Adoption and PTSD
June is National PTSD Awareness Month. Having suffered from PTSD (post-traumatic stress disorder), I know the road to healing can be filled with fear, uncertainty and loneliness. But please know, healing will come. EMDR (Eye Movement Desensitization and Reprocessing) therapy (discussed later in this post) benefited me greatly.
This post will focus on the trauma/PTSD suffered by adopted children. Much of the information following has been pulled from two different websites: www.ptsd.va.gov** and GoodTherapy.org* (Lesli Johnson).
Adoption Can Bring Trauma / PTSD (Post-Traumatic Stress Disorder)*
The impact of adoption (and all that happened leading up to the need for adoption) is far-reaching and ever-changing—a process that continues throughout the lifespan of the adopted person and those connected. Multiple placements, foster care, or time in an orphanage can exacerbate this trauma.
An infant or child separated from their birth mother will almost certainly experience some level of trauma, as they will perceive this event to be a dangerous situation. The sensations, sights, and sounds with which they were familiar are gone, and the mother is no longer available to soothe the child or help the child self-regulate. Because the only part of the brain fully developed at birth is the brain stem—this controls the sympathetic nervous system, which generates the “fight, flight, or freeze” response—babies are unable to use parasympathetic abilities, such as self-soothing.
When this happens before the age of 3, it is encoded as implicit memory—like any event that takes place before the development of language. As noted trauma expert Bessel van der Kolk explains in his book The Body Keeps the Score, “We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on the mind, brain, and body.”***
When a traumatic event occurs or something happens that is perceived as traumatic, the associated memories may become stored in the brain and nervous system in a maladaptive way—frozen rather than processed. Current reactions are fueled by negative beliefs stemming from events that occurred in the past. People become stuck. In some cases, trauma that happened years ago continues to feel like it’s happening in the present.
Many adoptees have issues related to attachment ruptures. An adopted child whose parent is a few minutes late to pick them up from school may dissolve into tears. The internalized belief or negative cognition that child develops may sound something like “It’s not safe to trust” or “People I love leave me.”
An adult who was adopted may unknowingly recreate abandonment scenarios in relationships, unconsciously choosing partners who are not truly available and do leave, fulfilling the negative belief “I am not worth it” or “I am not lovable.”
In both examples, the reaction in the present is disproportionate to the situation. This is useful information that some feeling, experience, or memory from the past is being triggered. A much younger “self” is running the show. The fight, flight, or freeze response gets activated in these situations, and the prefrontal cortex, the part of the brain in charge of executive functioning and decision making, goes offline. The person may feel disregulated, scared, and confused.
What are the Symptoms of PTSD?**
PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.
There are four types of symptoms of PTSD, but they may not be exactly the same for everyone. Each person experiences symptoms in their own way.
- Reliving the event (also called re-experiencing symptoms). You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.
- Avoiding situations that remind you of the event. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
- Having more negative beliefs and feelings. The way you think about yourself and others may change because of the trauma. You may feel guilt or shame. Or, you may not be interested in activities you used to enjoy. You may feel that the world is dangerous and you can’t trust anyone. You might be numb, or find it hard to feel happy.
- Feeling keyed up (also called hyperarousal). You may be jittery, or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. You might suddenly get angry or irritable, startle easily, or act in unhealthy ways (like smoking, using drugs and alcohol, or driving recklessly.
Can children have PTSD?
Children can have PTSD too. They may have symptoms described above or other symptoms depending on how old they are. As children get older, their symptoms are more like those of adults. Here are some examples of PTSD symptoms in children:
- Children under 6 may get upset if their parents are not close by, have trouble sleeping, or act out the trauma through play.
- Children age 7 to 11 may also act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
- Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.
So what does a typical EMDR session with an adopted person look like?
EMDR therapy targets unprocessed memory as well as the emotions, beliefs, and body sensations associated with it. Bilateral stimulation (generally eye movements, tapping, or tones) activates the brain’s information processing system, allowing the old memories to be digested or reprocessed and stored in an adaptive way—even if the person doesn’t have an autobiographical account of the memory (for many adoptees, the trauma happened before they developed the language to explain the events, so the memory is primarily somatic in nature and stored in the nervous system).
After gathering history and establishing rapport, the therapist and person in therapy work together to establish target memories and present triggers that are causing suffering and/or interfering with daily life. The “targets” are the starting points of the session and a point of reference to trace the memory back in time. Using bilateral stimulation, EMDR helps integrate the early memories, body sensations, emotions, and negative beliefs the person has. Over a series of sessions, symptoms are reduced, and beliefs associated with the memories or experience are shifted to a more positive and adaptive state.
Rather than the belief “I’m not lovable,” the person may be able to recognize and have a felt sense of worth despite what happened in the past. Many therapists combine various EMDR protocols, guided imagery, mindfulness practices, and visualization to create calm states and nurturing figures in the present to help heal the wounds of the past.
EMDR is safe, effective, noninvasive, and powerful. It does not involve medication or hypnosis, and works wonderfully with talk therapy with people who were adopted.
If you want or need support on your healing journey, find an EMDR therapist in your area.
More Information on PTSD
Please visit the Veteran’s Administration PTSD website for basic information on trauma and treatment options.
My friends Shelly and Wanda offer great insight and help at their website PTSD Perspectives.
* GoodTherapy.org “Adoption Trauma and the Healing Role of EMDR Therapy” by Lesli Johnson
** The National Center for PTSD
*** van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. London, UK: Penguin Books.