Trauma by many other names

A man in his 50’s whom I worked with for some time has, I suspect, broken the record for the number of well intended diagnoses he received before the clarity of his trauma response became clear.

His life before the age of 5 was not easy. His parents were violent with each other and sometimes with him. He learned to duck for cover and keep pretty quiet. He flew under the radar until he hit school where at first he was withdrawn, afraid and overwhelmed. He daydreamed a lot. It didn’t take long before his peers began to poke this slightly odd and awkward fellow, and he retaliated in the way he had learned how, with the force of self preservation and primal fear. Then he was punished and made to feel bad about himself, while his attacker was soothed and protected. He could make no sense of this but soon learned that adults were as dangerous as his taunting peers. He learned that there was something wrong with him and he was to blame. He didn’t notice that teachers cared, but didn’t know what to do. He didn’t notice their exasperation or desperation, he just felt the hurts and the danger.

He didn’t learn. School was a daily battle ground, not a place for exploration. Finally he was taken aside and tested and diagnosed with a Receptive Learning Disorder. The years went by. Then came the ADHD diagnosis, and the medication. The years went by, and someone called him Oppositional and spoke of Conduct Disorder. He dropped out of high school, developed Substance Abuse Disorder, learned some more interesting survival skills and scored a Borderline Personality Disorder diagnosis.

Then he met a woman and things settled. Love can do that! He went to TAFE and got a job. Life was stable for some years until his second child was born. Things got busier. There were financial stressors, sleep disturbance and he was torn between loving his family and feeling overwhelmed. He refused to fight with his wife, determined not to expose his boys to the violence that surrounded his early life, and so he withdrew. Deeply and profoundly. His wife was worried and dragged him to get help. A diagnosis of Major Depression and some medication was the result. Long and protracted, but slowly it lifted as his boys grew and became skillful footballers and he joined their play with a newfound passion. He threw himself into being a “football dad” and found energy to apply for a more interesting job. He discovered passion for his work, an abundance of energy, he needed less sleep and started behaving erratically. He was hospitalized and scored a diagnosis of Bipolar Disorder. Finally, when his marriage was threatened he sought help for himself. Describing the dissociated, disconnected survival skills that had become his winning formula, in all their variations, triggered by heightened emotions, he was finally able to begin healing the hurt and learning new ways.

Trauma responses in veterans returning from war zones are now well understood by professionals, and becoming more so in our community. This understanding has helped to extrapolate what works in healing these people, to other trauma inducing events, such as natural disasters, motor vehicle accidents, and other life threatening events. We are well aware that exposure to domestic violence can produce trauma responses, but small children still provide the biggest challenge to identifying and treating trauma.

What if we just assume that all kindergarten children who are disconnected, afraid, have bizarre tantrums, or can’t seem to engage in learning or social activities are displaying symptoms of trauma. I think this lens would bring automatic compassion from teachers and carers, rather than judgement and punishment. Compassion, hey! What a difference that could make. What if we as adults knew what  to do to provide a safe space where healing and reconnection could happen, and further traumatising situations were prevented. Rewind 50 years and 7 diagnoses and wonder what might have been different if this man was helped when he was 5.

The Australian Childhood Foundation has some great resources for creating trauma informed schools. Take a look here It is influenced by the work of Bruce Perry, (currently my favorite child Psychiatrist) among others. Bruce Perry’s work combines a gentle human approach to healing trauma, with an awareness of the need to provide a context where learnings that were missed during the trauma response, can be learned anew through play and interactions that are aligned to the developmental age where the learning would normally have otherwise occurred. His beautiful book The Boy Who Was Raised As A Dog: and other stories from a child Psychiatrists notebook, is well worth the read.




One thought on “Trauma by many other names

  1. Thank you Gabrielle.
    Moving writing on the devastating legacy of trauma being diagnosed as ADHD etc and the power of the label.
    Bruce Perry is one of my favorite child psychiatrists and Sami Timimi (No More Psychiatric Labels:Working Beyond Diagnosis) is another.


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