Speaker 1: Welcome to the adopting and fostering home podcast. Whether your family has been on this journey for years or you’re just getting started. We’re here to support and encourage you along the way, and now your hosts, Lynette Ezell and Tera Melber.
Tera: Welcome back everyone. Today we’re really excited to welcome Katie Smith to the podcast. Katie is a licensed clinical social worker and a play therapist, and she works primarily with children, adolescents and adult women who are recovering from experiences of complex developmental trauma. The best part for us, for Lynette and me, is that Katie owns Arbor Cove Therapy and practices really near us in Roswell, Georgia. So welcome Katie.
Katie: Thank you. Thank you for having me.
Tera: Yeah, we’re super excited to have you because we know that you integrate lots of different treatments like EMDR. That’d be something for people to Google really quick, and theraplay and TBRI, which we’ve talked about in the past that you integrate that with your client’s faith because you really believe as a Christian that we’re designed to move toward healing in the deepest parts of who God created us to be.
Lynette: Yeah. So today we just want to focus, Katie, on secondary trauma, and it’d be really helpful to me and my family to Tera and her family, to our listeners for you to describe to us what secondary trauma truly is.
Katie: Sure. So secondary traumatic stress is a term that originally came about as people were studying what happens to people like myself. So people in the helping professions like first responders, therapists, medical professionals, as a result of just repeated exposure to taking care of others who have experienced trauma. And, so it’s defined as taking on symptoms of post traumatic stress disorder as a result of repeated exposure to either hearing about the experiences of someone who has been traumatized or caregiving; that kind of day to day, not really getting a break, kind of exposure either through what you hear about or just trying to help when someone’s experiencing that.
Lynette: So for every single adoptive mom and foster parent. Have kids 24-7, that would seem like it would be inappropriate term for those parents for sure. I’ve not thought about the therapist sitting there listening to this every single day.
Katie: Yeah, that was my first kind of learning about this was when I was working at an agency within the context of child welfare services. And I was at a conference where someone presented on this and it was like, oh well it makes sense, after really bad day, I want to go home, and I think one time I actually did go home and eat a whole bag of like Werther’s Caramels or something. Not my finest moment, but like why we do some of these things to try to cope with like what we’re taking home with us on a daily basis if we’re exposed to this in our job.
And then the more I worked with foster and adoptive families, the more I was just kind of perplexed about the lack of information about this that was going out to them. I feel like as professionals, we’re pretty familiar now with these terms of secondary traumatic stress or vicarious trauma, but there’s not a lot out there for foster and adoptive parents. And as I thought about us, well gosh, like if we’re kind of picking up symptoms of post-traumatic stress just from working an 8-to-10 hour day with people, what must this be like? It has to be just rampant and chronic for families who are living this on a daily basis trying to care for someone who’s healing from these experiences.
Lynette: You know, I remember one time the headmaster at a school, a little private school where one of my children were attending at the time, we’re not there anymore, but, he called me to talk to me about test scores. It was a good call, but I was anticipating a bad call. You know, summer can be difficult because you lose your schedule, and these kids really need structure. That’s the word I’m looking for, and I need structure in the summer, but all that’s out the window. And he called me, just started weeping and that’s exactly what it was.
Katie: You kind of develop that same filter that someone who’s experienced trauma develops where your default is to look for threat, expect threat. There’s that negative filter, that’s one of the kind of symptom clusters of post-traumatic stress disorders, negative cognitions and mood, which is basically just a negative filter in terms of how you view the world going from viewing it as predominantly a pretty safe place on most days to predominantly, threatening place or dangerous place.
Lynette: So it’s beyond an Eeyore mentality. It’s deeper than that. Yeah.
Katie: Well it’s just something that kind of becomes your default, which I guess is similar to kind of that Eeyore mentality, but a lot of times I think what happens is, whether it’s professionals or parents, we start to beat ourselves up about that or get really freaked out about that. Like I look in the mirror and I think, “Where did I go? This isn’t who I was when we started this journey.” So that must mean that there’s something wrong with me that I’m having, I wake up every day and you know, I just kind of have this negative expectation.
Tera: Of waiting for the ball to drop.
Katie: Yeah. Like what’s going to happen?
Lynette: Because it has 50 times before.
Katie: Yeah. And that’s the thing is it’s not without reason. You’ve had a lot of negative calls from the school or you’ve had some days that have really gone sideways in or you’ve had to pick up the pieces of a child’s dysregulation or stuff at home getting broken or fights breaking out or whatever it is.
You had a lot of negative experiences that have formed that template where out of a desire for just self protection, you start defaulting to starting the day with your walls already up. And it’s a potential point of connection with the children in your parenting that have experienced trauma, because my goodness, you know what a point of empathy like, Oh well they make sense. You know why they’re maybe going to school already kind of ready for a fight, or seeming that way because they’ve had a ton of negative experiences in their life with other people. And so it makes sense that they have that default. And so now I’m experiencing a little about of what that feels like because it’s happening to me too, but sometimes when people just feel like they’re having a lot of these symptoms, they’re more irritable than they used to be or they are having trouble sleeping or they don’t want to be around their child, all of those things.
