

“Oh,” I noted blandly. “In the bathroom?”

The boy nodded. The blush spread down to below his chin.

“I think most people strain when they poo. It can make their faces red.”

His eyes widened at that, or perhaps also at my matter-of-fact discussion of matters too many in society render embarrassing even though these are naught but normal body-functions.

“Did you look, too?” he tried.

“At my face? You mean, when I use the bathroom?”

He bit his lower lip and nodded, balancing a tightrope of shame and disclosure and curiosity and possibly worry. Perhaps all. Perhaps more.

“I can’t say I have, but it is just what happens when people move their bowels. It is normal to strain or push a little.”

He thought about it. Continued to play with the figurine in his hands.

I wrestled with whether to say anymore. I wanted to reassure him but also wanted to know if it was hurting him to go to the bathroom, so I would know whether there was a problem that needs to be checked. I wanted to know if anything changed recently … if something happened … Heavens knows plenty had in the past, even if I did not know exactly what. Was this him just being more aware of his own body, or was it an attempt to speak of other things … of other kinds of red-faced strain he might’ve seen? Was it both?

I breathed.

He didn’t look distressed. Then again, Toy-figurine Man had lost his head a few times.

Another moment passed.

“Yeah, Dara does it, too.” He stated, asked.

The new infant at his foster home.

I nodded encouragement.

“Sometimes her face gets really red and funny and then Mama Molly changes her.” He looked at me, shame and blush seeming to recede. “You can smell it,” he giggled, testing.

“I bet,” I smiled.

“It stinks,” he took himself into full-out-laugh zone now. “Mama Molly says Dara’s poo stinks to infinity and beyond.”

I grinned. Mama Molly was a keeper. “Poo sure can.”

“Mine does!” he chortled.

Toy-figurine Man got his head back. Kept it on. Got put onto his bike and taken around the table and into the box.

“So,” the boy raised his chin in the direction of his folder and the games on the chair next to me. “Can we start?”

 

 

 

For Linda Hill’s SoCS prompt: Strain

 

“I Go In The Closet In My Head”

Trauma and Dissociation in Children Living with Domestic Violence

(Originally published in ISSTD News, October 2018)
hiding-1209131_1920

Photo: Pixabay

 

Eli, age seven, lives with his younger sister, Marianne, age four, and their mother, Lisa, in New York City. They had lived in a domestic violence shelter for a year, and before that with his stepfather, Mark, till Lisa fled with the kids following repeated violence. Huddled in his bed, Eli had often heard his stepdad beating his mother. He’d wait helplessly till she sought refuge in the children’s room once Mark stormed out. She’d sob herself to sleep on the floor by his bed as he lay awake, worrying his stepdad would return and hit her more.

Mark was the only father Eli knew. His biological father left shortly after he was born. Eli adored his stepdad. He loved it when Mark took him to the park and showed him “how to build muscles” on the monkey-bars. He also hated Mark for hurting his mother, and felt guilty for admiring the very strength that brutalized her. When one night his bruised mother took him, still in pajamas, to a “hotel for mommies,” Eli wanted to go back home. He cried and screamed and it made his mother cry. One of the shelter’s women told Eli he was being “selfish” and that if he “wanted to grow up to be a decent man” he would “stop hurting his mom.” Eli felt confused. Was he hurting his mommy like his stepdad hurt her? Sometimes his stepdad would apologize in the morning and say “he didn’t know his own strength.” Did Eli also not know his own strength? Did he hurt his mommy without meaning to?

Eli stopped fussing, but he still missed his stepdad. There were no dads in the shelter, only whiny babies, toys big kids wouldn’t share, and mommies with scared eyes and scary bruises. He didn’t like it there. He couldn’t go to his own school. He couldn’t see his friends or go to the park where he’d played catch with Mark. Instead, he had school in the shelter and played at the playroom where the carpet smelled funny. Eli tried to be good but still his mommy cried at night. Maybe he was hurting her by his thoughts of wanting to go home? He didn’t know how to stop wanting to go home.

