On Trauma, Children, and Societies

I introduced three categories of conditions in my previous blog entry (Trauma; addictive/compulsive behaviour; certain personality disorders), and three general categories of individuals who draw their appreciation of these conditions from their specific ability or inability to relate to them. Members of these categories either have never experienced one of these conditions personally, or they suffer from one or several of them, or they are in a state that I have named recovery.

It is possible that such a systematisation only fits a cultural context of Western societies. The perception of reality by a self-aware mind happens within a cultural context, though it may be influenced by some genetic predispositions. For sure the main influence is happening throughout childhood and adolescence, in every specific society. Literally all aspects of what an individual learns about where he or she belongs, what defines the identity within a group, a society, a culture, a belief system, a system of faith, it begins with education by parents and caregivers.

In my attempt to describe the context of trauma and my line of work, I have to appreciate that. I have to acknowledge that my approach; my way relating to it; my way of empathising with, for example, victims of trauma; my ideas about which impact the consequences of trauma have; my ideas how to assist in healing trauma; that all this happens within the framework of the societies of the type I grew up in. My appreciation is formed through education, through science, through value systems and belief systems to which I have been exposed, which form the Western world in which I live.

Let me explain this with a little example:

I came across an interesting statement (look here for one of several references) on the fundamental cultural context of healing, and assistance to it. In this piece, a Rwandan genocide survivor makes reference to healthcare professionals from Western countries, attempting to apply a Western approach to healing:

“You know, we had a lot of trouble with Western mental health workers who came here immediately after the genocide, and we had to ask some of them to leave…They came and their practice did not involve being outside in the sun like what you’re describing – which is, after all, where you begin to feel better. There was no music or drumming to get your blood flowing again when you’re depressed and you’re low and you need to have your blood flowing. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. There was no acknowledgement of the depression as something invasive and external that could actually be cast out of you again. Instead, they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to get them to leave the country.”

Trauma experienced by adults is a well explored issue which has made it into public awareness. Scientific research has made tremendous progress in understanding how trauma impacts on the brain. The long form of the acronym PTSD, Post Traumatic Stress Disorder, is known by many. People share at least a little conceptual understanding. You and I have experiences within our families and networks of friends about the impact of trauma. My grand uncle never spoke about his experiences as a soldier during the most brutal World War I. My former father in law never ever opened up on his experiences during the Nazi Regime. Both of them were visibly and deeply affected.

I want to focus on what trauma does to young children: The impact of trauma on a child in its early or later stages of development is tremendous, in any society. What I say is that the way how societies deal with trauma may be specific to the societal and cultural context, but the fact that trauma happens to children, and has a deep effect, is common to all individuals in all societies who face violence and abuse of children, and their caregivers. Therefore, every society affected by conflict needs to address these effects of trauma in order to move on, and this way is specific to every society in question. There may be an universal framework for healing, but I suspect it is limited.

My personal experience would indicate that we empathise with the impact of violence and trauma on children, but we stop short from real acknowledgement of its lifelong consequences: It appears to me that we often deny, or disregard, its impact. This impact on life when somebody is exposed to early trauma is much more fundamental, and to some considerable extent unalterable. It may be that, in a mainstream discussion, we feel empathy, and pity, but we may wrongly expect that the child has to move on, on its way into adulthood, and as an adult.

As a matter of fact, no single child can do that.

Trauma requires support for healing. Any seriously traumatised individual is unlikely to undo the impact of trauma without support, and this is especially true for children. A child literally has no single tool which would enable it to support his or her own healing. A child completely depends on the support of caregivers. If these caregivers then are affected by massive trauma as well, they are becoming dysfunctional in many ways that affect their nurturing and educating children. Consequently, the child will almost certainly grow up becoming a dysfunctional adult. It’s a double whammy: Suffering from own trauma, being raised by traumatised caregivers. In societies that are affected by massive violence, including acts of genocide, including systematic use of rape and violence against women, children, and other vulnerable groups, as an instrument of conflict and war, this has catastrophic consequences: These societies form, from individual wounds, common wounds. These common wounds persist, their results are visible in generations of that society to come. They, in my experience, form the foundation for future relapse into violence.

