debor016

In his fifteen years before his admission to residential, Martin has been repeatedly abused by multiple people, including horrifying sexual abuse. When first admitted he was primitive and reactive, unable to trust anyone, easily panicked and always alert for danger. Whenever he felt threatened he lashed out, often physically. Gradually however Martin began to feel safe and was able to form some relationships with staff. His outbursts became less frequent and less severe, and he was more often able to participate in fun activities. He demonstrated an ability to draw and created some amazing cartoons. Both he and the staff are beginning to feel some hope for his future. He and his therapist are talking about a possible move to a group home or a foster family. It was very discouraging then when the report came from school that Martin was suspended for threatening his teacher. He became extremely agitated, would not go to his next class, threw some books, and told the teacher that he was g...

In my last two blog posts I have written about incorporating the ideas of Bruce Perry and those of Risking Connection to create a new approach to congregate care treatment. Let’s see if I can put this all together. Foundational ideas: 1. Our children were injured early in their lives, therefore their lower brains have been damaged. This part of the brain is involved with bodily regulation, the calmness/alertness cycle, the danger response and the regulation of emotion. It has tendrils into all parts of the brain. 2. Early experiences create templates or patterns of relationships deep in the lower brain. These templates are what the person expects from relationships, their deepest assumptions about what kind of world this is and how people treat you. 3. Brains can change and be healed at any age, and it takes a lot of repetition. 4. Parts of the brain change only while you are using them. 5. Whatever you use in the brain gets stronger; you get better at whatever you do most. 6. Things t...

In May I wrote about what it would mean if we really believed that children will act better when they feel better, and discussed what "feel better" would really mean. Feeling better includes: • Feeling safer • Felling calmer • Feeling more connected: • Feeling better physically • Feeling less shame • Feeling more competent • Feeling more effective I am struck with the connection between this way of thinking and our understanding about how the brain changes. The brain changes in a use dependent way: what happens often is strengthened; what is not used withers away. What happens together is associated, which means that one thing evokes the other. Many repetitions are needed to change something previously learned or associated. We also know that human interaction is intrinsically rewarding, and that if humans do not have enough of this reward they are more vulnerable to seeking other rewards such as those available from cutting, drugs, aggression, etc. We want our children to as...

What do we know about how to change the brain? •Brains develop and change sequentially. The lower part, which concerns the body, the danger response, and emotional reactions, develops before the higher part which involves words and analytical thinking. Brains develop and change in a use-dependent way. If you use a part more, it gets stronger. If you dn’t use it, it withers away. What fires together wires together. Things that repeatedly happen together get associated in the brain, and the next time one happens it brings up the other. In early years of brain formation, patterns are set in to the brain which determine our assumptions and expectations of life. If a child is hurt by people in the early years, they expect people to hurt them from then on. If you want to change a part of the brain, you have to use it. So, if you are talking, you are not changing the lower part of the brain. You are only affecting the thinking part. Many repeptitions are needed to change a previously learned ...

Recently our girls have been expressing their intense and unremitting pain. Latasha finds so many creative ways to hurt herself- she eats staples, bangs her head, and hits herself in the face hard enough to make herself bleed. Jessica is so sure that her family is blaming her for revealing her sexual abuse by her uncle that she tried to hang herself. Shahara ran away and tried to pick up some older men. Marguerita takes off her clothes and tries to scratch herself all over, and then she swallowed an open safety pin. We send them to the ER, they come back in a few hours. We surround them with caring, and they feel only despair. These girls see no hope. They have no one in the world who they are sure loves them. They hate themselves and blame themselves for everything that has happened in their lives. They see no road to any positive future. The staff and therapists feel a great deal of caring and compassion for these girls. And yet, their behavior is exhausting. It’s hard to believe tha...