Even when they finally left the shelter they didn’t go home. His mommy said their new apartment was “home, sweet home,” but it wasn’t. It wasn’t even near the park and he had a new school with different everything. Also, his mommy was scared again. She had a lot of locks on the door, and slept on the floor by his bed again. Like before. She cried even though Mark wasn’t there to hit her. Eli tried to take care of his mommy but he didn’t know how. He was doing it all wrong. He didn’t know what to do.

When I met Eli, he was repeating Kindergarten and showed difficulty with attending,
comprehending, and meeting academic demands. Teachers reported he could be talkative but mostly seemed to be “in his own little world” and frequently complained of stomach-aches, asking for his mother to take him home. His occasional explosive aggression led to questions about whether he needed a more restrictive environment “for the protection of everyone involved.” Both Eli and Marianne had attended a therapeutic play group at the shelter, and the counselor there noted that Eli had “tended to keep to himself” and was “always with one ear to the door, listening if his mom was okay.” The little boy hadn’t been aggressive toward others at the shelter, but the counselor wasn’t surprised to hear “some of that rage bubbled up eventually.”

“Lions are strong,” Eli emphasized. “They eat the deer.”
We had just finished reading a story about forest animals and their needs, and he seemed disappointed that no one got eaten.
“Yes,” he added, smacking his palm on the closed book. “Later, he’ll beat her up and then he’ll eat her. He can kill her …”
He shuddered and looked up at me and appeared a lot younger than seven. “That sounds very scary,” I noted gently.
He pointed to the deer on the cover of the book. “Can she hide?” he asked.
I nodded and pointed in the direction of a napkin. I wanted to give him space to go where he needed. It was obvious this wasn’t about deer and lions.
Eli took in a trembling breath.
“I hide.” He whispered and reached for my hand. “I hide inside the closet in my mind.”

It’s what he did when mommy was being hurt and when she cried and when he missed his stepdad and when he didn’t know what to do: he went inside the closet inside his mind. Not the real closet, where people can find you, but a better one, in his head: A closet where only he could open the doors, where no bad sounds or smells got in. It wasn’t scary in his closet, just quiet. But sometimes he forgot to open the doors and pay attention and the teachers said he wasn’t a good listener and kids said he was stupid. His mommy told him that if she kept missing work to take him home from school she’d lose her job and they’d lose their apartment. But he worried about her. He heard her tell a friend on the phone that she was scared Mark would shoot her at work. Like on TV. He wanted mommy to take him home so she won’t be at work where Mark can come. And sometimes he thought he heard scary Mark coming so he’d jump out of his closet fast and hit but then people told him he was being bad, too. It made him want to go back in the closet inside his head but he needed to look after his mother. He was “the man of the house” now. He didn’t know what to do.

Exposure to domestic violence hurts children (Edleson 1999, Sousa et al 2011). Witnessing violence impacts children as much—and sometimes more—than being hit. It is unbearable to a child to be helpless to save the caregiver they need, and it can be even worse when the one harming the caregiver is also someone the child depends on. Children often convince themselves that the violence—and its prevention—is somehow theirs to control (Levendovksi et al 2003, Sousa et al, 2011). In a child’s mind, if only they were better, quieter, and less needy, the people they rely on would not become terrified or terrifying.

The very words that accompany domestic violence can be confusing. Did mom “ask for it?” Did stepdad “only hit her because he loved her?” Does saying “I’m sorry” mean it didn’t happen? Unable to make sense of what is happening around them, children—like Eli retreating into his “closet inside his mind”—might shut-down and dissociate. They can appear unemotional and numb, stop attending, and fall behind socially and at school. They might mirror the aggression they’d seen. Very often children feel guilty if they love the person who hurts the other person they love, and guilty for hating the person they love for hurting another person they love. They rarely have the words or space to describe any of this. Children who apply dissociation to cope with terror and helplessness may also shut down at reminders of the trauma, reinforcing dissociation and resulting in children who are less available for processing information and utilizing available support (Siegel 2012, Silberg 2013, Wieland 2011, Yehuda 2005, 2016).

