This is the third in a series of what will be ten posts inspired by Dr. Perry’s case-studies. It was a small (but perfectly formed) group that met for Chapter 3 and this post captures an element of the discussion that has haunted me since, as a secondary teacher and SENCo reflecting on what I could have done better.
Beginning with a brief outline of the case-study, Chapter 3 focuses on Dr. Perry’s work with the child victims of the Waco siege of 1993, when a 51 day stand-off between US federal agents and the Davidian cult ended with the destruction by fire of the cult’s compound and 80 fatalities.
Dr Perry’s ‘rapid response’ trauma assessment team was brought in to support the children through this crisis. He had formed the team in part to research why children are impacted by traumatic events in such a wide range of ways – some seemingly unscathed while others develop serious mental illnesses and behaviour problems:
No one knew where the devastating symptoms of conditions like post-traumatic stress came from, and why some children would develop, say, primarily dissociative symptoms, while others would be mainly hyper-vigilant. (p61)
To explore this, it was necessary to work with children immediately after a traumatic event rather than years later, which tended to be when children were brought to him. There was indeed rich learning: “The seeds of a new way of working with traumatised children were sown in the ashes of Waco.” (p85)
The Davidian children had experienced severe abuse at the hands of their mercurial cult leader, David Koresh. He believed that the will of children needed to be broken with strict physical discipline if they were to stay ‘in the light.’ Maintaining an iron grip, he separated husband from wife, child from parent, friend from friend – undermining any relationship that could challenge his rule of terror. Children lived in constant fear of the physical attack and public humiliation that could result from the tiniest error, “like spilling milk.” (p60). Children were starved, beaten with a wooden paddle and for the girls there was the sure knowledge that many would be groomed to become ‘Brides of David’, as young as ten.
On top of this appalling context, the children were facing the real and present terror of the siege itself when Dr Perry met them. They had witnessed a deadly raid on their home, been driven away from their parents in tank-like vehicles, interrogated by FBI and Texas Rangers, often for hours, and placed temporarily in a strange children’s home, their future destination unknown. The children did not feel like they had just been liberated. They felt like hostages.
We immediately recognised that we had a group of children that had essentially been marinated in fear. The only way we could get them the help they needed was to apply our understanding of how fear affects the brain and then consequently changes behaviour. (p67)
Perry reminds us that the brain evolved from the inside out and that it develops in much the same order. The brainstem completes much of its development in utero and in early infancy. The midbrain and limbic systems develop next and the frontal lobes of the cortex, which regulate planning, self-control, and abstract thought do not complete their development until late adolescence.
This sequential development explains why very young children are at great risk of suffering lasting effects of trauma: their brains are still developing.
The same miraculous plasticity that allows young brains to quickly learn love and language, unfortunately, also makes them highly susceptible to negative experiences as well. (p68)
Fear, our most primal emotion, arises from the brainstem and shuts down the highest cortical regions first. We subsequently lose the capacity to think, plan, even sometimes to speak. We just react. With prolonged fear, there can be chronic or near permanent changes in the brain. Terror, especially early in life, may cause an enduring shift to a more impulsive, more aggressive, less thoughtful and compassionate way of responding to the world. This is because the brain is use-dependent. The more a system like the stress response system is fired, the more it changes and the greater the risk of altered functioning. Similarly, the less the cortical regions are used, the smaller and weaker they become:
Exposing a person to chronic fear and stress is like weakening the breaking power of a car while adding a more powerful engine: you’re altering the safety mechanisms that keep the ‘machine’ from going dangerously out of control. (p69)
Dr. Perry explains how understanding the importance of use-dependent development was vital to his work in treating the traumatized children of Waco.
He found that they needed the opportunity to process what had happened at their own pace and in their own ways. They didn’t need traditional ‘therapy’ from a stranger. The children were able to control when, with whom and how they interacted with the nurturing adults around them. Soothing connections were made according to compatible personality types and a powerful therapeutic web was observed to develop around the children. Staff meetings charted these interactions and it emerged that therapeutic experiences were taking place in short, minutes-long interactions.
