My dad teaches me about treating attachment and trauma

May 25 08:16 2011 Warren Pettitt PhD Print This Article

Who would have ever thought that my father could have taught me so much about working with truamatized children.  He developed Alzheimer's about 10 years ago and it has been so difficult to see the progression of the disease. The last few years many lessons have paralleled his disease with the children I see.

I recently took my 91 year old father who suffers from dementia to a restaurant. I gently guided him with his walker to a table and left him there as I went to order the food in a long cafeteria style line. I made sure that he could see me in line and every few minutes I turned and waved at him through the crowd of people. When I was out of sight he drummed the table with his fingers,Guest Posting looked questioningly at his walker, and seemed nervous and lost. As soon as he saw me wave he was relieved but this only lasted a couple of minutes. Since the line was long I occasionally went over to the table to tell him what I was ordering and that I would be back shortly. This eased his anxiety and enabled him to wait instead of searching for me. I was patient with him because I knew he had a disability that limited him. I’m sure observers in the restaurant thought that I was the one acting odd. When I finally joined him he was fine.

This reminded me so much of our foster or adoptive children with behavior problems due to a lack of object permanence or constancy. They misbehave as soon as parents are out of sight because, like my father, they cannot hold the emotional presence of the parent. They missed learning this due to a lack of consistent loving care early in development. Their resulting behaviors are often exasperating and we are tempted to say things to them like “can’t I leave you alone for a minute”. The answer to that question is “no”. They are like emotional toddlers that need a parent’s presence continually. If you have a child that misbehaves as soon as you are out of sight try treating them like I did my father. If that works you know that you have some further permanence work to do. The good news is that with guidance children that suffered early abuse and neglect can develop permanence and their behaviors will improve.

Traumatized children have a different reality

One of the things that I have learned from my dad is to enter his reality. He is in the last stages of Alzheimer’s and if he needs to have a key in his wallet for his car and check on it every few minutes that is okay. This makes him feel that his car is okay even though he can’t drive and his keys don’t fit the car. When he is fussing about going home, instead of confronting him about not being able to fly to Indiana I say “you really need to get home, let me help you get an airline ticket to fly.” Of course he has to wait to fly and his ticket is fake but this helps him to wait a little longer.

How about adopted and foster kids that are recovering from trauma? What would it be like if we entered their reality instead of trying to get them to accept ours? Their reality may be that it is really scary to do just what someone else wants. We can enter their reality by saying “this is really difficult for you, how can I help?” Maybe they just need someone to join them in the task so that they feel less anxious. Once they calm they can do it on their own. Maybe their reality is that you can’t trust adults. (After four foster homes and three “forever homes” would you believe anything?) We might need to accept their inability to trust even though our reality is that we are different from all of the others who have left them.

Bottom line; start at the child’s reality and slowly help them enter yours.

Avoiding power struggles with traumatized children

“Why do I need to take these pills? I don’t need them!!” Rather than fight my father who does not understand why he needs pills and is very angry I say, “Let’s take a break”. I know that I can always change his mood with a cookie. We sit down with a cookie or brownie and talk a bit. After a few minutes he is in a calmer place and I slip him his pill. What a difference a little break makes. You may not want to use sugar with your children like I do with my father who is suffering from Alzheimer’s but the idea of taking a break is sound. Why try to reason with a child that is not operating out of the reasoning part of the brain? We know that kids recovering from trauma go to the survival part of the brain for fight or flight when they get stressed. Once they calm you may be able to talk with them and get them to comply. At least the processing part of the brain is available.

Children recovering from trauma go quickly to survival brain

My mother was out with my father who has Alzheimer’s. He tried to get out of the car because he was angry. She stopped at a gas station for help and while she was in the station he got out of the car. A kind lady picked him up because he was stumbling in the parking lot. She took him to the grocery store because that’s where he said he was going. When mom came back to the car he had disappeared. After calls to 911 and a visit by the fire department and the police my father and mother were reunited.

When I got out of a meeting at work I discovered five frantic calls on my cell phone from my mom saying she lost my dad. I raced home to help and thought I was quite calm considering the events of the day until I found my coffee cup in the refrigerator. When we are traumatized we go to the survival part of our brain and don’t think clearly. This made me think how futile it is to try to talk with a child in survival brain. Children that have experienced trauma quickly go to a state of alarm and terror when they are stressed. Best to wait until they are calm before you talk with them because, like me, they could look normal but not really have access to the more complex parts of the brain to think things through. I am thankful that I do not have to operate in survival brain many times everyday like children recovering from trauma.

Traumatized children need positive reminders

“Hi Dad it’s Deb”. Every time that I see Dad I introduce myself even though he is living with me. He has Alzheimer’s and he often does not recognize me. This means that I introduce myself to him at least 20 times a day.  I wonder how it would be with the children that have severe behavior problems to speak kindly to them at least 20 times a day. “Hi Jimmy it’s Mom and I love you”. I know from being a parent of “normal kids” that I had a tendency to talk to them more when they were doing something wrong. How about switching the odds and having 20 positive reminders with only several “don’t do that” comments. Maybe the child would start to recognize mom and dad as positive influences in their life rather that always on their case. Food for thought. Give it a try.

Traumatized children need the parents presence

Why is my father sitting in the hall outside of the bathroom having his coffee? My mom is in the bathroom and she is his connection to reality. He has alzheimer's and the world does not make any sense without her.
How many mothers have said “I can’t even go to the bathroom without my kids bugging me?” I wonder how it feels to be lost in the world without the presence of another person. How does it feel when that one connection keeps telling you to leave them alone? This is the plight of attachment disordered children. They depend on a parent for the world to seem whole but they drive that parent crazy along the way. They usually show there need for the parent by constant nonsense chatter or other obnoxious behaviors. Let’s keep in mind that what they really need is the presence of the parent and we can give them that presence in a respectful and honoring way. “Come here and sit next to me while I work on this project, you can help”
Thanks dad, enjoy your coffee in the hallway.

Insights into living with traumatized children

My father passed away a few weeks ago. He taught me many things throughout my life but I would like to focus on the last few months because it relates to treating traumatized and troubled children. Though I tried to understand the experience of parents that love and live with these children I think living with my dad has enlightened me.

My father had Alzheimer’s and came to live with me for several months. I soon found that I did not have a moment to myself unless I hid in the bedroom and my husband stayed in the living room with my father. Dad was continually confused and often angry. He fixated on things like his car or his keys and would argue about if for hours. When he got upset he threatened to run away. This made us all sleep less soundly and my husband sleep on the couch guarding the door. We gave him lots of love though we only saw rare moments of reciprocal response. A couple of times we had to call the police to find him and bring him back home. It was emotionally and physically exhausting. I am in awe of foster and adoptive parents that do this for years. No wonder when they first see me they say “I can’t do this anymore”. Now I understand just a bit more.

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About Article Author

Warren Pettitt PhD
Warren Pettitt PhD

I am the director of the Family Christian Counseling Center of Phoenix, AZ.  I have extensive training and experience in treating children and has been serving families for over 20 years.  I am one of a handful of Registered Play Therapist Supervisors in the state of Arizona. My specialty is helping children recover from trauma, abuse and neglect; and I am skilled in treating attachment issues.

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