Youth who have experienced adverse childhood experiences and trauma have learned to be reactive. As a matter of survival, some may have needed to act reflexively before thinking, to take an offensive stance rather than leave themselves vulnerable. Others may have learned to dissociate themselves from the horrors they experienced – to zone out or disconnect from reality, when they were powerless to change it.
Because there is no way of knowing who has suffered trauma, we must consistently practice in a trauma-informed manner. This reminds us to ask the right questions, to interact in a way that will not trigger youths’ reactivity or cause them to dissociate, and to structure our practices in a way that will not re-traumatize by reinforcing their sense of powerlessness or shame.
We might note the following in teens who have experienced trauma:
It may be harder to forge a trusting relationship, because the young person has not experienced adults as consistently safe.
Parents and teachers may describe the youth as easily upset, easily provoked, or highly reactive.
The youth may display what others consider inappropriate emotions and behavior.
The young person may be triggered by traumatic reminders.
The youth may be diagnosed as hyperactive, or oppositional, or conduct-disordered.
The teen may appear inattentive, but he is actually hyper- attentive to “danger signals” of which adults are not aware.
A common post-traumatic presentation is dissociation. This may be reported as “lying” – which actually represents a confabulated reality produced to replace actual events difficult to recall - or “zoning out” – which has proven adaptive during traumatic moments.
Many who have experienced trauma have a harder time distinguishing between healthy and unhealthy relationships. Therefore, the issue of trust and betrayed trust will be a major, on-going issue. Relationships worthy of trust are the foundation of progress.
Appropriate boundaries are key underpinnings of relationships. Because traumatized youth have so little experience with trust, breaking their trust or not following through on a perceived commitment can cause great harm.
Think about the possibility of past adversity as an underlying problem when you are up against something you don’t understand. If you cannot understand why someone does or doesn’t do something that seems to be common sense, be curious and ask “What happened?”
Offer youth the absolute respect and unconditional love they may never have experienced.
Do not speak over them. If they are in an escalated state, provide a safe space for them to take a time-out and pass the reactive state. Use calm tones and space to guide them out of their altered state
Be an active listener, play back their stories with an outsider’s voice. Be unafraid of showing them what is both right and wrong in how to deal with conflict. Hold them accountable when negative behaviors become comfortable coping mechanisms.
Don’t belittle their sensitivity. If it feels real to them, it is real and worthy of a space to be heard and processed
Allow psychiatric diagnoses to inform your approach, but not to define the teen. Traumatized youth are often misdiagnosed.
A calm environment is a safe environment. No matter how stressed you become, lower the tension in the room to avoid triggering a traumatic memory or creating a perceived threat to safety.
A traumatized individual may need more physical space. Any sudden moves can be misinterpreted as an attack, an encroachment on personal space can trigger a memory of being trapped.
Body language is critical to maintaining a sense of safety. Traumatized youth will react to being judged and are hypervigilant to any perceived threat.
Traumatized youth will often react before thinking about consequences largely because the part of their brain that fires in response to threat reacts instantly. Activation of the reasoning, judging, and evaluating parts of the brain happens later and only then may the young person be able to inhibit their instantaneous reactions, but by that time it may be too late. In any situation where the young person is frightened, upset, or angry it is better to create a safe space where the youth can retreat and take the time needed to calm down.
When we Are trauma informed, we shift from a stance of “What’s wrong with you?” to “What happened to you?”
When we are trauma informed we are respectful and minimize the possibility of triggering their reactivity.
When we are trauma informed we understand what is about us and what is not about us. When we do not interpret mistrust, reactivity, or anger as personally directed, we can respond with empathy rather than defensiveness.
When we are trauma informed we learn to “hold” others’ pain in a supportive way rather than to “own” it.
When we work with youth who have endured unbearable lives, we often find that in sharp contrast to them being “damaged” or “broken,” they are sensitized and fully commited to making others’ lives better.
For more information, learn about The Sanctuary Model. http://www.sanctuaryweb.com/sanctuary-model.php
Adapted from: Trauma Informed Practice: Working with Youth Who Have Suffered Adverse Childhood (or Adolescent) Experiences written by Sandra L. Bloom, Zeelyna Wise, Joseph Lively, Marcos Almonte, Stephanie Contreras, and Kenneth R. Ginsburg. In "Reaching Teens: Strength-Based Communication Strategies to Build Resilience and Support Healthy Adolescent Development" Elks Grove Village IL; American Academy of Pediatrics; 2013.