No matter which society, no matter which culture, children are born with a clean slate. Certainly, genetic predisposition impacts on how children develop, but newborn always are, as Pia Mellody⁠1 describes it, valuable, vulnerable, imperfect, dependent, and immature. This is just one attempt to frame the initial condition a child is in, but it appears to be useful to me.

If you look at these categories, nurturing and raising of children means to assist them in moving from this highly dependent initial condition into interdependent adulthood. “Interdependent” means that an individual is able to function within a societal context, and doing so in a more or less healthy way. “Living healthy” always relates to quite some extent to what a peer group would generally consider to be appropriate.

Like all mammals, we learn what we need to know, how to be, how to act as an adult from caregivers. Instincts and genetically coded behaviour exist, but every mammal learns how to interact, how to hunt, how to relate to a peer group, through nurturing, play, and education. In our human case, it requires, give or take, twenty years. I believe that even in societies in which children take on roles that we, in Western societies, would consider appropriate only much later, this profoundly biological, psychological, and social, process simply requires that much time. No matter whether a society marries a girl early on to an adult, no matter from when on a child begins to take family responsibilities, or has to begin to work: Forming the adult self, able to function in any society in an appropriate interdependent manner, in our human case it takes time.

In a Western context, there is established clinical and therapeutic evidence for a group of symptoms that follow protracted and/or severe forms of abuse in childhood (which impact on a child as trauma). Citing one of many authors on this, Pia Mellody⁠2, I am not motivated by the topic of her specific book, a phenomenon called “codependence”, but by it’s healthy opposite, what I referred to above as “interdependence”. In her vast work, Pia Mellody identifies the following conditions as a consequence of the inability or impairment of an individual to act in an interdependent (healthy) way: (1) Negative control; (2) Resentment; (3) Distorted, or nonexistent spirituality; (4) Avoiding reality; (5) Impaired ability to sustain intimacy. Her work represents important experience in understanding a fundamental connection between childhood trauma, through physical or emotional abuse, and, what she calls “less than nurturing” education.

With more easy, but blunt words: Dysfunctional parents, unwillingly and often unknowingly, create dysfunctional children, who grow up becoming dysfunctional adults. So, how does a surviving parent, traumatised by the loss of loved ones, and traumatised as a victim of violence and abuse, educate a child in a way that this child becomes an interdependent healthy member of the society? How more complicated is this, if also that child itself has been subjected to unimaginable violence? I will write about sexual and gender based violence, or about slavery, and forming children into child soldiers, in later articles. But how does a child with such trauma wounds grow up, being taken care of by caregivers who struggle with recovery from trauma themselves?

Clinical experience in our Western societies establishes in almost all cases of childhood trauma a direct link into dysfunctional patterns including compulsive/addictive abuse of substances and/or behaviour, or developing physical or mental forms of illness. Cases of widespread abuse of alcohol or substances through the loss of cultural context, identification, collective low self-esteem, in subjugated minority communities come to my mind. I remember my knowledge about Australian aborigines, for example, but also the dysfunctional behaviour in ghetto communities that we all deal with as police officers. We allow, create, or accept, unhealthy conditions in minorities, and/or ghettos, and then we blame the members of those groups for the dysfunctional behaviour which is an inevitable consequence.

But aside that common experience, which has very concrete consequences for the community-oriented policing work in all our countries, in my line of work I see the huge numbers of victims of horrible violence, children and caregivers, after conflict, and genocide.

Which sets the stage for case studies, but before that, within a next instalment, for further quantification and qualification of the violence that is part of contemporary conflicts. I have case studies including my own experiences, like in Bosnia & Herzegovina on my mind, or, for example, Rwanda. But also case studies of ghetto situations, in countries of the Western world.