Even after a parent flees domestic violence, strain often continues, and children might mirror it in ways that reflect not only past trauma, but also current issues. A parent who escaped domestic violence can still be vulnerable. They might still be scared. They might have limited financial, social, and emotional resources. Children sense this, and may hide their own difficulties to protect the parent from distress. When feelings of resentment, anger, worry, or grief inevitably overwhelm them, the children can feel doubly guilty. Unfortunately, just as Eli was scolded at the shelter, children might be chided if they misbehave and be told “there’s already enough to deal with.” They might dissociate to avoid added shame and helplessness. They might become hyper-aware of the parent’s mood and try to accommodate it (Ostrowski et al 2007, Lyons-Ruth & Block 1996).

A loss of home—even the mere risk of it—can be overwhelming and preoccupying, leaving children anxious, wary, worried, angry, or withdrawn. The parent may be managing depression, posttraumatic stress, financial insecurity, and grief; all of which can inadvertently reinforce unhealthy dynamics. This is why it is crucial anyone who works with families fleeing domestic violence, understands children’s behaviors and the functions they serve.

Domestic violence hurts children. While children don’t always communicate their distress verbally, they almost always do so in their behaviors: In aggression and acting out, in shutting down, in falling behind, in what they won’t talk about, in what they do or cannot do (Silberg 2013, Waters 2005, 2016, Yehuda 2005, 2011, 2016). It is paramount we hear them, for our reaction may become the measure of whether they believe help is available.

Eli’s mother was depressed, but she was also determined to keep her children safe and to minimize the impact of trauma on their future. She entered counseling to deal with her own unresolved history, and enrolled Eli in a therapeutic playgroup. She became more involved in his therapy with me, and learned to support his narrative when he spoke of his feelings, including difficult ones about the violence he’d witnessed. Together, at his request, we made a visual representation of the “closet inside his mind” using a shoebox that the two of them painted to fit his inner representation. Eli was able to put his “big feelings” into the closet-box for safe keeping so that he can attend better at school. He was delighted when his mother made a small blanket for his closet “so even the biggest feelings can be cozy and safe.”

With his mother less frightened and himself less alone, Eli was able to let in play, instruction, joy, and praise. His explosive aggression ceased, and he was catching up on language, academics, and friendships.

“Remember when I told you about my closet in my mind?” he said at one of our sessions. “I don’t need to hide there anymore. It’s old and it’s too small for me,” he added without judgment. “I was little, but now I can speak up and if I get scared I can go to mommy or the teacher … or you. I don’t need that closet. The bad memories can rest there.”

 

Bibliography:
Edleson, J.L. (1999). Children’s witnessing of adult domestic violence, Journal of Interpersonal Violence, 14:839-870.

Levendosky, A.A., Huth-Bocks, A.C., Shapiro, D.L., Semel, M.A. (2003). The impact of domestic violence on the maternal–child relationship and preschool-age children’s functioning, Journal of Family Psychology, 17(3):275–287.

Lyons-Ruth, K., Block, D., (1996). The disturbed caregiving system: Relations among childhood trauma, maternal caregiving, and infant affect and attachment, Infant Mental Health Journal, 17(3):257-275,

Ostrowski, S.A., Norman, M.A., Christopher, C., Delahanty, D.L. (2007). Brief report: The impact of maternal Posttraumatic Stress Disorder symptoms and child gender on risk for persistent Posttraumatic Stress Disorder symptoms in child trauma victims, Journal of Pediatric Psychology, 32(3):338–342.

Siegel, D.A. (2012). The Developing Mind: How relationships and the brain interact to shape who we are, 2nd Edition, New York: The Guilford Press.

Silberg J.L. (2013). The Child Survivor: Helping Developmental Trauma and Dissociation, New York: Routledge Publishers.

Sousa. C., Herrenkohl, T.I., Moylan, C.A., Tajima A.E., Klika, J.B., Herrenkohl, R.C., Russo, M.J. (2011) Longitudinal study on the effects of child abuse and children’s exposure to domestic violence, parent–child attachments, and antisocial behavior in adolescence, Journal of Interpersonal Violence, 26(1):111–136.