If they feel like they’re just this scattershot, cluster of symptoms, it can really trigger a lot of shame and a lot of self-criticism. Whereas one of the reasons why I love talking about this with families is to see them have that moment of realization of like: Oh my gosh, this is a thing like this is something that makes some more sense to me now. And especially when we talk about what causes it, it really normalizes it for families, and helps them kind of shift, at least out of the shame that I think keeps us stuck.
Tera: How long does it take typically when you’re working with a child or an adolescent that’s a foster or adoptive child and you’re with a parent, how long before you see that they feel comfortable talking to you? Or when you start to see them say, I just felt irritable all the time. I wish that this is really messed up my whole entire life. This is not what I was expecting. All of those things that nobody wants to say out loud.
Lynette: I don’t want this chapter in our story.
Katie: That’s a great way to put that. You know, it really varies, I have some families that come in and they’re just so in crisis, by the time they walked through the door that they’re just like laying it all out on the table and very transparent because they kind of have to be. They’re just at that breaking point. So, that happens a lot. And then sometimes there are families, they’re still really trying to put the good face on it and do the best they can and soldier on, and especially if they’re struggling with a lot of shame and they may be hesitant.
So really what I’ve started doing is, when I start working with a family, whether it’s I’m working with the mom or I’m working with the child, right from the get go in our initial assessment, I just go ahead and ask about it or I’ll kind of put it out there and say: a lot of the parents that I see, they struggle with this or they kind of feel like sometimes they really regret that they started this journey to begin with, or they really have a lot of criticism of themselves.
And a lot of times just bringing that into the room, just tears will come and then we can have that conversation and start really working on that. We also have a monthly support group at our practice where moms, well it’s open to parents, but right now we’ve just had moms coming. Moms can come, and I think just knowing that there’s a group like that out there kind of normalizes it sounds like: “Oh, you know, other people are struggling with this too and there’s this place where I can go and just really talk in an open and honest environment and get support and not have people look at me like, what?” And so that seems to really help bring a lot of transparency.
Tera: So you mentioned some symptoms of secondary or vicarious trauma that people would experience. Would that kind of epitomize all of that? Is that irritability and maybe regret, feeling regret or guilt and shame? Are there other symptoms that we could be looking for in our own lives?
Katie: So when we think about post-traumatic stress disorder, there’s four symptom clusters. One is symptoms of intrusion, so that within the context of talking about secondary traumatic stress, what that can look like is thoughts about the trauma that your child experienced, kind of popping up in your head when you don’t expect them to, when you don’t want them to, you’re just going about your day and you just start having these thoughts.
Lynette: So you make a mental picture of maybe what your child went through and you think?
Tera: But it just pops into your head randomly. I can relate to that; Not that we have personal experience.
Katie: So symptoms like that avoidance, for someone who has PTSD, that’s avoiding reminders of the traumatic thing that happened to them. So for someone experiencing secondary traumatic stress, a lot of times this is where that whole piece of like, as much as I hate to admit it, like: “I really just wish my child would be at afterschool for two weeks solid,” or whatever it is, just really wanting to avoid child because there’s just so much going on for them as a result of their trauma that has become traumatic for you.
The parent feels overwhelmed or a parent feels rejected or a parent feels a sense of hopelessness. And so all of those emotions are getting triggered by their child or not really shouldn’t say by their child, but by the behaviors and emotions that their child is struggling with. And so the parent kind of starts without even necessarily realizing it, kind of avoiding spending less time with that child or keeping them arm’s bay a little bit.
Lynette: Katie can I? So you talk about maybe the parent feels like they need space from the child, and so we know that there are residential treatment centers and those sorts of things. Don’t you think there’s a time and place for that at some point?
Katie: You know, I do. I’m very, very hesitant to recommend residential treatment. In fact, I think there’s only been one time in the last three years that I’ve been in private practice that I’ve really felt like we needed to go that direction, and it was when the alternative seem to be disruption.
But I do think so, and sometimes it, and usually when I’d think that way it’s because of this dynamic and when everything else we’ve tried just doesn’t seem to be able to be braking the parent and child out of this dynamic or they just seem to be constantly kind of triggering each other. And there’s almost a concern that the child is more being re-traumatized more because of feeling rejected by the parent or by other members of the family then they would be by going to something like residential treatment for a while. So it gives everybody a break and a chance to interrupt this loop.
Tera: But you could get stuck into it for something just to give breaks or that kind of thing for parents just to regroup.
Katie: Absolutely. And that’s something that I encourage parents to do all the time is definitely to look for respite, even if it’s just, a date night occasionally, or even if it’s just a couple of hours, can you take more advantage of afterschool programs or you know, is there a caregiver that can come in and just be with this child for a few hours in the afternoon, even if it’s just to help them with their homework. Because that’s such a common kind of ground for blow ups. So anything like that that gives parents a break, I’m a huge fan of. I think it’s so important.
Lynette: Yeah, and there are times – friend of mine had to do it because of security. I mean just to keep everyone in the home safe.