Now, finishing with a book recommendation. Read the memoirs of a child soldier. It is heartening, but it will go under your skin: “A Long Way Gone⁠3: Memoirs of a Boy Soldier, by Ishmael Beah”.

From Amazon’s book page: “This is how wars are fought now: by children, hopped-up on drugs and wielding AK-47s. Children have become soldiers of choice. In the more than fifty conflicts going on worldwide, it is estimated that there are some 300,000 child soldiers. Ishmael Beah used to be one of them.

What is war like through the eyes of a child soldier? How does one become a killer? How does one stop? Child soldiers have been profiled by journalists, and novelists have struggled to imagine their lives. But until now, there has not been a first-person account from someone who came through this hell and survived.

In A Long Way Gone, Beah, now twenty-five years old, tells a riveting story: how at the age of twelve, he fled attacking rebels and wandered a land rendered unrecognizable by violence. By thirteen, he’d been picked up by the government army, and Beah, at heart a gentle boy, found that he was capable of truly terrible acts. This is a rare and mesmerizing account, told with real literary force and heartbreaking honesty.

“My new friends have begun to suspect I haven’t told them the full story of my life.

‘Why did you leave Sierra Leone?’

‘Because there is a war.’

‘You mean, you saw people running around with guns and shooting each other?’

‘Yes, all the time.’

‘Cool.’

I smile a little.

‘You should tell us about it sometime.’

‘Yes, sometime.'”

1 Pia Mellody, With Andrea Wells Miller and J. Keith Miller; “Facing Codependence”, HarperCollins, 1989 and 2003, New York, ISBN 978-0-06-250589-7, page 63

2 Ibid, page 45

3 Beah, Ishmael (2006). A Long Way Gone: Memoirs of a Boy Soldier. New York: Sarah Crichton Books

On Trauma and Societies

This entry amends and deepens my earlier article “Trauma – An Entry Point”. So some is a repetition, but put into a larger context.

There is a group of conditions with damaging impact which’s members, at first sight, may seem disparate. These conditions fundamentally affect development, personality, and behavior, and impact on forming relationships. Scientific understanding of these conditions, and what they do to individuals, has made significant progress over the past decades.

However, in my experience they also impact on communities, and societies, especially when some of them occur on a large scale, to a huge number of members of a society, as a consequence of violent conflict.

To my knowledge, this area is less charted, in psychology, and in sociology.

The three conditions are:

(1) Trauma;

(2) Compulsive behavior and addiction and their interrelationship; and

(3) Certain personality disorders which, at least, seem to occur as a consequence of trauma especially when exposed to it at an early stage of life.

These conditions can be examined using a multidisciplinary approach including genetic, neuronal, biochemical and environmental/behavioral  sciences. This is especially useful when it comes to the various degrees of their influencing each other and working together.

These conditions, in principle, can be seen in any living organism, at least of some complexity, and to varying degrees, again depending on the complexity of the organism in question.

We all know the story of the dog where it’s owner knows or suspects that the animal has been abused, say, the dog was rescued from being chained and beaten frequently, for example. We immediately see the impact, some animals are extremely anxious, others may be aggressive and can not be held around children. I have not seen anyone who does not understand the causal consequence between the abuse and the behavior of an animal. The dog may even have been adopted for reasons including pity. Animal adoption online markets are full of narratives about abuse.

My experience with human beings who have experienced trauma, especially early trauma, is different. The layers of human development from child to adult, and within an adult’s life, seem to make the causal context less visible. I may hear on a party sentences like “Our new dog was clearly abused as a puppy”. I can neither remember or imagine a similar easygoing discussion about a human being. These conversations are very different.