Waters, F. (2005). When treatment fails with traumatized children. . .Why? Journal of Trauma and Dissociation, 6:1–9.

Waters, F. (2016). Healing the Fractured Child: Diagnosis and treatment of youth with dissociation, Springer, New York.

Wieland, S. (Ed.) (2011). Dissociation in Traumatized Children and Adolescents: Theory and clinical interventions, Psychological Stress Series, Routledge Publishers.

Yehuda, N. (2005). The language of dissociation. Journal of Trauma and Dissociation, 6:9–29.

Yehuda, N. (2011). Leroy (7 Years Old)—“It Is Almost Like He Is Two Children”: Working with a dissociative child in a school setting, in Wieland’s (Ed.) Dissociation in Traumatized Children and Adolescents: Theory and clinical interventions, New York: Routledge, Psychological Trauma Series.

Yehuda, N. (2016) Communicating Trauma: Clinical presentations and interventions with traumatized children, Routledge, New York.

 

For more information about trauma and development: check the Resources, Trauma and Development and Publications pages on this site.

 

Do Not Quail

hold on

Photo: Osnat Halperin-Barlev

 

When powerful

Pound podiums

With rabid lies

To sow mistrust,

Don’t falter

From the facts

Of what is wrong

And what is right.

Don’t quail before

Deep cruelty

That shreds your heart

To cries.

Step forth

For those who have no voice,

Be brave

And mobilize.

 

 

Merriam-Webster’s word for June 19, 2018:

Quail

This post continues the blogging challenge in which Merriam-Webster’s Word of the Day, serves as inspiration a-la the “Daily Prompt.”

Want to join me? Feel free to link to this post on your blog, and/or post a link to your blogpost in the comment section below so others can enjoy it, too. Poetry, photography, short stories, anecdotes: Go for it!

For more visibility, tag your post with #WordOfDayNY, so your post can be searchable.

“Follow” me if you want to receive future prompts, or just pop in when you’re looking for inspiration. Here’s to the fun of writing and our ever-evolving blogging community!

 

 

“A Bandaid for my heart”

She asked me if I knew about dying.

I said I knew it hurt when someone we love died.

She nodded and fiddled with the pencil, poked the tip against her finger, poked again. Again.

I wondered if she was trying to make the hurting take a form she understood through the pinprick of a just-sharpened pencil. I gently put my hand on hers.

She looked up at me, thankfully without embarrassment or worry of judgment. Feelings weren’t easy for this child, whose very early years were filled with much that couldn’t be expressed and had no wording. Her grandfather passed away right before her birth and a hue of grief lingered many months, adding to her mother’s post-partum depression. Her mother has recovered since, and the home was generally caring, but unspoken early patterns of if-you-are-quiet-you-won’t-overwhelm-mom and waiting for another’s space to open so you can have your needs met still played out often. The girl, not yet ten, was more likely to attend to others’ feelings than her own; more likely to dismiss her anguish to not distress others.

I smiled at her and she smiled back shyly. Her eyes glistened and she sniffed.

“My dad told you?”

“Your mom did.”

Her eyes flew to mine, surprised at being thought of. She took another breath. Tears slid down her cheeks.

“I’m sorry, Sweetie.” I handed her a tissue and snuck a bit of extra affection into the gesture. Just because. She noticed. Smiled the sad smile again.

Her great-grandmother died two nights before. Her father’s grandmother was a fixture in the child’s life. A rock. The one who filled the gaps, stepped in, held, held on. An elder in the best sense of the word. There was a love there that spanned generations. A special bond with this child.

It was a gentle death, the mother said. Doctors believed the grandma had passed away peacefully in her sleep. No pain. No long decline. That was a blessing, but for the child this loss still hollowed.

“I didn’t get to say goodbye,” she whispered.