To experience the psychological safety essential for recovery and growth, the children also needed predictable routines and clearly demarcated boundaries, enforced through an empathic, relational approach to discipline. Staff were fully aware that the children’s permanently aroused, fearful state would make them prone to mistakes – impulsive or aggressive behaviour. It was important not to punish them for these natural responses but to redirect their behaviour until they calmed down and were able to reflect. It was vital that discipline did not undermine relationships, because:
Relationships matter: the currency for systemic change was trust, and trust comes from forming healthy working relationships. People, not programmes, change people. (p85)
Longer term, outcomes varied enormously. Some of the Davidian children went on to study at college, have families and careers. Others led profoundly troubled and chaotic lives. Dr. Perry is clear about what made the difference:
The children who did the best after the Davidian apocalypse were not those who experienced the least stress or those who participated most enthusiastically with us at the cottage. They were the ones who were released afterwards into the healthiest and most loving worlds. In fact, the research on the most effective treatments to help child trauma victims might be accurately summed up in this way: what works best is anything that increases the quality and number of relationships in the child’s life.
We can only speculate about the extent to which experience of school impacted on outcomes for these children, but the evidence would suggest substantially – because school is potentially a huge contributor of high quality relationships. It is one of the most important protective factors that children can access. A teacher making a connection with a child can change a life. We know this. Not only do neuroscientists like Dr. Perry tell us it is so, but we have the powerful personal testimony of survivors like Ian Wright and Jaz Ampaw-Farr. (If you haven’t watched her “Power of Everyday Heroes’ on YouTube, you really must).
But the experience of school can also be harmful; stress and fear inducing rather than reducing. We have seen that children impacted by trauma are often hyper-vigilant and volatile – they will make mistakes. If we are not trauma-informed in the way that we respond to these, then we can expect distress and with that dysregulation to intensify. We are in effect fuelling the brainstream and at the same time restricting cortical growth when ‘consequences’ are all we’ve got; when we are doggedly ‘consistent’ in the administration of these.
Two questions of critical importance then:
1. Do we know our children and young people well enough to ensure we ‘First, do no harm’ when we respond to their distressed behaviour?
2. Do our systems allow us to respond in flexible and helpful ways?
The case-study below illustrates that we can and do, as educators, change lives when the answer to these questions is yes. The work described below is beautiful, but I think relatively uncommon in secondary schools – including all of those that I have worked at. That’s why the anecdote haunts me. I think many of us, as we immerse ourselves in the world of trauma-informed practice, would respond differently to some of our most ‘challenging’ young people if we could only go back. We can all, I’m certain, bring a ‘Sam’ to mind.
A Case Study
‘Sam’ began at a new school as a Year 5 (?) pupil having been permanently excluded from another setting for ‘persistent disruptive behaviour’. Professionals counted nine adverse childhood experiences (ACES) from scrutiny of his social care file and discussions with his very young single mum on admission. Domestic violence, arson, prison, pedophilia, bereavement and mental illness all featured in his troubled and complex history.
It was anticipated that he would need a high level of support, at least through transition, and a key adult was assigned this role. As she approached the Y5 class with him, his fear and anxiety increased visibly and by time they reached the door he was punching and kicking her.
Recognising this as the survival behaviour of an extremely anxious boy, the key adult resolved to get to know him away from the classroom. The next week, a table was provided for him outside the class and they worked there. Later, another pupil joined Sam to work outside the classroom and gradually a small group was formed. Whilst class 5 were in assembly, Sam and his key adult would thoroughly explore the classroom.
Eventually, he felt safe enough to join the classroom to learn alongside his peers. Progress continued such that, as a Y6 child, all he needed from his key adult was a daily check-in and the chance to talk about home. She was by now working with another highly vulnerable new starter and Sam was proud to have been asked to mentor him. He was able to offer the assurance that things do get better, people are kind and school is safe.
Sam’s behavior deteriorated towards the end of Y6 as he became anxious about transition into a large high school. As it turned out, with good reason. He appeared back at his primary school one cold afternoon with the news, “I’ve been kicked out.” He never returned to mainstream.
Mary Meredith 