It appears to me that we can readily appreciate the impact of violence on an animal, but my personal experience with the set of reactions when confronted with somebody who has been subjected to violence, to trauma, to injustice on an extraordinary scale, is different. The scale of reactions includes indifference, disinterested attitude, or inability to appropriately interact with such an individual. Reactions can include gossip to third people like “He or she should get over it”, they can, not only in extreme cases, even outright victimize and traumatize this individual again.

Why? I struggle to come up with a comprehensive answer, but to me it stands out that the topic of abuse appears to be a societal taboo: Victims, if they can remember that they were abused, regularly don’t talk. The reasons include shame, and alienation by others. Every police officer knows (or should…) the term “secondary victimization”. It happens, for example, to rape victims, through the sometimes helpless, sometimes outright malicious, and always inappropriate reactions of family, friends, law enforcement, and justice.

Moreover, in my experience the reactions to human abuse appear to include other elements which make the consequences so difficult to see, and to deal with. They include uneducation, sometimes almost medieval belief, and disinterest. As an example, I take a sentence many of us have heard all too often: “A slap does not harm a child, it’s good for the child”.

Despite well-documented negative impact on the development of children, this belief is very common. To my disbelief, I had even to learn that some State legislation in the U.S. still allows physical punishment of children. Just read this one.

I do believe that massive experience of violence, and especially sexual and gender based violence on a mass scale which occurs in conflict, not seldom deliberately used as a weapon of war, of individual and societal destruction, leads to the occurrence of all three conditions on a scale that affects that societies’ ability to move on, and to reconcile, or not. I have made practical experience of that everywhere where I have worked.

Our ability to appreciate these phenomena and to relate to the behavioral consequences of their existence in an individual is radically different, in my view, within the three following groups, which I introduced in my first article:

(A) Those who don’t have one or several of these conditions;

(B) Those who have, and often don’t know; and

(C) Those who recover from one or several of these conditions, and/or integrate the knowledge of their partly unalterable consequences consciously into their lifes.

These three constituencies mix and may communicate about these issues on basis of a vastly different understanding:

The person who is not affected (A) has limitations to relate, and thus, to understand. Relapse into addictive behavior, compulsive disorders, anxieties, anorexic behavior, just to name very few, appear to be alien to these persons. They have genuine difficulties grappling with relating to why this is happening, beyond an intellectual level. Read “Confessions of a Sociopath: A Life Spent in Plain Sight” by M.E. Thomas. Try to relate to her narrative, assuming you, the reader, are not a sociopath. It’s really demonstrating the case.

The person who is affected (B), does not, at least fully, know and/or is in a condition excluding understanding, through complex denial mechanisms. This person is genuinely unhappy and may even be ready to admit that, but understanding does not suffice and denial adds. The denial can be visible to (A), but that person has often no idea what this denial really means, and how it works. Often, a person (A) concludes that a person (B) is weak. An addict has character deficiencies, full stop. A traumatized abuse victim is weak, he or she should get over it. Full stop. A personality disorder, like, let me just say, frequent panic attacks and inability to be with other people, may establish pity at best. But that person is weak, full stop.

In order to appreciate my entry point into this discussion, read, for example, the definition of the American Society for Addiction Medicine ASAM. According to this definition, based on what we now know through sophisticated science, addiction is a brain disease. I will come to addiction much later, the point here is “brain disease”. The very same way, trauma is a wound inflicted on the brain.

Whilst we may talk about brain injuries and diseases on a neuronal level in educated academic discussions, my impression is that much of society approaches these conditions including from a perspective treating them as character deficiencies.

The person who recovers (C), increasingly understands, as his or her recovery progresses. Recovery is hard work. Thus, the recovering person develops an intimate understanding of what happened, and why.

It is from this perspective that I see and want to examine the impact on societies where large groups of individuals are victimized. Understanding the impact helps finding better ways to help addressing it, increasing the ability of a society to reconcile.

Because if there is no reconciliation, there is high likelihood of relapse into new conflict.

For further reading, here is just one personal account. I will use some more in future entries.