“I know. I’m sorry.” I moved a strand of hair off her cheek. “You can still say it. Maybe not in the way you’d have wanted, but still …”

“Yeah,” she sniffed. Dismissed. Reconsidered. Looked up. “How?”

“Any way you can think of, almost.”

She pondered. “Dad said she can hear me. In my dreams. In my thoughts.” Her eyes probed. She wanted to believe it.

“I believe that’s possible, yes.”

“How?”

“I don’t know exactly. I just feel it. In my heart. About people I love and passed away. It feels right to me that we are still connected, that in some way they can hear me.”

Her eyes overflowed again but her face softened. “I think I’ll talk to her. Tonight, maybe. You know, just me and her.”

I nodded, smiled.

She sighed. Drew in a shuddering breath. Sighed again.

“I miss her,” she whispered. “It hurts. I wish I had a Bandaid for my heart.”

hands-and-heart

 

Trauma’s Memory Problems : A good article

child trauma

Trauma all too often brings up the detective in people, prods them to question, pin point, dissect accounts, weigh relative credibility. It is an odd thing, given the reality that trauma–by its very essence of overwhelm and shutting down of language centers, processing, and memory integration–affects how one may be able to remember, recount, and narrate it. Trauma is difficult to articulate and often too difficult to comprehend, even to know. And yet, it is often demanded to be phrased in exact details that go beyond every-day memory. As if trauma memory should be, somehow, more stellar, subject to higher standard, to bigger scrutiny.

Granted, there may be a motive in it: people would rather believe trauma is less frequent and not as severe. If there are holes in a story, maybe it is ‘proof’ that it did not take place, or not as badly, or not deliberately … At the same time, there is an inherent lack of understanding about how memory and overwhelm conflict and contradict each other. In some ways, a misremembered, disjointed, incoherent event fraught with numbness and confusion may well BE one of a trauma … rather than be proof of something not happening …

Trauma is a problematic thing for memory.

People remember trauma differently. Some remember constantly, vividly, intrusively. Some remember oddly. Some remember snippets, or sensations, or disjointed unease that seems disconnected from anything that seems to make sense. Some remember sometimes. Some remember not at all.

Children, especially, may find not remembering safer than to try and manage the overwhelming reality of what to let reality in may mean. They may have to keep things in the ‘not knowing’ folder to go on and push away reminders that make no sense, they recant, reverse, deny, ignore.

In the article below, the author explores memory and trauma, denial and dismissal, inaccuracies and interpretations, shame and judgment, burden and prejudice, reality and myth.

It is a worthy read for anyone who has been touched by or knows someone who has been touched by trauma (that should include the lot of us, really …). It is an even worthier read if one keeps in mind how it would be all the more difficult for children to conceptualize and remember trauma cohesively, when they have less tools with which to manage what they had endured, and are more vulnerable to misconceptions about what it says to them, about them, about those who hurt them, about the world, about who they may be or have become.

​I Was Sexually Assaulted As A Child. Here’s Why I Didn’t Remember For Years.

http://thinkprogress.org/health/2014/12/23/3606576/memory-and-sexual-trauma/

Teaching Children Calm

deep breath

“Calm down!” Sounds simple, but for many young children it is a foreign concept unless and until we show them how.  Especially if they had known more overwhelm than calm.

Young children who experience overwhelming events such as neglect, severe stress, abuse, chronic illness, or sudden separation at a young age can be traumatized. The world around them no longer–maybe never–feels safe. They don’t know how to regulate, how to calm themselves, how to manage when they get upset. They act out, they hit, they don’t listen, they ‘misbehave.’ They have a hard time making good decisions, explaining their actions, or utilizing memory. They fall behind at school, socially, in their ability to learn new things, communicate, or play.

Trauma changes the brain and can interfere with development. It also creates a vicious cycle of hyper-vigilance and checking-out that costs children opportunities for learning, interaction, and connection.

Children need adult support to manage traumatic aftermath. They cannot be expected to find the way without help. Many of them may need psychotherapy, but even then they need support in non-therapeutic interactions in the day to day. Support that we can all learn to provide by understanding trauma. By knowing what trauma is and how it works, recognizing what it does, how it affects children, and learning what we can do to help reduce its effects so a child get traction in the now.