Katie: That’s a great point, safety issues, certainly becomes a big issue.
Tera: So we have intrusion and avoidance. What’s another one?
Katie: So another one is what I mentioned earlier and that’s the negative mood and cognition. So getting to that point where you just develop a predominantly negative view of yourself, of others and of the world, and oftentimes that feels like just always feeling like you’re on edge or you just expect the worst to happen. Where you expect the worst of yourself or other people. It’s where that shame falls into that umbrella. And then the last major symptom cluster is arousal or reactivity, and that’s talking about symptoms like, you know, just your heart racing, feelings of panic almost. But just feeling really worked up or irritable, really keyed up and anxious, difficulty sleeping. All of those things kind of fall into that. So that idea that again, being exposed to the trauma that your child experienced or just being around your child kind of causes this reactivity in your body.
Lynette: Because the body truly keeps the score.
Tera: So what in the world we do about all that? Well, I was thinking about my symptoms.
Katie: Well, I think one of the biggest things is just kind of understanding what’s going on, again at the body level, because that can really help make it make more sense and kind of take the shame out of it. Like there’s something wrong with me, and shifting it, just like Bruce Perry talks about – kind of shifting our understanding of people who’ve experienced trauma from, what’s wrong with you to what happened to you?
Lynette: I like that quote.
Katie: Yeah, and I think when we can have that perspective on our children, but also on ourselves, like there’s not anything wrong with me. It’s that, this trauma has kind of entered into the life of this child that I love, and as a result into our family, as we kind of become the container for them to work out their healing, that we are actually having very normal reactions to an abnormal thing that should have never happened to this child.
Katie: But it did. And the way we’re reacting to it is actually really normal. So I think that’s really the first thing to, to start moving towards healing because that really determines the trajectory of our decision making into what we do. We’re going to respond in very different if we’re blaming ourselves versus looking at it as more of a neuro-biological response to trauma. There’s a really good book that Daniel Hughes wrote called brain-based parenting; I don’t necessarily recommend it to all of my clients because it’s very clinical and detailed and kind of dry, but it’s helpful in terms of the basic concept of it and understanding this because he and his co-writer, Jonathan Balen talk about the what is going on in the body when we parent and they talk about five pathways that really have to be online.
So they talk about there’s the parental approach system, which basically means feeling like parenting is safe. So feeling like you can approach your child, and that you’re going to be welcomed and not rejected and certainly not assaulted or attacked like what happens in some families, but just you can approach this child and engage with them however you need to.
Katie: Then there’s the parental-child reading system, which is basically, “This child makes sense to me.” So feeling like the child is queuing you accurately; when they’re upset that means that they need a hug or when they’re withdrawn, that means they’re sad. All of those things that we come to expect whether that’s just from what we know about child development or parenting children who haven’t experienced trauma, we have that template of, this is how this child makes sense to me and we apply that to a child that’s experienced trauma and sometimes we don’t read this new child accurately, or they’re miscuing because of their past experiences.
Lynette: Wow. How could you not? That’s such a great point because it could be years, I mean you get an older child you’ve missed all that gleaning of all of that.
Tera: And their cues that they’ve given have had to be a certain way to protect themselves.
Lynette: Absolutely, survival mode.
Tara: So there’s survival keys, not necessarily what you would think would be typical.
Katie: Absolutely. There’s also the parental meaning making system, which is just parenting makes sense. So, I understand why I’m doing this and sometimes again that kind of goes sideways when you’re parenting someone who’s trying to heal from trauma, things don’t always make sense the way that you think that they will. And then there’s the parental and reward system, which is basically parenting satisfying. I feel good
Lynette: I’m walking in relationship and this is working.
Katie: I feel like we’re connected, I feel like I’m, I’m doing what I felt like I was called to do from the very, I feel like we’re making some progress. I feel like this child is healing some and that’s kind of hitting on our dopamine system. We release this neurotransmitter dopamine whenever we have a sense of like getting a reward for something. So when this system is offline or getting continually blocked, we’re not getting that.
And then there’s the parental executive system, which is kind of like the control center for the other four. So all of these things are working in conjunction, and the other part of just our physical being that gets kind of knocked offline when this isn’t working properly, is that parental approach system. When we feel like we can’t approach the child, touch the child, engage in any of those activities of closeness, our oxytocin gets affected, which is the hormone they call the love hormone that gets released when we feel like, or when we are able to be really physically close with someone and give them a hug or talk with each other in a really warm, soft tone, all of that. And so when that gets knocked offline, just again from a biological perspective, if we don’t have the oxytocin we need and the dopamine that we need then we’re not going to be the parents that we would like to be. We’re going to go into that mode of threat avoidance versus safety and approach, but it’s a physical thing that’s happening to us.
Lynette: You know, Katie, all this conversation about secondary trauma is fascinating and we’ve never covered this on the podcast before, so we’d appreciate it if you would just hang tight, and we would love to continue recording with you so that we can do a part two to this fascinating conversation.
Speaker 1: You have been listening to the adopting and fostering home, a resource of the North American mission board. For more information about today’s podcast and other relevant resources, visit sendrelief.org