Meltdowns are common in young children of a certain age. But did you know that meltdowns and emotional outbursts are even more common among children who struggle with attachment issues and traumatic pasts?
Many parents — and even some mental health professionals — are uninformed about the particular effects that traumatic experience can have on the developmental stages of a youngster. To help clinicians who want to aid these kids and their families, Debra Wesselman, Cathy Schweitzer, and Stefanie Armstrong have written Integrative Team Treatment for Attachment Trauma in Children: Family Therapy and EMDR.
The book is meant to help clinicians assist parents in responding more empathically and effectively to meltdowns and other behaviors. And the authors do a fantastic job of introducing the topic of trauma and attachment. When a child has experienced abuse, neglect, rape, violence, witnessing violence, a death, adoption, hospitalization, or living in multiple places, there is much in the way of attachment theory and neurobiology to address.
However, as the full title suggests, the authors also weave in EMDR, suggesting how a family therapist can team up with an EMDR practitioner to help with treatment. This may not be for everyone, as there are clinicians who either do not believe in the effectiveness of EMDR, do not wish to delve into the study of it, or feel it is simply outside of their area of competence. The good news is, while the authors begin writing about EMDR in the later chapters of the book, all the earlier sections about trauma and childhood development stand solidly on their own. Thus even if you are a practitioner who does not find EMDR useful to read about, the book can still be of great help when it comes to treating young patients.
One of the issues the authors tackle well is that what looks like defiance, oppositional behavior, selective hearing, or inattention in a child can really be emotionally instability due to trauma and a cry for help. Traumatic pasts can cause problems for children at home, in school, and in the general community. Their emotional and psychological health is very fragile, and adults around them must learn how to view their child’s problems through the “trauma lens.”
As the authors put it, children who experience trauma and disruption within their earliest attachment relationship “may evidence neurological changes in the brain and may exhibit delayed emotional and social growth and development.” Especially when there have been multiple traumas, with cumulative effects, the authors write, it is important to realize that these experiences affect the actual neurobiology of the child. They also explain that issues due to trauma can be triggered, even magnified, by the transition from home to to a school setting.
Understanding a child through the so-called trauma lens will help parents access more empathy in response to their child’s meltdowns. It can help them, as adults, refrain from exacerbating the problem through their own anger, rage, or use of multiple punishments. At times, the only way into the world of children with traumatic pasts is through understanding, empathy, and rapport-building.
The book, then, gives readers a great way to evaluate how they or their clients are responding to meltdowns. First, the authors explain, it is important to note that there are three stages of meltdown. Phase one is acting out, or panic. This stage includes a child who is completely out of control and requires a parent to be mindful of how emotionally and psychologically distraught the child is. The child’s brain is “stuck,” the authors write, and needs an empathic adult to respond.
Phase two is acting in, or shame. This stage includes a hyper-aroused child whose anger or rage is fueled by shame and rear of rejection. The child may push the parent away at this stage and reject physical touch.
Finally, phase three is called repair and reconnection, or emotional pain. The child in this stage is better able to manage his or her emotions. The brain is “unstuck” and capable of receiving love and forgiveness from the parent.
These stages are extremely important to keep in mind for parents (and for mental health professionals). It helps us understand the child’s emotional chaos, but also helps the parent identify the best way to intervene — and when. The timing of parental response is key: It will determine how successfully the parent and child can get through a given meltdown. And the book explains all of this well, highlighting easy steps therapists can take in teaching this to parents.
Struggling with children who have complex, traumatic histories requires lots of supervision and consultation with experienced professionals. Wesselman, Schweitzer, and Armstrong offer mental health professionals the information they need for each therapy session and each complicated case.
If you are a practitioner interested in how EMDR can help with traumatized children, then this is a good book to pick up. But again, the best part about this text is that there are many chapters on family therapy and trauma attachment — even if EMDR is not your thing. As a clinician who often engages in family therapy, I’ve found that this book is a wonderful addition to my trauma-based reading collection.
Integrative Team Treatment for Attachment Trauma in Children: Family Therapy and EMDR
W. W. Norton & Company, March 2014
Hardcover, 320 pages