In an excellent opinion article in the NYTimes this week: Teaching Children To Calm Themselves, David Bornstein details one such system of support set in place, and how it already works to change the lives of the children as well as of the adults who care for them: teachers, caregivers, siblings, even the school-bus drivers. http://opinionator.blogs.nytimes.com/2014/03/19/first-learn-how-to-calm-down/

Read it. Then share it with anyone who works with children. Or who has one.

Spread the word. Our children are worth it. Open the path to teaching calm.

boy with dog

For more information about the impact of trauma on communication, check The Language of Trauma, and other publications here.

For more information about the Adverse Child Experiences Study, and the cost (literally and figuratively) of trauma throughout the lifespan, check: http://www.cdc.gov/ace/

For more information about how to help traumatized children at home and in the classroom, check the links to the ISSTD’s FAQ pages here.

Heartbeat of love

heartbeat

The little boy had a difficult beginning. Born unwelcome, left at an orphanage in a rural area overseas, raised in a crib in a room full of other babies in cribs–bereft of stimulation or affection or even much in the way of nourishment, when funds at the orphanage were low.

He was among the fortunate ones who survived infancy, and was adopted at age two, to parents who showered all the love they had on him and then found that they had even more to give when that threatened to run out. He was not easy to care for, you see. Unresponsive, non-communicative, alternately rubbing himself against their legs like a kitten, squirming to get off, or slumping like a lump of potatoes in their arms. He either cried inconsolably or stared stoically. He would eat things that should not be eaten and hide foods that should. He could not fall asleep unless he was in an empty bed, never a quiet room, and only after a long while of rhythmic head banging. He barely spoke. Only sometimes responded to his name. It was not looking good.

Fortunately, these parents had excellent instincts, stout souls, and good guidance. They sought help to know how to best assist a child so traumatized that he had learned to take himself away to cope. How to support a child who did not know others could be relied on. How to guide into love a child who did not recognize affection as markers for attachment or caring. They did not believe those who said that their son was autistic. “Maybe he is,” they argued, “but how could we know if he’s autistic, if he never had a chance to truly communicate?”

They sought other opinions and took him to speech language therapy and sensory therapy. They went to counseling themselves–there was much heartbreak to deal with in finally having a child and finding him unwelcoming of love. They looked for help with someone who understood developmental trauma and the adjoining dissociation that often follows–they wanted to know more how to best support him. They knew just loving him more was not enough: they had to find a way to help him process what he’d lived before he could find hope to live differently. Together with professionals, they worked to help give voice to what had none, they walked with him along the story of his lost beginning and his suffering and his strength and masterful coping and his current safety. He needed to know it in all of his being before he could trust it. Gently, they helped him heal.

Persistent gentle kindness integrated with knowledgeable attention and direction helped. The child bloomed. He is no longer checked out from his world, or words, or feelings. He’s in first grade now. Still closing gaps in language and communication, and he may always carry scars from his early years and a plausible exposure to substances before birth that make it difficult for him to regulate his body’s reactions and excitement. However, a more affectionate little boy you would be pressed hard to find. He’s happy. He knows he’s loved.

Not too long ago we were busy with a task where we listed things one does in the morning, or after school, or on weekends, or in a mall, or a park, or before going to sleep at night. To the last he said: “take a bath, brush my teeth, read a book, put my head on mama or papa’s chest.”

I smiled at that–the mom told me that they had a nightly routine where they’d cuddle, making up for the many lonely nights of empty cribs and no arms to rock him. They would snuggle together for a while, let him use them as a pillow, then kiss him goodnight. The parents had held him most the night when he was younger, once he let them.

The boy nodded at me, maybe taking my quiet smile as a sign that he needed to convince me of the veracity of what he was saying, or its importance. “Mama is softer, …” he continued, “and papa’s chest boo-booms louder. I like it. It makes me feel nice inside and it helps me not feel like I have to bang my head.”

Enough said.