Faith, author of Hoping to Adopt blog, commented on my What’s Not in the DSM post the other day about how it bothers her that Post-Traumatic Stress Disorder is classified as a “disorder” in the same way that BiPolar Disorder, Schizophrenia or Autism are. I see her point that these disorders are different at their root than PTSD. PTSD was “caused” by trauma and in most cases that means that someone inflicts the abuse or neglect upon the victim that causes the trauma. The others are mostly believed to be primarily genetic, with the exception of autism, which many believe to be genetic-based triggered by the environment.
But PTSD isn’t alone as a “caused” disorder. And in the world of adoption and foster care, our children have a higher risk of those “caused” disorders. RAD and FAS come to mind immediately. By its very definition, RAD occurs because of a break between infant and primary caregiver. And by its very definition, FAS is caused by the alcohol ingested by the birth mother. But there’s more.
Selective Mutism, which Theresa on Adoptive Parenting blogged about recently, is listed as an anxiety disorder, thought to be “caused” by extreme anxiety. Not all anxiety has trauma as its root, but a good share of it does. There are adopted children who manifest their trauma reaction by not being able to speak. And then, of course, there is the whole family of Dissociative Disorders, all thought to be brought on by acute stress or trauma.
Do you see where I’m going with this? I understand Faith’s thinking that PTSD is a fairly “normal” response to prolonged or severe trauma. And I’d agree that for many people it would be. But so are RAD, Dissociative Disorders, and Selective Mutism. And in some camps you could make a case for Obsessive Compulsive Disorder, too. Yet, I do believe that the trauma has done something to the person’s brain…it is fundamentally altered.
For nearly nine years, I’ve thought about this a lot, worried about it, wished I could have stopped the trauma. It is, after all, the common denominator in many of LuLu’s problems. In fact, I’d wager to say that if the trauma of her past would come out of the equation; if the abuse, neglect, lack of stimulation and poor nutrition were not factors; there would likely be many fewer special needs in LuLu’s combo platter.
I find the whole thing grossly ironic. Our society downplays trauma at ever turn. (Or shall I say we did until events like 9-11.) This is especially true of trauma of children and infants. They were too young to remember; therefore, too young to impact. But the truth is, and recent neuroscience confirms this, that the earlier the trauma (and the more prolonged) the deeper the actually changes to the brain. The brain’s functioning changes, and so does its structure. All areas of learning and language can be affected. Issues can be life long.
How we view the way our brains work comes into question too. Largely as a society we view our brains as a psychological organ, with little biology involved. What I mean is that if something’s wrong and we seek treatment for that, we seek it to treat the symptoms and change the behaviors. Further we consider these disorders to be some psychological (or worse yet, moral) weakness of that person. Because, after all, we hear stories in the news all the time about the kids who beat the odds and shrug off years of horrendous abuse and are just fine. Can’t the rest of these poor tortured souls with all these disorders just pull themselves up by their boot straps???
We just can’t, as a society, look trauma squarely in the eye. We don’t address it directly. We don’t identify it early or treat it aggressively enough to truly make the difference. It’s as if facing trauma is too traumatic for us all.
So what happens then, when we fail to address a traumatized child’s disorders? Well, the person’s diagnosis shifts at adulthood into that family known as Personality Disorders to things like Borderline Personality Disorder or Antisocial Personality Disorder.